Eosinophilic pustular folliculitis pathology

Introduction

Eosinophilic pustular folliculitis is a heterogeneous group of disorders consists of clinical subsets including classic Ofuji disease, HIV-associated, paediatric, cancer, and medication-associated eosinophilic pustular folliculitis. All have a similar histological appearance.

Histology of eosinophilic pustular folliculitis

In eosinophilic pustular folliculitis, there is eosinophilic spongiosis and pustulosis involving the infundibular region of the hair follicle. The follicular architecture is usually preserved. There can be minimal numbers of neutrophils or mononuclear cells within the infiltrate.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Images provided by Dr Duncan Lamont, Waikato Hospital

Special studies in eosinophilic pustular folliculitis

PAS or silver methenamine preparation should always be examined to exclude dermatophyte infections.

Differential diagnosis to eosinophilic pustular folliculitis

Dermatophyte infection