Eosinophilic Pustular Folliculitis (Ofuji’s Disease): Efficacy of Isotretinoin

Abstract

The case of a 30-year-old man with a 6-year history of eosinophilic pustular folliculitis (EPF) is reported. Isotretinoin (1 mg/kg/day) led to a dramatic improvement of all the lesions within 2 weeks. The withdrawal of the drug was followed by a recurrence after 10 days of the papulopustular f ollicular and pruritic lesions. Reintroduction of isotretinoin was successful. The benefits of isotretinoin in the treatment of EPF have to the best of our knowledge never been reported previously. The mechanisms underlying this efficacy may involve the inhibition of the eosinophilic chemotactic factors thought to be present in sebaceous lipids and in the stratum corneum of patients suffering from EPF.

Eosinophilic Pustular Folliculitis: Successful Treatment with Interferon-Alpha

“…These include antibiotics [2], local and systemic corticosteroids [2], dapsone [2][3][4], isotretinoin [4,5] as well as UVB phototherapy [6]. Several case re ports described a successful control of the disease by indomethacin [7][8][9].…”

Eosinophilic Pustular Folliculitis (Ofuji’s Disease) with Response to Indomethacin

“…Treat ments used include topical and oral corticosteroids [2], dapsone [2][3][4][5], oxyphenbutazone, aspirin, colchicine, glycyrrhizin [2], minocycline [2,6], isotretinoin [7] as well as indomethacin [8][9][10], The rationale for using indomethacin was suggested by Takematsu and Tagami [11].…”

“…Response to oral and topical corticosteroids is variable [2]. Other treatment modalities reported as effective include dapsone [2][3][4][5], oxyphenbutazone, aspirin, colchicine, glycyrrhizin [2], minocycline [2,6] as well as isotretinoin [7], There have been a few reports of a remarkable effect with indomethacin [8][9][10]. We present 2 patients with eosino philic pustular folliculitis whose skin lesions cleared within days of treatment with indomethacin.…”

Off-label uses of retinoids in dermatology

“…Berbis (1989) reported a case of a 30-year-old man with a 6-year history of eosinophilic pustular folliculitis (EPF). Isotretinoin (1 mg/kg/day) led to a dramatic improvement of all the lesions within 2 weeks.…”

“…Acitretin was then tapered off to 10 mg/d then maintained at this dose as lesions reappeared with further dose reduction. Isotretinoin is proposed on the hypothesis of a link with sebaceous secretion, but results have been contradictory [96,97].…”