Eosinophilic Pustular Folliculitis: Successful Treatment with Interferon-Alpha

Mohr, Charles; Schütte, B; Hildebrand, A.; Luger, T.A.; Kolde, G.

doi:10.1159/000246558

Cited by 18 publications

(15 citation statements)

References 8 publications

(12 reference statements)

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“…This similar combination has been reported to be successful in a previous case report. This observation further supports the hypothesis that EPF is a result of underlying immune dysregulation 14,15,19,20 rather than secondary to an infective process. 4 It is interesting to note that, apart from indomethacin, controlled-release ketoprofen was used in three of our patients with favourable results.…”

Section: Discussionsupporting

confidence: 84%

“…It was interesting to note that involvement of the forehead, mandibular and nasal areas were less commonly observed. 15 It is also noteworthy that many of our patients had been treated unsuccessfully with various therapeutic agents prior to their diagnosis of EPF, including topical and oral corticosteroids, topical and systemic antifungal agents, systemic antibiotics such as erythromycin and tetracycline, and isotretinoin. Pruritus was a common symptom reported in 78.3% of our patients, compared with 42% of patients reported in another series.…”

Section: Discussionmentioning

confidence: 90%

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Eosinophilic pustular folliculitis (Ofuji's disease) in Singapore: A review of 23 adult cases

2003

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The case records of 23 patients with classic eosinophilic pustular folliculitis (EPF), or Ofuji's disease, seen at the National Skin Centre in Singapore, from 1990 to 2001 were reviewed. All patients had clinical and histopathological findings consistent with EPF. There were eight men and 15 women (ratio 1:1.6). The mean age at presentation was 35 years. There was a marked predilection for Chinese patients (87%), with a racial distribution of 20:2:1 of Chinese, Malay and Indian patients, respectively. The most frequent site of occurrence was the face, particularly over both cheeks. The majority of patients (90%) treated with oral indomethacin had a good response within 2-4 weeks. Relapses were frequent in 82.6% of patients and maintenance with indomethacin or ketoprofen was beneficial. Eosinophilic pustular folliculitis is a rare but important disease entity presenting with recurrent indurated erythematous papulopustules and plaques on the face. Increased awareness of this condition is important as it can mimic many other conditions presenting as red plaques on the face.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 90%

Eosinophilic pustular folliculitis (Ofuji's disease) in Singapore: A review of 23 adult cases

2003

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“…The typical clinical course of eosinophilic pustular folliculitis includes spontaneous remission and exacerbations 5 . Reported disease activity has varied from weeks to years, 3–12 but to our knowledge no fatal cases have been described.…”

Section: Discussionmentioning

confidence: 95%

“…Treatment of EPF is difficult because the underlying pathogenic mechanism is unknown. Various case reports have described successful control of disease activity by isotretinoin, 6 indomethacin, 7 cyclosporin, 8 Re‐PUVA, 9 oral corticosteroids, 5,10 dapsone 5 and interferon therapy 11 . However, no treatment modality has been reported to be consistently effective in this disease.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic pustular folliculitis

Majamaa

Vaalasti

Vaajalahti

et al. 2002

Acad Dermatol Venereol

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“…IFN-α therapy has proven effective in the treatment of these lesions [19, 23, 63], although in 1 reported case [23] there was temporary worsening of lesions. In other reports, IFN-α has controlled other skin lesions (pruritic papules, nodules, plaques) associated with HES [16, 64] and has been effective in the treatment of eosinophilic pustular folliculitis (Ofuji’s disease) [65]. …”

Section: Organ System Response To Ifn-αmentioning

confidence: 99%

Interferon Treatment for Hypereosinophilic Syndromes and Systemic Mastocytosis

Butterfield¹

2005

Acta Haematol

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Hypereosinophilic syndromes (HES) and systemic mastocytosis (SMCD) are heterogeneous disorders with clinical symptoms from local and remote effects of excessive proliferation of eosinophils and mast cells, respec tively. Interferon α (IFN-α), alone or in combination with other medications, can be a useful, and at times life-saving, treatment for patients with HES. Receptors for IFN-α are present on eosinophils, and clinical benefits are due to its effect on eosinophil proliferation, migration, activation, and survival. These effects are likely mediated through multiple pathways including, but not limited to, inhibition of eosinophil colony-forming cells, upregulation of IFN-γ synthesis, and inhibition of production of eosinophil-active cytokines by T cells, mast cells, and mononuclear cells. IFN-α has been life-saving for patients with intractable HES that were resistant to prednisone, hydroxyurea, and other agents. Resistance to the eosinopenic effect of IFN-α does not develop and the dose of IFN-α necessary to maintain control of eosinophilia often decreases with time. The combination of IFN-α and hydroxyurea is very useful and allows dosage reduction of IFN-α and better control of hypereosinophilia than with either agent alone. The efficacy of IFN-α for treatment of SMCD has been more difficult to establish, with both favorable and unfavorable results reported. The disparate results may have resulted from the small number of patients with SMCD treated with IFN-α, the use of various criteria for a ‘successful’ treatment outcome, short duration of treatment and follow-up, and the use of modest dosages. In reported series, side effects from IFN-α have frequently been dose-limiting. IFN-α improves many of the clinical symptoms of SMCD including dermatological, hematological, gastrointestinal, and systemic symptoms associated with histamine release. IFN-α has a beneficial effect on skeletal symptoms because of its ability to increase bone density and reduce painful episodes from vertebral fractures. No consistent improvement in bone marrow infiltration by mast cells has been demonstrated except in a recent study employing high dosages of IFN-α. A beneficial effect from the combination of IFN-α and prednisone has been reported for several patients, suggesting that combined use of these two medications may provide synergism in treatment outcomes.

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Eosinophilic Pustular Folliculitis: Successful Treatment with Interferon-Alpha

Cited by 18 publications

References 8 publications

Eosinophilic pustular folliculitis (Ofuji's disease) in Singapore: A review of 23 adult cases

Eosinophilic pustular folliculitis (Ofuji's disease) in Singapore: A review of 23 adult cases

Eosinophilic pustular folliculitis

Interferon Treatment for Hypereosinophilic Syndromes and Systemic Mastocytosis

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