Disseminate and Recurrent Infundibular Folliculitis

Author: Stephen W White, MD; Chief Editor: Dirk M Elston, MD more...

Updated: Aug 15, 2011

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Background
Pathophysiology
Epidemiology
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Background

Disseminate and recurrent infundibular folliculitis (DRIF) was first described in 1968 by Hitch and Lund.^[1]The clinical presentation is much like miliaria or keratosis pilaris. It is mostly seen in young healthy people, and most patients have a dark skin color. It consists of generalized flesh-colored papules. Therapy has generally been unsuccessful.

Courtesy of San Antonio Uniformed Services Health Education Consortium slide files.

The validity of disseminate and recurrent infundibular folliculitis as a separate entity has been questioned. However, it does have such a characteristic clinical picture that for the present it is accepted as an entity.

Pathophysiology

The etiology of disseminate and recurrent infundibular folliculitis is not established.

Frequency

United States

Although the first case of disseminate and recurrent infundibular folliculitis was not reported until 1968, other more recent reports indicate that it is a fairly common occurrence. Clinics that see a large number of young dark-skinned patients report that disseminate and recurrent infundibular folliculitis is a common condition. Indeed, it may occur in large numbers in hot, humid weather.

International

Cases of disseminate and recurrent infundibular folliculitis have been reported from Europe and India.

Mortality/Morbidity

Pruritus is the troublesome symptom of disseminate and recurrent infundibular folliculitis. In the past, this was difficult to relieve. The condition may be recurrent over a number of years. Disseminate and recurrent infundibular folliculitis may make it uncomfortable for the patient to work in a hot, humid environment.

Race

Disseminate and recurrent infundibular folliculitis has been reported primarily in people of African American origin in the United States.^[2]Why a number of dermatoses tend to be papular and follicular in dark-skinned people is not known. This phenomenon is well documented in atopic dermatitis.

Sex

Although most of the patients are men, disseminate and recurrent infundibular folliculitis has been reported in women.

Age

Most of the reported disseminate and recurrent infundibular folliculitis patients have been healthy young adults.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Stephen W White, MD Clinical Assistant Professor, Department of Dermatology, George Washington University Hospital; Chief, Sub-section of Dermatology, Suburban Hospital

Stephen W White, MD is a member of the following medical societies: American Academy of Dermatology, International Society of Dermatology, Society for Investigative Dermatology, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Christopher R Gorman, MD Bethesda Dermatology, Private Practice; Assistant Clinical Professor, George Washington University School of Medicine and Health Sciences; Staff Dermatologist, National Naval Medical Center

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

James Fulton Jr, MD, PhD Center for Cosmetic Dermatology; Consultant, Vivant Pharmaceuticals, LLC

James Fulton Jr, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Laser Medicine and Surgery, Dermatology Foundation, International Society of Cosmetic and Laser Surgeons, and Skin Cancer Foundation

Disclosure: Vivant Pharmaceuticals Grant/research funds Consulting

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.

References

Hitch JM, Lund HZ. Disseminate and recurrent infundibulo-folliculitis: report of a case. Arch Dermatol. Apr 1968;97(4):432-5. [Medline].
Barriere H, Litoux P, Bureau B, Stalder JF. [Disseminate and recurrent infundibulo-folliculitis (Hitch and Lund)]. Ann Dermatol Venereol. Apr 1980;107(4):299-302. [Medline].
Hinds GA, Heald PW. A case of disseminate and recurrent infundibulofolliculitis responsive to treatment with topical steroids. Dermatol Online J. Nov 15 2008;14(11):11. [Medline].
Ravikumar BC, Balachandran C, Shenoi SD, Sabitha L, Ramnarayan K. Disseminate and recurrent infundibulofolliculitis: response to psoralen plus UVA therapy. Int J Dermatol. Jan 1999;38(1):75-6. [Medline].
Aroni K, Grapsa A, Agapitos E. Disseminate and recurrent infundibulofolliculitis: response to isotretinoin. J Drugs Dermatol. Jul-Aug 2004;3(4):434-5. [Medline].
Owen WR, Wood C. Disseminate and recurrent infundibulofolliculitis. Arch Dermatol. Feb 1979;115(2):174-5. [Medline].
El Shabrawi-Caelen L, Soyer HP. Clinical Pathologic Challenge: Patchy pityriasiform lichenoid eczema. Am J Dermatopathol. Jun 2005;27(3):216, 258.
White SW, Rodman OG. Disseminate and recurrent infundibulofolliculitis. J Assoc Military Dermatol. 1981;22-23.