Eosinophilic pustular folliculitis of infancy

Eosinophilic Pustular Folliculitis of Infancy (EPFI) is a rare dermatological condition primarily affecting infants. This condition is characterized by the development of itchy, sterile pustules on the scalp, face, and sometimes on the trunk and extremities. Unlike other forms of folliculitis, EPFI is notable for its eosinophil-rich infiltrate, which is a type of white blood cell often associated with allergic reactions or parasitic infections. The exact cause of EPFI remains unknown, but it is considered to be a self-limiting disorder, often resolving without treatment within weeks to months.

Symptoms and Diagnosis

The primary symptom of EPFI is the appearance of clusters of small, itchy pustules. These pustules are typically surrounded by an area of erythema (redness) and may appear on the scalp, face, and less commonly, on the trunk and limbs. The condition is generally non-scarring and does not lead to permanent hair loss.

Diagnosis of EPFI is primarily clinical, based on the characteristic appearance of the lesions and the age of the patient. Histopathological examination of a lesion biopsy can confirm the diagnosis, showing an eosinophilic infiltration around hair follicles. Additional tests, such as bacterial cultures, are typically negative, helping to rule out infectious causes of folliculitis.

Treatment

Treatment of EPFI is often not necessary, as the condition is self-limiting and tends to resolve spontaneously. However, in cases where the itching is severe or the lesions are persistent, topical corticosteroids may be used to reduce inflammation and discomfort. In some instances, oral antihistamines can also be helpful in managing pruritus (itchiness).

Etiology

The exact cause of EPFI is unknown. It is thought to be an inflammatory reaction, possibly triggered by an unidentified antigen. Unlike other eosinophilic conditions, there is no clear association with parasitic infections or systemic diseases in the case of EPFI.

Epidemiology

EPFI is a rare condition, with a higher incidence reported in Japan. It primarily affects infants, with most cases occurring in the first year of life. There is no known gender predilection.

Prognosis

The prognosis for EPFI is excellent, as the condition typically resolves spontaneously within a few months. Recurrences are uncommon, but have been reported in the literature.

See Also

• Folliculitis
• Eosinophil
• Dermatitis