Eosinophilic pustular folliculitis induced by chemotherapy

Laing, Mary; Laing, Tereze Ann; Mulligan, Niall; Keane, Fergus

doi:10.1016/j.jaad.2005.10.048

Cited by 24 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While classically reported in the setting of HIV, drugassociated eosinophilic pustular folliculitis (EPF) has been described with minocycline, chemotherapeutic agents [85] and carbamazepine [86]. Allopurinol is known to cause a generalized pustular follicular eruption with a dense perifollicular inflammatory eosinophilic infiltrate [87].…”

Section: Eosinophilic Pustular Folliculitismentioning

confidence: 99%

Eosinophilic Drug Allergy

Kuruvilla

Khan

2015

Clinic Rev Allerg Immunol

View full text Add to dashboard Cite

While peripheral or tissue eosinophilia may certainly characterize drug eruptions, this feature is hardly pathognomonic for a medication-induced etiology. While delayed drug hypersensitivity reactions with prominent eosinophilic recruitment have been typically classified as type IVb reactions, their pathophysiology is now known to be more complex. Eosinophilic drug reactions have a diversity of presentations and may be benign and self-limited to severe and life-threatening. The extent of clinical involvement is also heterogeneous, ranging from isolated peripheral eosinophilia or single organ involvement (most often the skin and lung) to systemic disease affecting multiple organs, classically exemplified by drug-reaction with eosinophilia and systemic symptoms (DRESS). The spectrum of implicated medications in the causation of DRESS is ever expanding, and multiple factors including drug metabolites, specific HLA alleles, herpes viruses, and immune system activation have been implicated in pathogenesis. Due to this complex interplay of various factors, diagnostic workup in terms of skin and laboratory testing has not been validated. Similarly, the lack of controlled trials limits treatment options. This review also describes other localized as well as systemic manifestations of eosinophilic disease induced by various medication classes, including their individual pathophysiology, diagnosis, and management. Given the multitude of clinical patterns associated with eosinophilic drug allergy, the diagnosis can be challenging. Considerable deficits in our knowledge of these presentations remain, but the potential for severe reactions should be borne in mind in order to facilitate diagnosis and institute appropriate management.

show abstract

Section: Eosinophilic Pustular Folliculitismentioning

confidence: 99%

Eosinophilic Drug Allergy

Kuruvilla

Khan

2015

Clinic Rev Allerg Immunol

View full text Add to dashboard Cite

show abstract

“…Drug-induced eosinophilic pustular folliculitis (EPF) is characterised clinically by the repeated occurrence of crops of pruritic follicular papulopustules with a tendency to form annular configurations, mainly on the scalp, face, trunk and extensor surfaces of the arms 133 – 135. The implicated drugs include anti-cancer agents (cyclophosphamide, methotrexate, 5-fluorouracil), minocycline, carbamazepine, indeloxazine hydrochloride, allopurinol and prolonged corticosteroid treatment 133 – 138.…”

Section: Predominantly Follicular/perifollicular Drug Reactionsmentioning

confidence: 99%

“…The implicated drugs include anti-cancer agents (cyclophosphamide, methotrexate, 5-fluorouracil), minocycline, carbamazepine, indeloxazine hydrochloride, allopurinol and prolonged corticosteroid treatment 133 – 138. The pathogenesis of EPF is unknown.…”

Section: Predominantly Follicular/perifollicular Drug Reactionsmentioning

confidence: 99%

“…The pathogenesis of EPF is unknown. A role for interleukin 5, cyclo-oxygenase-generated metabolites, intercellular adhesion molecule 1, and eosinophil chemotactic factor has been proposed 133 – 135. Histologically, drug-induced EPF is similar to classic EPF.…”

Section: Predominantly Follicular/perifollicular Drug Reactionsmentioning

confidence: 99%

“…Histologically, drug-induced EPF is similar to classic EPF. There is follicular epithelial spongiosis with eosinophil microabscess formation, variable lymphocytic trafficking and a perifollicular, perivascular lympho-eosinophilic infiltrate 133 138. Heightened awareness of drug-induced EPF is critical as drug withdrawal is the mainstay of treatment, unlike classic EPF, in which protracted complex treatment modalities are required to control the disease 136…”

Section: Predominantly Follicular/perifollicular Drug Reactionsmentioning

confidence: 99%

See 2 more Smart Citations

Drug-induced cutaneous pathology

Ramdial¹,

Naidoo²

2009

J Clin Pathol

View full text Add to dashboard Cite

Drug-induced cutaneous rashes, whether confined to the skin or part of a systemic disease, are characterised by a spectrum of inflammatory disease patterns that include perivascular dermatitis, nodular and diffuse dermatitis, vesiculobullous lesions, pustular eruptions, sclerodermoid reactions, vasculitis, folliculitis/perifolliculitis and panniculitis. While a single drug can elicit a range of reaction patterns, no reaction pattern is specific for a particular drug. Although the temporal link between initiation of drug therapy and the onset of the drug rash is critical to the diagnosis, drug reactions may also occur during the course of chronic drug ingestion. Clues to the drug-induced nature of the cutaneous eruption include the presence of overlapping histological reaction patterns and incongruent clinical and histopathological features. While eosinophils are an important tell-tale sign of a drug-induced reaction, they may also be conspicuous in skin rashes devoid of a drug association. Furthermore, eosinophils may be sparse or absent in some drug exanthems. Heightened awareness of the mimicry of a wide spectrum of cutaneous pathology by an ever-increasing range of therapeutic agents is pivotal to the diagnosis of drug-induced skin pathology.

show abstract