Back issues No.2 - 2003 / Original Study  

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Clinical Manifestations of Eosinophilic Folliculitis:A Review of 23 Patients
Ya-Ming Tsai , J. Yu-Yun Lee , J. Hamm-Ming Sheu, Ki-Kau Lee
Dermatol Sinica 21 : 126-135, 2003

Ofuji’s disease(OD), also named eosinophilic pustular folliculitis(EPF), is characterized by recurrent pruritic folliculopapules and discoid or annular plaques studded with pustules, which occurs mainly on the face. HIV-associated eosinophilic folliculitis(HIV-EF) typically manifests discrete urticarial folliculopapules, mostly on the upper trunk. Both forms of EF are characterized by sterile pustular eosinophilic folliculitis. In the past 13 years, a total of 23 cases of EF were diagnosed in our department based on the characteristic clinical and pathological findings. Of these, 16 were non-HIV EF(5 males, 11 females, aged 12-50 yrs, with a mean of 33 yrs), while 7 were HIV-EF(7 males, aged 35-67 yrs, with a mean of 48 yrs). In the non-HIV group, 13 showed clinical pictures of OD, the other 3 had lessons papular EF lesions similar to HIV-EF. Ten of the 23 EF patients had eosinophilia, and HIV-EF patients had decreased CD4 counts(mean 133/mm3). Microscopically, all EF cases showed eosinophilic folliculitis and perifolliculitis with pilosebaceous pustules or/and microabscess histopathologically. Interestingly, 6 cases with OD were associated with follicular mucinosis. Treatments including prednisolone, indomethacin, naproxen, diclofenac, doxycycline, dapsone, ultraviolet B. Fifteen patients were treated with prednisolone and it was effective except 2 HIV-EF. Indomethacin was effective in 4 patients. The rest seemed ineffective. Spontaneous remission was noted in 2 years in about half of the non-HIV patients, but in none of HIV patients. Our study suggests that EF is not rare in Taiwan, and EF should be differentiated from dermatophytosis, rosacea and follicular mucinosis clinically and pathologically.

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