Eosinophilic folliculitis

Eosinophilic folliculitis (EF) is a chronic skin disorder characterized by the presence of itchy, inflamed, and sometimes pus-filled lesions primarily located on the scalp, face, and upper body. This condition is marked by an elevated number of eosinophils, a type of white blood cell, in the hair follicles. Eosinophilic folliculitis is often seen in individuals with compromised immune systems, particularly those with HIV/AIDS, but it can also occur in healthy individuals, where it is known as idiopathic eosinophilic folliculitis.

Causes and Risk Factors

The exact cause of eosinophilic folliculitis remains unclear. However, it is believed to involve an abnormal immune response or hypersensitivity reaction. In individuals with HIV/AIDS, EF is thought to be associated with a reaction to opportunistic infections due to the weakened immune system. Other risk factors may include a history of atopic dermatitis or other allergic conditions.

Symptoms

Symptoms of eosinophilic folliculitis include:

• Itchy, red, or inflamed papules and pustules
• Lesions that typically appear on the face, neck, scalp, and upper body
• Possible scarring or hyperpigmentation after lesions heal

The itchiness can be severe and may significantly impact the quality of life of affected individuals.

Diagnosis

Diagnosis of eosinophilic folliculitis is primarily based on clinical examination and the patient's medical history. A skin biopsy may be performed to confirm the diagnosis, where histopathological examination reveals eosinophilic infiltration of the hair follicles. Additional tests may be conducted to rule out other conditions, such as fungal infections or scabies.

Treatment

Treatment of eosinophilic folliculitis aims to reduce symptoms and prevent recurrence. Options include:

• Topical corticosteroids to reduce inflammation
• Oral antihistamines for itch relief
• Antibiotics if a secondary bacterial infection is present
• Antiretroviral therapy for individuals with HIV/AIDS to improve immune function
• Phototherapy has also shown some effectiveness in managing symptoms

In cases of idiopathic eosinophilic folliculitis, identifying and avoiding potential triggers may help in managing the condition.

Prognosis

The prognosis for eosinophilic folliculitis varies. In individuals with HIV/AIDS, effective antiretroviral therapy can lead to significant improvement. In idiopathic cases, the condition may be chronic and recurrent, requiring ongoing management to control symptoms.

Epidemiology

Eosinophilic folliculitis is more common in adults than in children and has a higher prevalence among males compared to females. The incidence is particularly high among individuals with advanced HIV/AIDS.

See Also

• Dermatitis
• Folliculitis
• HIV/AIDS
• Eosinophilia

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