Recalcitrant eosinophilic pustular folliculitis of Ofuji with palmoplantar pustulosis: dramatic response to narrowband UVB phototherapy.

Type:Uv phototherapy   Time:2014-11-26 15:24:43
Recalcitrant eosinophilic pustular folliculitis of Ofuji with palmoplantar pustulosis: dramatic response to narrowband UVB 

phototherapy.
Lim HL1, Chong WS.
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Abstract
Eosinophilic pustular folliculitis of Ofuji is a recalcitrant disease typified by non-infective eosinophilic spongiosis 

involving the infundibular region of the hair follicle. We present a case of a 49-year-old Chinese man with known 

palmoplantar pustulosis and acrodermatitis continua of Hallopeau which was promptly resolved with methotrexate therapy. He 

returned with an erythematous papulopustular eruption with coalescence to annular plaques, occurring over the face, chest and 

back with active palmoplantar pustulation. Histology from skin biopsy of the palmar lesion was in keeping with palmoplantar 

psoriasis, while biopsy of the facial and truncal lesions revealed florid perifollicular eosinophilic congregation diagnostic 

of eosinophilic pustular folliculitis of Ofuji. Indomethacin was initiated with partial improvement of lesions with cyclical 

flares. A trial of narrowband ultraviolet-B phototherapy at a frequency of thrice weekly achieved sustained clearance of both 

eosinophilic pustular folliculitis and palmoplantar lesions. Indomethacin was tailed down and eventually discontinued with 

maintenance of narrowband ultraviolet-B therapy; this achieved successful control of the disease.