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Immunosuppression-associated eosinophilic folliculitis in Adult
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Immunosuppression-associated eosinophilic folliculitis in Adult

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Contributors: Koraisha Hoosen MBChB, MMed Sci, FCDerm, Anisa Mosam MBChB, MMed, FCDerm, PhD, Ncoza C. Dlova MBChB, FCDerm, PhD, Susan Burgin MD
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Synopsis

Immunosuppression-associated eosinophilic folliculitis : Folliculitis, Forehead, Superior chest, Upper back, Pruritus, EOS increased, Cheeks
Eosinophilic folliculitis (EF) is a chronic, culture-negative folliculitis of unknown etiology. The term "eosinophilic pustular folliculitis" is used interchangeably.

EF is characterized histologically by eosinophilic follicular inflammation. There are several variants:
Immunosuppression-associated EF is more common in males than females. It is usually seen in patients with HIV infection, but it has also been reported to occur in other immunocompromised patients, particularly those with bone marrow or heart transplants, lymphoma, leukemia, or myelodysplastic syndrome. In HIV, EF usually occurs in patients with a CD4 count of less than 300 cells/mm3. EF has also been reported in sanitation workers in Hong Kong from protective gear during the COVID-19 pandemic. 

Clinically, the disorder is characterized by recurrent, usually intensely pruritic papules and pustules in areas often affected by acne vulgaris. Occasionally, a more widespread distribution is seen. EF can be extremely symptomatic and refractory to treatment, but it may spontaneously improve as CD4 counts rise secondary to antiretroviral therapy for HIV. It can also worsen or manifest as part of an immune reconstitution phase.

Codes

ICD10CM:
L73.9 – Follicular disorder, unspecified

SNOMEDCT:
95333004 – Eosinophilic pustular folliculitis

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Last Reviewed:08/28/2017
Last Updated:12/20/2020
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Immunosuppression-associated eosinophilic folliculitis in Adult
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A medical illustration showing key findings of Immunosuppression-associated eosinophilic folliculitis : Folliculitis, Forehead, Superior chest, Upper back, Pruritus, EOS increased, Cheeks
Clinical image of Immunosuppression-associated eosinophilic folliculitis - imageId=388274. Click to open in gallery. caption: 'A close-up of urticarial and excoriated, pink and brown papules on the chest of a patient with AIDS.'
A close-up of urticarial and excoriated, pink and brown papules on the chest of a patient with AIDS.

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