Pruritic papular eruption and eosinophilic folliculitis associated with human immunodeficiency virus (HIV) infection: A histopathological and immunohistochemical comparative study

Afonso, Joao Paulo Junqueira Magalhães; Tomimori, Jane; Michalany, Nílceo Schwery; Nonogaki, Suely; Porro, Adriana María

doi:10.1016/j.jaad.2011.11.923

Cited by 23 publications

(23 citation statements)

References 23 publications

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“…In the HIV‐associated cases, degranulating eosinophils and mast cells are observed in the perifollicular area . Immunohistochemically, CD8 + lymphocytes are predominant in the HIV‐associated type …”

Section: Histopathological Findings Of Epfmentioning

confidence: 99%

Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis

Fujiyama

Tokura

2013

The Journal of Dermatology

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Eosinophilic pustular folliculitis (EPF) is an inflammatory disease characterized by repeated pruritic follicular papules and pustules arranged in arcuate plaques, and folliculotropic infiltration of eosinophils. The diagnosis of EPF is occasionally difficult and problematic because EPF may share the clinical appearance and histological findings with other diseases. Moreover, EPF has several clinical subtypes, including the classical type, infantile type and immunosuppression-associated type. Because the therapies of EPF are relatively specific as compared to eczematous disorders, accurate diagnosis is essential for the management of EPF. Clinical differential diagnoses include tinea, acne, rosacea, eczematous dermatitis, granuloma faciale, autoimmune annular erythema, infestations and pustular dermatosis. Histologically, cutaneous diseases with eosinophilic infiltrates can be differentially diagnosed. Follicular mucinosis, mycosis fungoides and other cutaneous T-cell lymphomas are the most important differential diagnoses both clinically and histopathologically. It should be kept in mind particularly that the initial lesions of cutaneous T-cell lymphoma resemble EPF.

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Section: Histopathological Findings Of Epfmentioning

confidence: 99%

Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis

Fujiyama

Tokura

2013

The Journal of Dermatology

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“…The blood eosinophils were found to be low in both groups as in our case study. The difference of the percentage of the eosinophilic infiltrates was also reported to be nonsignificant [7]. The clinical similarity of the lesions to Kaposi’s sarcoma was also noteworthy in this case.…”

Section: Discussionmentioning

confidence: 55%

“…However, we believe that the absence of peripheral eosinophilia in our case might also have been as a result of the previous corticosteroid treatments. In a recently reported comparative study, HIV-related pruritic papular eruption (HIV-PPE) and eosinophilic folliculitis were quantitatively distinguished mainly by the histopathological and immunohistochemical findings [7]. The intense perivascular and diffuse inflammatory infiltration, the tissue mast cell count by toluidine staining and expression levels of CD15 (for eosinophils), CD4 (T helper), and CD7 (pan-T lymphocytes) seen in HIV-EP were reported to be significantly higher than in HIV-PPE.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic panniculitis presenting with Kaposi’s sarcoma-like plaques in a patient who is human immunodeficiency virus positive: a case report

et al. 2012

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IntroductionEosinophilic panniculitis is an unusual type of panniculitis characterized by a prominent infiltration of subcutaneous fat with eosinophils without an exact etiopathogenesis. To the best of our knowledge, up to now eosinophilic panniculitis has been described in only one previous case with human immunodeficiency virus disease in the literature.Case presentationHere we report the case of a 44-year-old Caucasian man, who is human immunodeficiency virus positive, diagnosed with eosinophilic panniculitis. A dermatological examination revealed multiple, confluent Kaposi’s sarcoma-like purple colored, deep plaques and nodules on his right gluteal area and right thigh. The presence of the mixed inflammatory infiltrate of lymphocytes, macrophages, and numerous eosinophils involving both septa and lobules of the subcutis were noted on the histopathological examination. On the basis of all these clinical and histopathological findings the patient was diagnosed with eosinophilic panniculitis. He was given intravenous 60mg/day methylprednisolone for 3 consecutive days a week for 6 months. The lesions resolved almost completely after 6 months.ConclusionThe predominance of T helper-2 subset of T helper cells and the consequential increase in interleukin-5 cytokines accompanying peripheral eosinophilia and high serum immunoglobulin E levels may all be blamed for the development of eosinophilic panniculitis in our case study. As a result, we aim to emphasize that eosinophilic panniculitis should be kept in mind in the differential diagnosis of subcutaneous nodular lesions in patients who are human immunodeficiency virus positive. We also focus on the requirement of histopathological examination for the definitive diagnosis because the clinical features of eosinophilic panniculitis may easily be confused with Kaposi’s sarcoma.

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“…Papulopruritic eruption of HIV may present at any stage of HIV infection. Perivascular mononuclear infiltrates are visible in histological sections …”

Section: Discussionmentioning

confidence: 99%

“…Perivascular mononuclear infiltrates are visible in histological sections. 6 EF is notoriously difficult to treat. HIV-associated EF often responds to antiretroviral therapy, but some patients experience flares with immune reconstitution inflammatory syndrome.…”

Section: Discussionmentioning

confidence: 99%

A persistent itchy eruption

2013

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Pruritic papular eruption and eosinophilic folliculitis associated with human immunodeficiency virus (HIV) infection: A histopathological and immunohistochemical comparative study

Cited by 23 publications

References 23 publications

Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis

Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis

Eosinophilic panniculitis presenting with Kaposi’s sarcoma-like plaques in a patient who is human immunodeficiency virus positive: a case report

A persistent itchy eruption

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