Eosinophilic pustular folliculitis pathology

Authors: Dr Achala Liyanage, Dermatology Fellow, Waikato Hospital, Hamilton, New Zealand; Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand. Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, January 2015.

Eosinophilic pustular folliculitis is a heterogeneous group of disorders consists of five clinical subsets including classic Ofuji disease, HIV-associated, paediatric, fungal and parasite-associated, and a miscellaneous group. All have 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.

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

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