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Recalcitrant eosinophilic pustular folliculitis of Ofuji with palmoplantar pustulosis: dramatic response to narrowband UVB phototherapy
Author(s) -
Lim Hua Liang,
Chong WeiSheng
Publication year - 2012
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/j.1600-0781.2012.00665.x
Subject(s) - medicine , palmoplantar pustulosis , dermatology , papulopustular , spongiosis , folliculitis , acrodermatitis , pathology , demodex , psoriasis , acne , rosacea , alternative medicine , biology , mite , botany
Summary Eosinophilic pustular folliculitis of O fuji is a recalcitrant disease typified by non‐infective eosinophilic spongiosis involving the infundibular region of the hair follicle. We present a case of a 49‐year‐old C hinese man with known palmoplantar pustulosis and acrodermatitis continua of H allopeau which was promptly resolved with methotrexate therapy. He returned with an erythematous papulopustular eruption with coalescence to annular plaques, occurring over the face, chest and back with active palmoplantar pustulation. Histology from skin biopsy of the palmar lesion was in keeping with palmoplantar psoriasis, while biopsy of the facial and truncal lesions revealed florid perifollicular eosinophilic congregation diagnostic of eosinophilic pustular folliculitis of O fuji. Indomethacin was initiated with partial improvement of lesions with cyclical flares. A trial of narrowband ultraviolet‐ B phototherapy at a frequency of thrice weekly achieved sustained clearance of both eosinophilic pustular folliculitis and palmoplantar lesions. Indomethacin was tailed down and eventually discontinued with maintenance of narrowband ultraviolet‐ B therapy; this achieved successful control of the disease.