Clinical, Cosmetic and Investigational Dermatology (Jan 2024)

A Case of Eosinophilic Pustular Folliculitis Misdiagnosed as Eczema

  • Li Y,
  • Yang X,
  • Lu J,
  • Chen K,
  • Wu W,
  • Zhang M,
  • Li W

Journal volume & issue
Vol. Volume 17
pp. 199 – 204

Abstract

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Yuan Li,1,2 Xianxu Yang,3 Jiejie Lu,1 Kai Chen,3 Weiwei Wu,3 Ming Zhang,3 Wanni Li1 1Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China; 2Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 3Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of ChinaCorrespondence: Wanni Li, Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, 570100, Hainan, People’s Republic of China, Email [email protected]: Eosinophilic pustular folliculitis (EPF) is a rare skin disease. The typical skin lesions of classic EPF are localized on the upper limbs’ face, trunk, and extensor surfaces. However, when the skin lesions initially appear on the palms and soles, it is not easy to diagnose as EPF. Here, we report a case of a male patient who presented with erythematous plaques, pustules, and crusted erosions on the hands and feet, which were misdiagnosed as eczema ten years ago. Over ten years, the patient experienced recurrent erythematous patches with bumps and itching on the face, trunk, and extremities after improving the hand and foot lesions. A histopathological biopsy was performed to establish a definitive diagnosis, revealing pustules formed by eosinophilic infiltrates within the hair follicles. The diagnosis was confirmed as eosinophilic pustular folliculitis. The patient was treated with oral indomethacin at a dosage of 75mg/day, resulting in the disappearance of the skin lesions. After a 3-month follow-up, no recurrence was observed.Keywords: eosinophilic pustular folliculitis, indomethacin

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