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Infundibulofolliculitis - Skin
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Infundibulofolliculitis - Skin

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Contributors: Vimal Prajapati MD, Ben Barankin MD, Jeffrey D. Bernhard MD, Paul Kelly MD, Lowell A. Goldsmith MD, MPH, Lynn McKinley-Grant MD, Aída Lugo-Somolinos MD
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Synopsis

Infundibulofolliculitis, also known as disseminate and recurrent infundibulofolliculitis, and Hitch and Lund disease, is an uncommon idiopathic skin disorder characterized by the sudden onset of skin-colored follicular-based papules occurring most frequently on the trunk and proximal extremities of young adult males of African descent. Children, females, and individuals of other races/ethnicities can also be affected, albeit less frequently. The eruption can be intensely pruritic and is often self-limited, although lesions may persist for months to years before resolution. Recurrent remissions and exacerbations can occur in some patients. Various treatment options are available. However, this condition is often resistant to treatment.

Codes

ICD10CM:
L73.8 – Other specified follicular disorders

SNOMEDCT:
81856009 – Infundibulofolliculitis

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Differential Diagnosis & Pitfalls

  • Papular eczema – Pruritic follicular-based papules occur on flexural aspects of extremities and neck in individuals with darker skin tones. Onset is during infancy or childhood. History of atopy.
  • Folliculitis (any type) – Characterized by follicular-based papules and pustules and erythema.
  • Lichen nitidus – Papules are nonfollicular, more shiny, and flat-topped.
  • Keratosis pilaris – Occurs with much greater frequency, has more gradual onset, preferentially affects the upper and extensor aspects of arms and legs, often has seasonal variation (improves in summer, worsens in winter), and typically not pruritic. Follicular-based papules have more prominent central keratinous plug.
  • Lichen spinulosus – Follicular-based papules occur in circumscribed plaques and have more prominent central keratinous plug.
  • Pityriasis rubra pilaris – Follicular-based hyperkeratotic papules that spread in a cephalocaudal direction and other characteristic findings including scaly orange-red plaques (with "islands of sparing") and palmoplantar keratoderma.
  • Phrynoderma (hypovitaminosis A, or vitamin A deficiency) – Rare in developed countries except in the setting of intestinal malabsorption or anorexia nervosa. Associated systemic findings are often present.
  • Darier disease – Characterized by follicular and nonfollicular crusted, keratotic, erythematous or erythematous-to-brown papules that often coalesce to form larger papillomatous plaques, most often involving the seborrheic areas of the body. Characteristic nail findings can also be present.

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Therapy

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Last Updated: 05/21/2015
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Infundibulofolliculitis - Skin
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Infundibulofolliculitis : Brown color, Follicular configuration, Primarily truncal, Pruritus, Smooth papules
Clinical image of Infundibulofolliculitis
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