Which physical findings are characteristic of eosinophilic folliculitis (EF)?

Updated: Mar 17, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Eosinophilic folliculitis typically appears as an area of erythematous papules and pustules. These involve the face in most (85%) affected patients. Occasionally, the papules do not evolve into macroscopic pustules. [9]

Eosinophilic pustular folliculitis in a patient in Eosinophilic pustular folliculitis in a patient infected with HIV. Note acneiform hyperpigmented papules. Photograph courtesy of Sarah A. Myers, MD.

Other locations include the back and the extensor surface of the upper extremities.

Eosinophilic pustular folliculitis in a patient wh Eosinophilic pustular folliculitis in a patient who is HIV-positive. Note follicular-based excoriated papules and pustules on the trunk. Photograph courtesy of Sarah A. Myers, MD.

The papules gradually become confluent, creating indurate polycyclic plaques with a healing center and spreading periphery. Sometimes the plaques may be studded with papules and sterile pustules. [10] They ultimately fade away, leaving residual hyperpigmentation and scaling.

Atypical presentations or nonclassic forms of eosinophilic folliculitis occur in certain populations. Infantile eosinophilic folliculitis is characterized by erythematous papulopustules on the scalp as the primary area of involvement. Patients with HIV-associated eosinophilic folliculitis present with widespread urticarial lesions or large erythematous plaques with excoriations.

Involvement of mucosa and the palms and soles is rare. [11]


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