eMedicine Specialties > Dermatology > Diseases of the Adnexa

Eosinophilic Pustular Folliculitis: Follow-up

Author: Marian Dmochowski, MD, Assistant Professor, Department of Dermatology, University School of Medicine at Poznan, Poland
Coauthor(s): Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Jan 14, 2009

Follow-up

Prognosis

  • Unfortunately, the classic/Japanese form of this condition usually continues for years with recurrent relapses and remissions. Some patients have achieved long-lasting remissions with indomethacin alone or in combination with dapsone.
  • Patients with HIV-associated disease may benefit from highly active antiretroviral therapy. Treatment that restores immunity in individuals with HIV infection may clear their skin lesions, which otherwise are chronic and persistent. In the absence of improvement of the underlying immunodeficiency, HIV-associated eosinophilic folliculitis usually does not respond to any treatment; even with ultraviolet B and psoralen plus ultraviolet A phototherapy, the skin lesions recur on discontinuation of phototherapy.
  • Eosinophilic pustulosis of the scalp in infancy/childhood is a self-limited, albeit recurrent, dermatosis that can be relieved by topical corticosteroids.

Miscellaneous

Medicolegal Pitfalls

  • Failure to exclude other infectious diseases is a pitfall. A comprehensive microbial examination should be performed to exclude the possibility of an infectious disease in patients with eosinophilic pustular folliculitis – like clinical and histopathologic features.
 


More on Eosinophilic Pustular Folliculitis

Overview: Eosinophilic Pustular Folliculitis
Differential Diagnoses & Workup: Eosinophilic Pustular Folliculitis
Treatment & Medication: Eosinophilic Pustular Folliculitis
Follow-up: Eosinophilic Pustular Folliculitis
Multimedia: Eosinophilic Pustular Folliculitis
References
[ CLOSE WINDOW ]

References

  1. Ise S, Ofuji S. Subcorneal pustular dermatosis. A follicular variant?. Arch Dermatol. Aug 1965;92(2):169-71. [Medline].

  2. Ofuji S, Ogino A, Horio T, Oseko T, Uehara M. Eosinophilic pustular folliculitis. Acta Derm Venereol. 1970;50(3):195-203. [Medline].

  3. Boone M, Dangoisse C, André J, Sass U, Song M, Ledoux M. Eosinophilic pustular folliculitis in three atopic children with hypersensitivity to Dermatophagoides pteronyssinus. Dermatology. 1995;190(2):164-8. [Medline].

  4. Vakilzadeh F, Suter L, Knop J, Macher E. Eosinophilic pustulosis with pemphigus-like antibody. Dermatologica. 1981;162(4):265-72. [Medline].

  5. Nunzi E, Parodi A, Rebora A. Ofuji's disease: high circulating titers of IgG and IgM directed to basal cell cytoplasm. J Am Acad Dermatol. Feb 1985;12(2 Pt 1):268-73. [Medline].

  6. Takematsu H, Tagami H. Eosinophilic pustular folliculitis. Studies on possible chemotactic factors involved in the formation of pustules. Br J Dermatol. Feb 1986;114(2):209-15. [Medline].

  7. Maruo K, Kayashima KI, Ono T. Expression of neuronal nitric oxide synthase in dermal infiltrated eosinophils in eosinophilic pustular folliculitis. Br J Dermatol. Mar 1999;140(3):417-20. [Medline].

  8. Kostler E, Gossrau G, Kuster P, Bergner V, Seebacher C. [Sterile eosinophilic pustulosis (Ofuji). A rare entity in Europe]. Hautarzt. Sep 1995;46(9):643-6. [Medline].

  9. Weber L, Hochsattel R, Hesse G, Klein CE. [Sterile eosinophilic pustulosis (Ofuji)]. Hautarzt. Aug 1988;39(8):527-30. [Medline].

  10. Kudejko J, Jablonska S, Chorzelski T. [Cutaneous changes combining features of Kimura's disease and Ofuji's disease (folliculitis pustulosa eosinophilica). A new disease entity?]. Przegl Dermatol. Jul-Aug 1981;68(4):487-95. [Medline].

  11. Wong TW, Tsai YM, Lee JY, Hsu ST, Sheu HM. Eosinophilic pustular folliculitis (Ofuji's disease) in a patient with silicone tissue augmentation. J Dermatol. Sep 2004;31(9):727-30. [Medline].

  12. Keida T, Hayashi N, Kawashima M. Eosinophilic pustular folliculitis following autologous peripheral blood stem-cell transplantation. J Dermatol. Jan 2004;31(1):21-6. [Medline].

  13. Maejima H, Mukai H, Hikaru E. Eosinophilic pustular folliculitis induced by allopurinol and timepidium bromide. Acta Derm Venereol. 2002;82(4):316-7. [Medline].

  14. Ooi CG, Walker P, Sidhu SK, Gordon LA, Marshman G. Allopurinol induced generalized eosinophilic pustular folliculitis. Australas J Dermatol. Nov 2006;47(4):270-3. [Medline].

  15. Lee ML, Tham SN, Ng SK. Eosinophilic pustular folliculitis (Ofuji's disease) with response to indomethacin. Dermatology. 1993;186(3):210-2. [Medline].

  16. Miyauchi T, Fujigaki T, Uehara M, et al. Successful treatment of eosinophilic pustular folliculitis with indomethacin. Acta Dermatol Kyoto. 1985;80:9-13.

  17. Nishijima S, Sugiyama T, Nakagawa M, Odaka T, Takaishi K. Two cases of eosinophilic pustular folliculitis treated by acemetacin. J Dermatol. Oct 1994;21(10):779-82. [Medline].

  18. Brazzelli V, Barbagallo T, Prestinari F, Ciocca O, Vassallo C, Borroni G. HIV seronegative eosinophilic pustular folliculitis successfully treated with doxicycline. J Eur Acad Dermatol Venereol. Jul 2004;18(4):467-70. [Medline].

  19. Buchness MR, Lim HW, Hatcher VA, Sanchez M, Soter NA. Eosinophilic pustular folliculitis in the acquired immunodeficiency syndrome. Treatment with ultraviolet B phototherapy. N Engl J Med. May 5 1988;318(18):1183-6. [Medline].

  20. Lim HW, Vallurupalli S, Meola T, Soter NA. UVB phototherapy is an effective treatment for pruritus in patients infected with HIV. J Am Acad Dermatol. Sep 1997;37(3 Pt 1):414-7. [Medline].

  21. Wilson BD, Kucera JC, Shin PJ. The role of radiation treatment in the management of eosinophilic pustular folliculitis. J Med. 2002;33(1-4):111-3. [Medline].

  22. Kawaguchi M, Mitsuhashi Y, Kondo S. Successful treatment of eosinophilic pustular folliculitis with topical tacrolimus. Int J Dermatol. Aug 2004;43(8):608-10. [Medline].

  23. Rho NK, Kim BJ. Eosinophilic pustular folliculitis: successful treatment with topical pimecrolimus. Clin Exp Dermatol. Jan 2007;32(1):108-9. [Medline].

  24. Kanekura T, Mera Y, Mera K, Saruwatari H, Kanzaki T. Efficacy of transdermal nicotine patches for eosinophilic pustular folliculitis. Br J Dermatol. May 2005;152(5):1074-5. [Medline].

  25. Sugita K, Kabashima K, Koga C, Tokura Y. Eosinophilic pustular folliculitis successfully treated with sequential therapy of interferon-gamma and ciclosporin. Clin Exp Dermatol. Sep 2006;31(5):709-10. [Medline].

  26. Basarab T, Jones RR. Ofuji's disease with unusual histological features. Clin Exp Dermatol. Jan 1996;21(1):67-71. [Medline].

  27. Bilbao I, Landa N, Zubizarreta J. Foliculitis eosinofilica infantil. Aportacion de tres caso y nuevo enfoque etiopatogenico. Med Cutan Ibero Lat Am. 1996;24:297-301.

  28. Buchness MR, Sanchez M. HIV-associated pruritus. Clin Dermatol. Jan-Mar 1991;9(1):111-4. [Medline].

  29. Buezo GF, Fraga J, Abajo P, Rios L, Dauden E, Garcia-Diez A. HIV-Associated eosinophilic folliculitis and follicular mucinosis. Dermatology. 1998;197(2):178-80. [Medline].

  30. Camarasa JG, Moreno A, Gimenez Arnau A. Eosinophilic pustular folliculitis (Ofuji). In: Clinical Dermatology - The CMD Case Collection. 17th World Congress of Dermatology; 1987:339-40.

  31. Cutler TP. Eosinophilic pustular folliculitis. Clin Exp Dermatol. May 1981;6(3):327-32. [Medline].

  32. Ellis E, Scheinfeld N. Eosinophilic pustular folliculitis: a comprehensive review of treatment options. Am J Clin Dermatol. 2004;5(3):189-97. [Medline].

  33. Fearfield LA, Rowe A, Francis N, Bunker CB, Staughton RC. Itchy folliculitis and human immunodeficiency virus infection: clinicopathological and immunological features, pathogenesis and treatment. Br J Dermatol. Jul 1999;141(1):3-11. [Medline].

  34. Giard F, Marcoux D, McCuaig C, Powell J, Russo P. Eosinophilic pustular folliculitis (Ofuji disease) in childhood: a review of four cases. Pediatr Dermatol. Sep 1991;8(3):189-93. [Medline].

  35. Holst R. Eosinophilic pustular folliculitis. Report of a European case. Br J Dermatol. Dec 1976;95(6):661-4. [Medline].

  36. Ishibashi A, Nishiyama Y, Miyata C, Chujo T. Eosinophilic pustular folliculitis (ofuji). Dermatologica. 1974;149(4):240-7. [Medline].

  37. Larralde M, Morales S, Santos Munoz A, Lamas F, Schroh R, Corbella C. Eosinophilic pustular folliculitis in infancy: report of two new cases. Pediatr Dermatol. Mar-Apr 1999;16(2):118-20. [Medline].

  38. Lazarov A, Wolach B, Cordoba M, Abraham D, Vardy D. Eosinophilic pustular folliculitis (Ofuji disease) in a child. Cutis. Aug 1996;58(2):135-8. [Medline].

  39. Lucky AW, Esterly NB, Heskel N, Krafchik BR, Solomon LM. Eosinophilic pustular folliculitis in infancy. Pediatr Dermatol. Jan 1984;1(3):202-6. [Medline].

  40. Ofuji S. Eosinophilic pustular folliculitis. Acta Dermatol Kyoto. 1973;68:1-9.

  41. Ofuji S. Eosinophilic pustular folliculitis. Dermatologica. 1987;174(2):53-6. [Medline].

  42. Pec J, Frlickova Z., Fetisovova Z. Eosinophilic pustular folliculitis a case report. Acta Derm Venerol (Ljubljana). 1998;7:19-22.

  43. Piantanida EW, Turiansky GW, Kenner JR, Mather MK, Sperling LC. HIV-associated eosinophilic folliculitis: diagnosis by transverse histologic sections. J Am Acad Dermatol. Jan 1998;38(1):124-6. [Medline].

  44. Ramdial PK, Morar N, Dlova NC, Aboobaker J. HIV-associated eosinophilic folliculitis in an infant. Am J Dermatopathol. Jun 1999;21(3):241-6. [Medline].

  45. Rattana-Apiromyakij N, Kullavanijaya P. Eosinophilic pustular folliculitis: report of seven cases in Thailand. J Dermatol. Mar 2000;27(3):195-203. [Medline].

  46. Rosenthal D, LeBoit PE, Klumpp L, Berger TG. Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection. Arch Dermatol. Feb 1991;127(2):206-9. [Medline].

  47. Soeprono FF, Schinella RA. Eosinophilic pustular folliculitis in patients with acquired immunodeficiency syndrome. Report of three cases. J Am Acad Dermatol. Jun 1986;14(6):1020-2. [Medline].

  48. Taieb A, Bassan-Andrieu L, Maleville J. Eosinophilic pustulosis of the scalp in childhood. J Am Acad Dermatol. Jul 1992;27(1):55-60. [Medline].

  49. Takematsu H, Nakamura K, Igarashi M, Tagami H. Eosinophilic pustular folliculitis. Report of two cases with a review of the Japanese literature. Arch Dermatol. Jul 1985;121(7):917-20. [Medline].

  50. Teraki Y, Konohana I, Shiohara T, Nagashima M, Nishikawa T. Eosinophilic pustular folliculitis (Ofuji's disease). Immunohistochemical analysis. Arch Dermatol. Aug 1993;129(8):1015-9. [Medline].

  51. Teraki Y, Nishikawa T. Skin diseases first described in Japan. J Dermatol. Mar 1994;21(3):139-51. [Medline].

  52. Wollenberg A, Heckmann M, Braun-Falco O. [Erosive pustular dermatosis of the scalp after zoster ophthalmicus and trauma]. Hautarzt. Sep 1992;43(9):576-9. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

eosinophilic pustular folliculitis, EPF, Ofuji's disease, Ofuji disease, eosinophilic folliculitis, HIV-associated eosinophilic folliculitis, HIV-related eosinophilic folliculitis, infantile/childhood eosinophilic pustular folliculitis, sterile eosinophilic pustulosis, eosinophilic pustular dermatosis, infantile/childhood eosinophilic pustulosis of the scalp

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Marian Dmochowski, MD, Assistant Professor, Department of Dermatology, University School of Medicine at Poznan, Poland
Marian Dmochowski, MD is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Takeji Nishikawa, MD, Emeritus Professor, Department of Dermatology, Keio University School of Medicine; Director, Samoncho Dermatology Clinic; Managing Director, The Waksman Foundation of Japan Inc
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey Meffert, MD, Assistant Clinical Professor of Dermatology, University of Texas Health Science Center-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.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine 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, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.