Diagnostic Considerations

Clinical differential diagnoses include tinea, acne, rosacea, eczematous dermatitis, granuloma faciale, autoimmune annular erythema, infestations, and pustular dermatosis.^[33]The hyperimmunoglobulin E syndrome may be first evident as eosinophilic pustular folliculitis.^[5]

Histologically, follicular mucinosis, mycosis fungoides, and other cutaneous T-cell lymphomas should be considered.^{[33, 34]}

Classic form of eosinophilic folliculitis
- Acneiform eruptions
- Acne vulgaris
- Follicular eczema
- Folliculitis (bacterial, fungal, or dermatophytic)
- Pustular psoriasis
- Subcorneal pustular dermatosis (Sneddon-Wilkinson disease)
- Alopecia mucinosis
Pediatric eosinophilic folliculitis
- Acropustulosis of infancy
- Scabies
- Scalp pyoderma
Neonatal eosinophilic folliculitis
- Erythema toxicum neonatorum
- Miliaria
- Neonatal acne
- Neonatal varicella
- Transient neonatal pustular melanosis
HIV-associated eosinophilic folliculitis
- Pruritic papular eruption of HIV
- Reactions to arthropod bites and stings^[35]
- Follicular mycosis fungoides^[36]
- Photodermatitis
- Opportunistic infections
Severe cutaneous drug reactions
- Generalized pustular figurate erythema^[37]
- Acute generalized eruptive pustulosis

Differential Diagnoses

Acute Urticaria
Candidiasis
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome
Follicular lymphomatoid papulosis

Workup

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Media Gallery

Eosinophilic pustular folliculitis in a patient infected with HIV. Note acneiform hyperpigmented papules. Photograph courtesy of Sarah A. Myers, MD.
Eosinophilic pustular folliculitis in a patient who is HIV-positive. Note follicular-based excoriated papules and pustules on the trunk. Photograph courtesy of Sarah A. Myers, MD.
Eosinophilic folliculitis (low-power). Note eosinophilic spongiosis, particularly involving the infundibular region of the hair follicle.
Eosinophilic folliculitis (high-power). In addition to the abundant eosinophils, note the variable numbers of neutrophils and mononuclear cells.

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Author

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

M Angelica Selim, MD, MD Director of Dermatopathology, Departments of Pathology and Internal Medicine, Associate Professor, Duke University Medical Center

Disclosure: Nothing to disclose.

Christopher R Shea, MD Eugene J Van Scott Professor in Dermatology, Chief, Section of Dermatology, Department of Medicine, University of Chicago, The Pritzker School of Medicine

Christopher R Shea, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society of Dermatopathology, Arthur Purdy Stout Society, Association of Professors of Dermatology, Chicago Dermatological Society, Dermatology Foundation, Illinois Dermatological Society, International Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Rajendra Kapila, MD, MBBS † Professor, Department of Medicine, Rutgers New Jersey Medical School

Rajendra Kapila, MD, MBBS is a member of the following medical societies: American College of Physicians, American Medical Association, Infectious Diseases Society of America, Infectious Diseases Society of New Jersey

Disclosure: Nothing to disclose.

Harry Dao, Jr, MD Assistant Professor, Department of Dermatology, Baylor College of Medicine

Harry Dao, Jr, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Sections Eosinophilic Folliculitis
Overview
Presentation
- History
- Physical
- Causes
- Complications
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DDx
Workup
Treatment
Medication
Questions & Answers
Media Gallery
References

Eosinophilic Folliculitis Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

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