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[Ofuji's eosinophilic pustular folliculitis. Efficacy of acitretin].
Ann Dermatol Venereol 1997; 124(8):540-3AD

Abstract

BACKGROUND

We report the first case of eosinophilic pustular folliculitis (Ofuji's disease) which was successfully treated with acitretin.

CASE REPORT

A 50-year old women (HIV negative) had developed over 3 months an erythematopapulous plaque under the left orbit. The clinical and histological diagnosis was eosinophilic pustular folliculitis. Successive treatment with cetirizine then indomethacin was ineffective. Acitretin (0.5 mg/kg/d) was then started and led to cure within 1 month. Six weeks after the patient spontaneously stopped the treatment, the lesion recurred at the same localization. Further treatment with isotretinoin (0.5 mg/kg/d) was then given but did not alter progression of the lesion. Acitretin was then reintroduced at the same dose and again produced rapid cure. Acitretin was then tapered off to 10 mg/d then maintained at this dose as lesions reappeared with further dose reduction.

DISCUSSION

It is difficult to treat eosinophilic pustular folliculitis because of the random nature of response to different drugs. General corticosteroids, dapsone and indomethacin are classically proposed but with variable success. Isotretinoin is proposed on the hypothesis of a link with sebaceous secretion, but results have been contradictory. This drug was ineffective in our case. Acitretin did however provide very rapid improvement with an efficacy confirmed at reintroduction. This retinoid which does not have the specific action of isotretinoin could affect follicular keratinocytes which have been shown to be activated in this chronic skin disease.

Authors+Show Affiliations

Service de Dermatologie A, Hôpital Claude-Huriez, CHRU, Lille.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

9740848

Citation

Dubost-Brama, A, et al. "[Ofuji's Eosinophilic Pustular Folliculitis. Efficacy of Acitretin]." Annales De Dermatologie Et De Venereologie, vol. 124, no. 8, 1997, pp. 540-3.
Dubost-Brama A, Delaporte E, Catteau B, et al. [Ofuji's eosinophilic pustular folliculitis. Efficacy of acitretin]. Ann Dermatol Venereol. 1997;124(8):540-3.
Dubost-Brama, A., Delaporte, E., Catteau, B., Warembourg, A., Piette, F., & Bergoend, H. (1997). [Ofuji's eosinophilic pustular folliculitis. Efficacy of acitretin]. Annales De Dermatologie Et De Venereologie, 124(8), pp. 540-3.
Dubost-Brama A, et al. [Ofuji's Eosinophilic Pustular Folliculitis. Efficacy of Acitretin]. Ann Dermatol Venereol. 1997;124(8):540-3. PubMed PMID: 9740848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Ofuji's eosinophilic pustular folliculitis. Efficacy of acitretin]. AU - Dubost-Brama,A, AU - Delaporte,E, AU - Catteau,B, AU - Warembourg,A, AU - Piette,F, AU - Bergoend,H, PY - 1997/1/1/pubmed PY - 1998/9/19/medline PY - 1997/1/1/entrez SP - 540 EP - 3 JF - Annales de dermatologie et de venereologie JO - Ann Dermatol Venereol VL - 124 IS - 8 N2 - BACKGROUND: We report the first case of eosinophilic pustular folliculitis (Ofuji's disease) which was successfully treated with acitretin. CASE REPORT: A 50-year old women (HIV negative) had developed over 3 months an erythematopapulous plaque under the left orbit. The clinical and histological diagnosis was eosinophilic pustular folliculitis. Successive treatment with cetirizine then indomethacin was ineffective. Acitretin (0.5 mg/kg/d) was then started and led to cure within 1 month. Six weeks after the patient spontaneously stopped the treatment, the lesion recurred at the same localization. Further treatment with isotretinoin (0.5 mg/kg/d) was then given but did not alter progression of the lesion. Acitretin was then reintroduced at the same dose and again produced rapid cure. Acitretin was then tapered off to 10 mg/d then maintained at this dose as lesions reappeared with further dose reduction. DISCUSSION: It is difficult to treat eosinophilic pustular folliculitis because of the random nature of response to different drugs. General corticosteroids, dapsone and indomethacin are classically proposed but with variable success. Isotretinoin is proposed on the hypothesis of a link with sebaceous secretion, but results have been contradictory. This drug was ineffective in our case. Acitretin did however provide very rapid improvement with an efficacy confirmed at reintroduction. This retinoid which does not have the specific action of isotretinoin could affect follicular keratinocytes which have been shown to be activated in this chronic skin disease. SN - 0151-9638 UR - https://www.unboundmedicine.com/medline/citation/9740848/[Ofuji's_eosinophilic_pustular_folliculitis__Efficacy_of_acitretin]_ L2 - http://www.em-consulte.com/retrieve/pii/MDOI-AD-07-1997-124-8-0151-9638-101019-ART68 DB - PRIME DP - Unbound Medicine ER -