Eosinophilic pustular folliculitis
Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
Eosinophilic pustulosis, eosinophilic pustular folliculitis, Ofuji syndrome, eosinophilic folliculitis. Do not confuse with papuloerythroderma Ofuji 1984 ("deckchair sign").
Non-infectious, relapsing folliculitis.
- Infantile form.
- Classical form.
- Immune suppression-associated form.
- Rare, rather occurring in the Asian region (Japan)
- Infantile form: Boys are more often affected than girls. The frequency peak is between 5-10 months. Here often preceding infestations such as scabies, larva migrans.
- Classical form: Young men (3rd-5th decade of life).
- Rarely occurring in neonates. Sporadic neonatal cases exist.
- Adult form: In this case, young males (3rd-4th decade of life) are most affected
- In the immunosuppression-associated form: mostly HIV infections, from < 200 CD4 T cells.
- Drug-induced: carbamazepine, allopurinol.
Pruritic, erythematous papules, plaques and sterile pustules, some of which are confluent. Usually pustules are less visible. Regression is often visible centrally. Healing occurs with postinflammatory hyperpigmentation.
- In particular, the face (in women in 93%, in men 73% facial involvement).
- Classical form: face (about 90% of cases), trunk (1/3), extremities (1/4), hands/feet (1/5), scalp (1/10).
- Infantile form: face (approx. 2/3 of cases), trunk (2/3), extremities (1/10), hands/feet (0), scalp (1/5).
- Immunosuppression-associated form: face (approx. 25% of cases), trunk (0), extremities (25%), hands/feet (0), scalp (50%).
- Clinical picture
- Blood count, in 1/3 of cases eosinophilia
- HIV serology
- IgE level
Mostly face, torso, extremities
Superficial spongiotic, eosinophil-rich dermatitis with folliculitis
- Spontaneous healing is possible
- Healing under hyperpigmentation
- Seldom also under scarring.
- Ofuji S. Eosinophilic Pustular Folliculitis. Dermatology 1987;174:53-6.
- Ota T, Hata Y, Tanikawa A, Amagai M, Tanaka M, Nishikawa T. Eosinophilic pustular folliculitis (Ofuji's disease): indometacin as a first choice of treatment. Clinical and Experimental Dermatology 2001;26:179-81.
- Katoh M, Nomura T, Miyachi Y, Kabashima K. Eosinophilic pustular folliculitis: a review of the Japanese published works. J Dermatol 2013;40:15-20.