CASE REPORT
Eosinophilic pustular folliculitis in a 90-year-old patient
 
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1
Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Poland
 
2
Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
 
3
Department of Patomorphology, Medical University of Gdańsk, Poland
 
4
Department of Oral Biochemistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
 
 
Submission date: 2022-08-27
 
 
Final revision date: 2022-11-03
 
 
Acceptance date: 2022-11-04
 
 
Online publication date: 2023-02-07
 
 
Corresponding author
Mikołaj Cichoń   

Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, M. Smoluchowskiego 17, 80-214 Gdańsk, Poland
 
 
Pol. Ann. Med. 2023;30(1):82–85
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Eosinophilic pustular folliculitis (EPF), sometimes called Ofuji disease, is a chronic skin disorder of unknown etiology which develops predominantly in elderly man. Clinically it usually presents as itching centrifugally extending papulopustular rash.

Aim:
To present a case of EPF and to raise dermatologists’ awareness of this this dermatosis when dealing with patients who are in higher risk of EPF occurrence.

Case study:
A 90-year-old man presented to the dermatology clinic due to the itching rash that had been present for 3 months. Physical examination of the patient revealed red-brown papulopustules covering trunk and extremities, most severe on the frontal part of thighs. Other possible causative agents of the symptoms were excluded. Histopathological results together with clinical symptoms led us to the final diagnosis of classic EPF.

Results and discussion:
EPF is challenging to diagnose. The disease is very rare, especially in Europe, and clinical and/or histological appearance may mimic other dermatological conditions. The most commonly affected areas are face, back and trunk. EPF is usually classified into three main subtypes: classic, infantile and immunosuppression-associated. There are many viable therapeutic algorithms for the treatment of EPF.

Conclusions:
Eosinophilic pustular folliculitis should be considered in differential diagnosis of pruritic follicular papulopustular rash affecting elderly men. Histopathological results play a crucial role in the making of final diagnosis.

FUNDING
None declared.
CONFLICT OF INTEREST
None declared.
 
REFERENCES (11)
1.
Nervi SJ, Schwartz RA, Dmochowski M. Eosinophilic pustular folliculitis: A 40 year retrospect. J Am Acad Dermatol. 2006;55(2):285–289. https://doi.org/10.1016/j.jaad....
 
2.
Ise S, Ofuji S. Subcorneal pustular dermatosis. A follicular variant? Arch Dermatol. 1965;92:169–172.
 
3.
Korycińska J, Dzika E, Lepczyńska M, Kubiak K. Scabies: Clinical manifestations and diagnosis. Pol Ann Med. 2015;22(1):63–66. https://doi.org/10.1016/j.poam....
 
4.
Ellis E, Scheinfeld N. Eosinophilic pustular folliculitis: a comprehensive review of treatment options. Am J Clin Dermatol. 2004;5(3):189–197. https://doi.org/10.2165/001280....
 
5.
Ofuji S. Eosinophilic pustular folliculitis. Dermatologica. 1987;174(2):53–56. https://doi.org/10.1159/000248....
 
6.
Lucky AW, Esterly N, Heskel N, Krafchik BR, Solomon LM. Eosinophilic Pustular Folliculitis In Infancy. Pediatr Dermatol. 1984;1(3):202–206. https://doi.org/10.1111/j.1525....
 
7.
Kanaki T, Hadaschik E, Esser S, Sammet S. Eosinophilic pustular folliculitis (EPF) in a patient with HIV infection. Infection. 2021;49(4):799–801. https://doi.org/10.1007/s15010....
 
8.
Fujii M, Takahashi I, Kishiyama K, Honma M, Ishida-Yamamoto A. Case of generalized eosinophilic pustular folliculitis induced by allopurinol. J Dermatol. 2016;43(4):458–459. https://doi.org/10.1111/1346-8....
 
9.
Nomura T, Katoh M, Yamamoto Y, Miyachi Y, Kabashima K. Eosinophilic pustular folliculitis: A proposal of diagnostic and therapeutic algorithms. J Dermatol. 2016;43(11):1301–1306. https://doi.org/10.1111/1346-8....
 
10.
Marasca C, Ruggiero A, Fabbrocini G, Megna M. A Case of Ofuji Disease Successfully Treated with the Combination of Low-Dose Indomethacin and Topical Tacrolimus. Case Rep Dermatol. 2020;12(2):155–158. https://doi.org/10.1159/000509....
 
11.
Gallo G, Conti L, Quaglino P, Ribero S. Treatment of eosinophilic pustular folliculitis with low-dose isotretinoin. Int J Dermatol. 2022;61(7):262–264. https://doi.org/10.1111/ijd.15....