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Eosinophilic Folliculitis - Symptoms & Treatment


Eosinophilic folliculitis (EF) is a recurrent skin disorder of unknown etiology. There are several variants of eosinophilic folliculitis, which is also known as 'eosinophilic pustular folliculitis' or 'Ofuji disease'. The name is due to skin biopsy finding of eosinophils (a type of immune cell) around hair follicles. Folliculitis usually appears as small, white-headed pimples around one or more hair follicles - the tiny pockets from which each hair grows. It frequently begins as a pruritic, papular eruption that evolves into a weeping, crusting ulcer with a hypertrophic margin and central healing. The exact cause is unknown, but researchers have determined that a certain type of white blood cell is responsible for the inflammation. The signs and symptoms of eosinophilic folliculitis vary, depending on the type of infection. In superficial forms of the disorder, small pimples develop around one or more hair follicles. Eosinophilic folliculitis is most common among individuals with HIV, though it can occur in normal individuals where it is known by the eponym Ofuji disease. EF consists of itchy red bumps ( papules ) centered on hair follicles and typically found on the upper body, sparing the abdomen and legs.

In many cases, the infection clears on its own. Patients with Eosinophilic folliculitis make antibodies to the intercellular substance of the lower epidermis and the outer root sheath of the hair follicle. Palms and soles may rarely develop similar papules and pustules, but in such cases the condition should not be called 'folliculitis' as there are no follicles in these areas. The name eosinophilic folliculitis refers to the predominant immune cells associated with the disease ( eosinophils ) and the involvement of the hair follicles. Folliculitis can cause boils and, in rare instances, serious skin infections. Bacteria from folliculitis can enter the blood stream and travel to other parts of the body. Eosinophilic folliculitis may be suspected clinically when an individual with HIV exhibits the classic symptoms. The diagnosis can be supported by the finding of eosinophilia but a skin biopsy is necessary to establish it.

Causes of Eosinophilic folliculitis

The common causes and risk factor's of Eosinophilic folliculitis include the following:

  • Overgrowth of Malassezia or Demodex (the hair follicle mite).
  • A change in the immune system.
  • Living in a warm, humid climate.
  • Exposure to coal tar, pitch or creosote - common among roofers, mechanics and oil workers.
  • Bacteria, such as Staphylococcus.
  • Infection in the nose or other recent illness.

Symptoms of Eosinophilic folliculitis

Some sign and symptoms related to Eosinophilic folliculitis are as follows:

  • Eosinophilic folliculitis presents with red or skin-coloured dome shaped bumps and pustules.
  • The pimples sometimes contain pus (pustules).
  • Small pimples develop around one or more hair follicles.
  • The infection may itch or be somewhat tender.

Treatment of Eosinophilic folliculitis

Here is list of the methods for treating Eosinophilic folliculitis:

  • Hot tub folliculitis rarely requires treatment, although your doctor may prescribe an oral or topical medication to help relieve itching (anti-pruritic).
  • Use medicated powder in the area on a daily basis. This helps keep the area dry and reduces frictional pressures.
  • Ultraviolet therapy with ultraviolet B or with ultraviolet A and psoralen plus ultraviolet A may be beneficial.
  • The drug griseofulvin (Fulvicin) and topical antifungal medications are used to treat fungal folliculitis.
  • Other therapies include PUVA, topical tacrolimus, and isotretinoin.
  • This type of infection can be controlled by Mupirocin, (anti-biotic), Dicloxacillin.

 

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