Eosinophilic folliculitis

    Article Contributors: 
    Sean Klepper M.D.
    Artur Zembowicz M.D....

    Also known as: eosinophilic pusutular folliculitis

    Clinical Features:

    • Disease of unknown etiology
    • Affects four different demographics:
      • Adult Japanese men
      • Infants and young children
      • Patients with HIV
      • Patients with an atopic diathesis
    • Classic form (affecting adult Japanese men):
      • Most common on the face, trunk and upper extremities
      • Presents as erythematous follicular papules and pustules which coalesce to form polycyclic plaques with centripetal extension central clearing
      • Often pruritic
      • Postinflammatory hyperpigmentation is common.
      • There is often a peripheral leukocytosis with eosinophilia.
    • Pediatric variant:
      • Also shows a male predominance; patients are most often less than one year of age.
      • Most common on the scalp and forehead.
      • Differs from the classic variant in that the lesions in that it normally lacks the polycyclic morphology and centripetal extension.
    • HIV-associated variant:
      • Seen in the setting of advanced AIDS (CD4 count <200)
      • Severely pruritic
      • Presents with follicular urticarial papules with rare pustulation and no polycyclic plaques
    • The variant affecting patients with an atopic diathesis shows ulceration, follicular necrosis and eosinophilic vasculitis.

    Histologic Features:

    • Intra- and perifollicular inflammation rich in eosinophils
    • Often spongiosis of the follicle and sebaceous lobules
    • There are sometimes subcorneal eosinophilic pustules.
    • Often a pervivascular and interstitial lymphocytic infiltrate within the reticular dermis
    • The variant associated with an atopic diathesis shows the additional features of follicular necrosis and eosinophilic vasculitis.

    External Links:

    Cases associated with this book:

  • Eosinophilic folliculitis
    Author: Artur Zembowicz M.D. Ph.D.

    Conference: Dermpedia Teaching Collection