Eosinophilic pustular folliculitis in a 90-year-old patient

Abstract

IntroductionEosinophilic pustular folliculitis (EPF), sometimes called Ofuji disease, is a chronic skin disorder of unknown etiology which develops predominantly in elderly man. Clinically it usually presents as itching centrifugally extending papulopustular rash.AimTo present a case of EPF and to raise dermatologists’ awareness of this this dermatosis when dealing with patients who are in higher risk of EPF occurrence.Case studyA 90-year-old man presented to the dermatology clinic due to the itching rash that had been present for 3 months. Physical examination of the patient revealed red-brown papulopustules covering trunk and extremities, most severe on the frontal part of thighs. Other possible causative agents of the symptoms were excluded. Histopathological results together with clinical symptoms led us to the final diagnosis of classic EPF.Results and discussionEPF is challenging to diagnose. The disease is very rare, especially in Europe, and clinical and/or histological appearance may mimic other dermatological conditions. The most commonly affected areas are face, back and trunk. EPF is usually classified into three main subtypes: classic, infantile and immunosuppression-associated. There are many viable therapeutic algorithms for the treatment of EPF.ConclusionsEosinophilic pustular folliculitis should be considered in differential diagnosis of pruritic follicular papulopustular rash affecting elderly men. Histopathological results play a crucial role in the making of final diagnosis.