Eosinophilic folliculitis

Medical condition

Eosinophilic folliculitis

Other names| Eosinophilic pustular folliculitis, Sterile eosinophilic pustulosis"[1]
Specialty| Dermatology

Eosinophilic folliculitis is an itchy rash with an unknown cause that is most common among individuals with HIV, though it can occur in HIV-negative individuals where it is known by the eponym Ofuji disease.[2] EF consists of itchy red bumps (papules) centered on hair follicles and typically found on the upper body, sparing the abdomen and legs. The name eosinophilic folliculitis refers to the predominant immune cells associated with the disease (eosinophils) and the involvement of the hair follicles.

## Pathophysiology[edit]

The cause of EF is unknown. A variety of microorganisms have been implicated, including the mite Demodex,[3] the yeast Pityrosporum,[4] and bacteria.[5] An autoimmune process has also been investigated.[6]

## Diagnosis[edit]

Eosinophilic folliculitis may be suspected clinically when an individual with HIV exhibits the classic symptoms. The diagnosis can be supported by the finding of eosinophilia but a skin biopsy is necessary to establish it. Skin biopsies reveal lymphocytic and eosinophilic inflammation around the hair follicles.

## Treatment[edit]

Treatment of eosinophilic folliculitis in people with HIV typically begins with the initiation of Highly Active Anti-Retroviral Therapy in order to help reconstitute the immune system. Direct treatment of the EF itself focuses on decreasing the inflammation and itching. Topical corticosteroids and oral antihistamines can alleviate the itching and decrease the size and number of lesions. Treatment with the antifungal drug itraconazole, the antibiotic metronidazole, and the anti-mite drug permethrin may lead to some improvement of symptoms. Other therapies include PUVA, topical tacrolimus, and isotretinoin.[7]

## Epidemiology[edit]

Eosinophilic folliculitis associated with HIV infection typically affects individuals with advanced HIV and low T helper cell counts.[8] It affects both men and women as well as children with HIV and is found throughout the world.

EF may also affect individuals with hematologic disease such as leukemia and lymphoma.[9] It may also affect otherwise normal infants in a self-limited form.[10] HIV-negative individuals can also develop EF -- this is more common in Japan.[11]

## See also[edit]

* Eosinophilic pustular folliculitis of infancy
* List of cutaneous conditions

## References[edit]

1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
2. ^ Ofuji, S; Ogino, A; Horio, T; Oseko, T; Uehara, M (1970). "Eosinophilic pustular folliculitis". Acta Dermato-Venereologica. 50 (3): 195–203. PMID 4193219.
3. ^ Bodokh, I; Lacour, JP; Perrin, C; Bourdet, JF; Ortonne, JP (1994). "Papular eruption in AIDS: role of demodectic mites?". Acta Dermato-Venereologica. 74 (4): 320–2. doi:10.2340/0001555574320322. PMID 7976100. S2CID 33746330.
4. ^ Ferrándiz, C; Ribera, M; Barranco, JC; Clotet, B; Lorenzo, JC (1992). "Eosinophilic pustular folliculitis in patients with acquired immunodeficiency syndrome". International Journal of Dermatology. 31 (3): 193–5. doi:10.1111/j.1365-4362.1992.tb03934.x. PMID 1568818. S2CID 1196523.
5. ^ Smith, KJ; Skelton, HG; Yeager, J; Ruiz, N; Wagner, KF (1995). "Metronidazole for eosinophilic pustular folliculitis in human immunodeficiency virus type 1-positive patients". Archives of Dermatology. 131 (9): 1089–91. doi:10.1001/archderm.131.9.1089. PMID 7661619.
6. ^ Fearfield, LA; Rowe, A; Francis, N; Bunker, CB; Staughton, RC (1999). "Itchy folliculitis and human immunodeficiency virus infection: clinicopathological and immunological features, pathogenesis and treatment". The British Journal of Dermatology. 141 (1): 3–11. doi:10.1046/j.1365-2133.1999.02914.x. PMID 10417509. S2CID 12727217.
7. ^ Ellis, E; Scheinfeld, N (2004). "Eosinophilic pustular folliculitis: a comprehensive review of treatment options". American Journal of Clinical Dermatology. 5 (3): 189–97. doi:10.2165/00128071-200405030-00007. PMID 15186198. S2CID 72079927.
8. ^ Parker, SR; Parker, DC; McCall, CO (2006). "Eosinophilic folliculitis in HIV-infected women: case series and review". American Journal of Clinical Dermatology. 7 (3): 193–200. doi:10.2165/00128071-200607030-00006. PMID 16734507. S2CID 71615655.
9. ^ Patrizi, A; Chieregato, C; Visani, G; Morrone, P; Patrone, P (2004). "Leukaemia-associated eosinophilic folliculitis (Ofuji's disease)". Journal of the European Academy of Dermatology and Venereology. 18 (5): 596–8. doi:10.1111/j.1468-3083.2004.00982.x. PMID 15324404. S2CID 45311563.
10. ^ Buckley, DA; Munn, SE; Higgins, EM (2001). "Neonatal eosinophilic pustular folliculitis". Clinical and Experimental Dermatology. 26 (3): 251–5. doi:10.1046/j.1365-2230.2001.00807.x. PMID 11422167. S2CID 36497326.
11. ^ Teraki, Y; Nishikawa, T (2005). "Skin diseases described in Japan 2004". Journal der Deutschen Dermatologischen Gesellschaft. 3 (1): 9–25. doi:10.1046/j.1439-0353.2005.04076.x. PMID 16353745. S2CID 26787648.

## External links[edit]

Classification|

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External resources|

* eMedicine: med/687

* v
* t
* e

Disorders of skin appendages

Nail|

* thickness: Onychogryphosis
* Onychauxis

* color: Beau's lines
* Yellow nail syndrome
* Leukonychia
* Azure lunula

* shape: Koilonychia
* Nail clubbing

* behavior: Onychotillomania
* Onychophagia

* other: Ingrown nail
* Anonychia

* ungrouped: Paronychia
* Acute
* Chronic
* Chevron nail
* Congenital onychodysplasia of the index fingers
* Green nails
* Half and half nails
* Hangnail
* Hapalonychia
* Hook nail
* Ingrown nail
* Lichen planus of the nails
* Longitudinal erythronychia
* Malalignment of the nail plate
* Median nail dystrophy
* Mees' lines
* Melanonychia
* Muehrcke's lines
* Nail–patella syndrome
* Onychoatrophy
* Onycholysis
* Onychomadesis
* Onychomatricoma
* Onychomycosis
* Onychophosis
* Onychoptosis defluvium
* Onychorrhexis
* Onychoschizia
* Platonychia
* Pincer nails
* Plummer's nail
* Psoriatic nails
* Pterygium inversum unguis
* Pterygium unguis
* Purpura of the nail bed
* Racquet nail
* Red lunulae
* Shell nail syndrome
* Splinter hemorrhage
* Spotted lunulae
* Staining of the nail plate
* Stippled nails
* Subungual hematoma
* Terry's nails
* Twenty-nail dystrophy

Hair|

| Hair loss/
Baldness|

* noncicatricial alopecia: Alopecia
* areata
* totalis
* universalis
* Ophiasis

* Androgenic alopecia (male-pattern baldness)
* Hypotrichosis
* Telogen effluvium
* Traction alopecia
* Lichen planopilaris
* Trichorrhexis nodosa
* Alopecia neoplastica
* Anagen effluvium
* Alopecia mucinosa

* cicatricial alopecia: Pseudopelade of Brocq
* Central centrifugal cicatricial alopecia
* Pressure alopecia
* Traumatic alopecia
* Tumor alopecia
* Hot comb alopecia
* Perifolliculitis capitis abscedens et suffodiens
* Graham-Little syndrome
* Folliculitis decalvans

* ungrouped: Triangular alopecia
* Frontal fibrosing alopecia
* Marie Unna hereditary hypotrichosis

|

Hypertrichosis|

* Hirsutism
* Acquired
* localised
* generalised
* patterned
* Congenital
* generalised
* localised
* X-linked
* Prepubertal

Acneiform
eruption|

| Acne|

* Acne vulgaris
* Acne conglobata
* Acne miliaris necrotica
* Tropical acne
* Infantile acne/Neonatal acne
* Excoriated acne
* Acne fulminans
* Acne medicamentosa (e.g., steroid acne)
* Halogen acne
* Iododerma
* Bromoderma
* Chloracne
* Oil acne
* Tar acne
* Acne cosmetica
* Occupational acne
* Acne aestivalis
* Acne keloidalis nuchae
* Acne mechanica
* Acne with facial edema
* Pomade acne
* Acne necrotica
* Blackhead
* Lupus miliaris disseminatus faciei

|

Rosacea|

* Perioral dermatitis
* Granulomatous perioral dermatitis
* Phymatous rosacea
* Rhinophyma
* Blepharophyma
* Gnathophyma
* Metophyma
* Otophyma
* Papulopustular rosacea
* Lupoid rosacea
* Erythrotelangiectatic rosacea
* Glandular rosacea
* Gram-negative rosacea
* Steroid rosacea
* Ocular rosacea
* Persistent edema of rosacea
* Rosacea conglobata
* variants
* Periorificial dermatitis
* Pyoderma faciale

Ungrouped|

* Granulomatous facial dermatitis
* Idiopathic facial aseptic granuloma
* Periorbital dermatitis
* SAPHO syndrome

Follicular cysts|

* "Sebaceous cyst"
* Epidermoid cyst
* Trichilemmal cyst
* Steatocystoma
* simplex
* multiplex
* Milia

Inflammation|

* Folliculitis
* Folliculitis nares perforans
* Tufted folliculitis
* Pseudofolliculitis barbae

* Hidradenitis
* Hidradenitis suppurativa
* Recurrent palmoplantar hidradenitis
* Neutrophilic eccrine hidradenitis

Ungrouped|

* Acrokeratosis paraneoplastica of Bazex
* Acroosteolysis
* Bubble hair deformity
* Disseminate and recurrent infundibulofolliculitis
* Erosive pustular dermatitis of the scalp
* Erythromelanosis follicularis faciei et colli
* Hair casts
* Hair follicle nevus
* Intermittent hair–follicle dystrophy
* Keratosis pilaris atropicans
* Kinking hair
* Koenen's tumor
* Lichen planopilaris
* Lichen spinulosus
* Loose anagen syndrome
* Menkes kinky hair syndrome
* Monilethrix
* Parakeratosis pustulosa
* Pili (Pili annulati
* Pili bifurcati
* Pili multigemini
* Pili pseudoannulati
* Pili torti)
* Pityriasis amiantacea
* Plica neuropathica
* Poliosis
* Rubinstein–Taybi syndrome
* Setleis syndrome
* Traumatic anserine folliculosis
* Trichomegaly
* Trichomycosis axillaris
* Trichorrhexis (Trichorrhexis invaginata
* Trichorrhexis nodosa)
* Trichostasis spinulosa
* Uncombable hair syndrome
* Wooly hair nevus

Sweat
glands|

| Eccrine|

* Miliaria
* Colloid milium
* Miliaria crystalline
* Miliaria profunda
* Miliaria pustulosa
* Miliaria rubra
* Occlusion miliaria
* Postmiliarial hypohidrosis
* Granulosis rubra nasi
* Ross’ syndrome
* Anhidrosis
* Hyperhidrosis
* Generalized
* Gustatory
* Palmoplantar

|

Apocrine|

* Body odor
* Chromhidrosis
* Fox–Fordyce disease

Sebaceous|

* Sebaceous hyperplasia

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