Cases Of Eosinophilic Pustular Folliculitis Research Articles

Two cases of eosinophilic pustular folliculitis successfully treated with abrocitinib.

Eosinophilic pustular folliculitis (EPF) is a rare, non-infectious, inflammatory disease characterized by an eosinophil-dominated infiltrate within and around pilosebaceous units. Sometimes, EPF manifests with eruptions in follicle-free areas, although it is not common, and treatment may be difficult. In this case study we report two patients with refractory EPF who presented with eruptions of both classic follicle areas and follicle-free areas. These two patients were successfully treated with abrocitinib after treatment failure with several traditional therapies, such as indomethacin, steroids, and cyclosporin. One patient achieved complete remission at week 4 and the other at week 1, with no reported adverse effects. Therefore, we believe that abrocitinib may be a viable and safe therapeutic option for refractory EPF.

Predictive Model for Differential Diagnosis of Inflammatory Papular Dermatoses of the Face.

BackgroundThe clinical features of inflammatory papular dermatoses of the face are very similar. Their clinical manifestations have been described on the basis of a small number of case reports and are not specific.ObjectiveThis study aimed to use computer-aided image analysis (CAIA) to compare the clinical features and parameters of inflammatory papular dermatoses of the face and to develop a formalized diagnostic algorithm based on the significant findings.MethodsThe study included clinicopathologically confirmed inflammatory papular dermatoses of the face: 8 cases of eosinophilic pustular folliculitis (EPF), 13 of granulomatous periorificial dermatitis-lupus miliaris disseminatus faciei (GPD-LMDF) complex, 41 of granulomatous rosacea-papulopustular rosacea complex (GR-PPR) complex, and 4 of folliculitis. Clinical features were evaluated, and area density of papular lesions was quantitatively measured with CAIA. Based on these variables, we developed a predictive model for differential diagnosis using classification and regression tree analysis.Results The EPF group showed lesion asymmetry and annular clusters of papules in all cases. The GPD-LMDF complex group had significantly higher periocular density. The GR-PPR complex group showed a higher area density of unilateral cheek papules and the highest total area density. According to the predictive model, 3 variables were used for differential diagnosis of the 4 disease groups, and each group was diagnosed with a predicted probability of 67%~100%.ConclusionWe statistically confirmed the distinct clinical features of inflammatory papular dermatoses of the face and proposed a diagnostic algorithm for clinical diagnosis.

Facial and extrafacial eosinophilic pustular folliculitis: a clinical and histopathological comparative study

Although more than 300 cases of eosinophilic pustular folliculitis (EPF) have been reported to date, differences in clinicohistopathological findings among affected sites have not yet been evaluated. To evaluate differences in the clinical and histopathological features of facial and extrafacial EPF. Forty-six patients diagnosed with EPF were classified into those with facial and extrafacial disease according to the affected site. Clinical and histopathological characteristics were retrospectively compared, using all data available in the patient medical records. There were no significant between-group differences in subject ages at presentation, but a male predominance was observed in the extrafacial group. In addition, immunosuppression-associated type EPF was more common in the extrafacial group. Eruptions of plaques with an annular appearance were more common in the facial group. Histologically, perifollicular infiltration of eosinophils occurred more frequently in the facial group, whereas perivascular patterns occurred more frequently in the extrafacial group. Follicular mucinosis and exocytosis of inflammatory cells in the hair follicles were strongly associated with facial EPF. The clinical and histopathological characteristics of patients with facial and extrafacial EPF differ, suggesting the involvement of different pathogenic processes in the development of EPF at different sites.

Eosinophilic pustular folliculitis: A review of the Japanese published works

Eosinophilic pustular folliculitis (EPF), also known as Ofuji's disease, is an inflammatory dermatosis that was first described in Japan in 1970. More than 300 cases have been reported so far, and 113 Japanese cases have been reported in Japan since 1980. To comprehend the characteristics of Japanese EPF cases, we classified these cases into three types: classic, immunosuppression-associated (IS-EPF), and infancy-associated (I-EPF). Trends in age of onset and in distribution and characterization of eruptions differed between the types. We found 91 cases of classic EPF (mean age, 39.7years), consisting of 66 males (73%) and 25 females (27%), in most of which eruptions primarily affected the face; 18 cases of IS-EPF (44.2years), consisting of 15 males (83%) and three females (17%), in which eruptions affected the face less predominantly; and four cases of I-EPF (7.0years), consisting of two males (50%) and two females (50%), primarily affecting the scalp. The number of IS-EPF cases has increased since the late 1990s, reflecting the increasing number of HIV-positive patients in Japan. Systemic non-steroidal anti-inflammatory drugs were effective in more than 70% of cases. Dimethyl diphenyl sulfone, antibiotics including minocycline, psoralen plus ultraviolet A therapy and ultraviolet B treatments worked in some cases. Topical steroids and tacrolimus were also effective in some cases of EPF, while topical indomethacin was less effective.

Atypical clinical appearance of eosinophilic pustular folliculitis of seborrheic areas of the face

Eosinophilic pustular folliculitis is a pruritic eruption that preferentially involves the face. It is characterized by well-demarcated erythema, extending peripherally with a central clearing and pigmentation, together with sterile pustules lining the periphery. We describe five cases of eosinophilic pustular folliculitis with pruritic papules and erythema on seborrheic areas of the face, which lacked the typical features of classic eosinophilic pustular folliculitis--pustules and peripheral extension--but showed eosinophilic infiltration of the hair follicles, histologically. The eruption quickly responded to oral indomethacin except for one case that responded to tranilast and one case that was associated with acquired immunodeficiency syndrome, with recurrences in defined areas of the face. Our findings in these cases suggest that eosinophilic pustular folliculitis may vary in clinical appearance.

Eosinophilic pustular folliculitis (Ofuji’s disease) without macroscopic pustules

Eosinophilic pustular folliculitis (EPF), first described by Ofuji et al. in 1970, is a rare dermatosis characterized by pruritic papules and pustules on circinate erythematous plaques with eosinophilic infiltration in and around the hair follicle. We report three cases of EPF that showed no macroscopic pustules during the total observation period. Histopathological examination revealed eosinophilic infiltration in and around the hair follicle in the lower dermis and subcutis. EPF consists of clinical variants, one of which lacks obvious pustules.

Two cases of eosinophilic pustular folliculitis with atypical clinical features

Eosinophilic pustular folliculitis(EPF) is characterized by recurrent crops of pruritic folliculocentric papulopustules that occur mainly on face, trunk and extremities of young men. The main histologic feature is the infiltration of eosinophils into the follicular epidermis and adjacent dermis. Herein, we report two cases of EPF, one in a 35-year-old female and the other in a 58 year-old man. Histopathologic findings of the skin biopsy taken from 2 patients represented the heavy infiltration of eosinophils around and in the hair follicles, sebaceous glands and blood vessels. We could see beneficial responses by administration of dapsone in both cases.

Two Cases of Eosinophilic Pustular Folliculitis Treated by Acemetacin

The report deals with two cases of eosinophilic pustular folliculitis in a 45-year-old man and a 25-year-old woman. After their conditions failed to respond to oral and topical corticosteroids, minocycline, anti-allergic drugs, aspirin and several types of nonsteroidal anti-inflammatory drugs, good results were obtained with acemetacin.

Eosinophilic cellulitis and eosinophilic pustular folliculitis

This report describes a patient with a drug reaction and histologic changes of both eosinophilic cellulitis and eosinophilic pustular folliculitis. We propose that some cases of eosinophilic pustular folliculitis, like eosinophilic cellulitis, may occur as a result of a hypersensitivity phenomenon.

EosinophiIic Pustular Folliculitis (Ofuji)

Three cases of eosinophilic pustular folliculitis (Ofuji) are reported. The condition is characterized by follicular, tiny red papules with formation of pustules on fairly well-defined, slightly indurated erythematous plaques. The lesions have a tendency to central healing and peripheral extension, and are asymmetrically distributed on the face, the back, the arms, and sometimes the palms and/or soles. The condition proceeds with remissions and exacerbations. Histological features are pustular folliculitis from the ostium to the sebaceous gland, chiefly composed of polymorphs and eosinophiles.