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A Case of Eosinophilic Pustular Folliculitis since Birth. CHILDREN-BASEL 2021; 8:children8010030. [PMID: 33430336 PMCID: PMC7825765 DOI: 10.3390/children8010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
A newborn male infant presented with multiple pustules and erosions with erythema involving his scalp and forehead at birth. One week after birth, new pustules continued to appear, forming crusted, ring-shaped plaques with pigmentation. Tests for possible pathogens were negative. Tzanck smear and skin biopsy revealed pustules beneath the stratum corneum at sites corresponding to hair follicles, which contained eosinophils and neutrophils. Taken together, a diagnosis of eosinophilic pustular folliculitis (EPF) was made. The pustules on the head disappeared rapidly with topical corticosteroid treatment, although new eruptions were still observed on the trunk about one month after birth. To our knowledge, only two cases of EPF since birth have been reported to date. Here, we also discuss the differential diagnosis of noninfectious pustular diseases at birth, including erythema toxicum neonatorum and transient neonatal pustular melanosis. These diseases, and EPF, may present with very similar clinical symptoms at birth, and the Tzanck test or biopsy may be required for differential diagnosis.
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O'Brennan EA, Shukla R, Parslew RAG. Cropped studded pustules in an infant. Clin Exp Dermatol 2019; 44:912-914. [PMID: 30604461 DOI: 10.1111/ced.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/27/2022]
Affiliation(s)
- E A O'Brennan
- Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - R Shukla
- Department of Paediatric Histopathology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - R A G Parslew
- Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
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Reginatto FP, Villa DD, Cestari TF. Benign skin disease with pustules in the newborn. An Bras Dermatol 2017; 91:124-34. [PMID: 27192509 PMCID: PMC4861557 DOI: 10.1590/abd1806-4841.20164285] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 03/03/2015] [Indexed: 11/29/2022] Open
Abstract
The neonatal period comprises the first four weeks of life. It is a period of
adaptation where the skin often presents several changes: transient lesions,
resulting from a physiological response, others as a consequence of transient
diseases and some as markers of severe disorders. The presence of pustules in
the skin of the newborn is always a reason for the family and for the assisting
doctor to be worried, since the newborn is especially vulnerable to bacterial,
viral or fungal infection. However, the majority of neonatal skin pustules is
not infectious, comprising the benign neonatal pustulosis. Benign neonatal
pustuloses are a group of clinical disease characterized by pustular eruptions
in which a contagious agent is not responsible for its etiology. The most common
ones are erythema toxicum neonatorum, the transient neonatal pustular melanosis
and the benign cephalic pustulosis. These dermatoses are usually benign,
asymptomatic and self-limited. It is important that the dermatologist and the
neonatologist can identify benign and transient lesions, those caused by
genodermatoses, and especially differentiate between neonates with systemic
involvement from those with benign skin lesions, avoiding unnecessary diagnostic
tests and worries.
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Affiliation(s)
| | - Damie De Villa
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
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Porriño-Bustamante ML, Sánchez-López J, Aneiros-Fernández J, Burkhardt P, Naranjo-Sintes R. Recurrent pustules on an infant's scalp with neonatal onset. Int J Dermatol 2015; 55:505-8. [PMID: 26266955 DOI: 10.1111/ijd.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Pilar Burkhardt
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
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Abstract
Neonatal pustular eruption is a group of disorders characterized by various forms of pustulosis seen in first 4 weeks of life. Its presentation is often similar with some subtle differences, which can be further established by few simple laboratory aids, to arrive at a definite diagnosis. Given their ubiquitous presentation, it is sometimes difficult to differentiate among self-limiting, noninfectious, pustular dermatosis such as erythema toxicum neonatorum, transient neonatal pustular melanosis, miliaria pustulosa, etc., and potentially life threatening infections such as herpes simplex virus and varicella zoster virus infections. This review article tries to address the chronological, clinical, morphological, and histological differences among the various pustular eruptions in a newborn, in order to make it easier for a practicing dermatologist to diagnose and treat these similar looking but different entities of pustulation with a clear demarcation between the physiological benign pustular rashes and the infectious pustular lesions.
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Affiliation(s)
- Sangita Ghosh
- Department of Skin and VD, PGIMS, Rohtak, Haryana, India
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Tucker M, Ramolia P, Wells MJ. JAAD Grand Rounds. Neonate with extensive papulovesicles. J Am Acad Dermatol 2013; 68:877-9. [PMID: 23602179 DOI: 10.1016/j.jaad.2011.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 04/28/2011] [Indexed: 10/26/2022]
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Hernández-Martín Á, Nuño-González A, Colmenero I, Torrelo A. Eosinophilic pustular folliculitis of infancy: A series of 15 cases and review of the literature. J Am Acad Dermatol 2013; 68:150-5. [DOI: 10.1016/j.jaad.2012.05.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/13/2012] [Accepted: 05/22/2012] [Indexed: 11/24/2022]
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Aquino LL, Wu JJ, Dyson SW, Metz BJ. Erythematous papules and pustules on the scalp. Pediatr Dermatol 2009; 26:195-6. [PMID: 19419471 DOI: 10.1111/j.1525-1470.2009.00900.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lisa L Aquino
- Department of Internal Medicine, University of California, Irvine, California, USA
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Abstract
As erupções vesicopustulosas neonatais compreendem um grupo de desordens que surgem nas primeiras quatro semanas de vida. Apresentam extensa relação de diagnósticos diferenciais e, na maioria das vezes, podem ser identificadas clinicamente ou mediante recursos laboratoriais simples. Os dermatologistas devem reconhecer esses quadros cutâneos e, sobretudo, saber diferenciá-los de outras dermatoses graves e potencialmente fatais.
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Abstract
In the newborn, there exists a wide spectrum of pustular skin diseases. These range from transitory, benign adaptation disorders up to systemic, life threatening illnesses. In 30-60% of newborns pustules are observed in association with the relatively harmless Erythema toxicum, the origin of which is still unknown today. It is necessary to differentiate this from the pustular diseases which may be of infectious or non-infectious nature and which require therapy. Typical pathogens include Malassezia furfur, Staphylococci, Streptococci, Candida spp. and the herpes virus group.
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MESH Headings
- Diagnosis, Differential
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/therapy
- Practice Guidelines as Topic
- Practice Patterns, Physicians'
- Pyoderma/congenital
- Pyoderma/diagnosis
- Pyoderma/epidemiology
- Pyoderma/therapy
- Skin Diseases, Infectious/congenital
- Skin Diseases, Infectious/diagnosis
- Skin Diseases, Infectious/epidemiology
- Skin Diseases, Infectious/therapy
- Skin Diseases, Papulosquamous/congenital
- Skin Diseases, Papulosquamous/diagnosis
- Skin Diseases, Papulosquamous/epidemiology
- Skin Diseases, Papulosquamous/therapy
- Treatment Outcome
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Brazzelli V, Barbagallo T, Prestinari F, Ciocca O, Vassallo C, Borroni G. HIV seronegative eosinophilic pustular folliculitis successfully treated with doxicycline. J Eur Acad Dermatol Venereol 2004; 18:467-70. [PMID: 15196164 DOI: 10.1111/j.1468-3083.2004.00948.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Eosinophilic pustular folliculitis (EPF) is an unusual disease, first described in adult East Asians in 1970 by Ofuji. It is characterized by follicular papules and pustules tending to coalesce and form plaques involving the trunk, face and extremities. In recent years, it has been often associated with human immunodeficiency virus (HIV) infection or with immunosuppressed and/or oncohaematological patients. EPF has been described in immunocompetent adult caucasian patients only occasionally. The diagnosis requires clinical and microbiological features such as sterile folliculitis and histopathological findings characterized by folliculitis and perifolliculitis with eosinophilic infiltrate. We describe an HIV seronegative caucasian male with EPF, allergic to non-steroidal anti-inflammatory drugs and indomethacin, treated with oral doxicycline. The treatment led to the complete remission of the lesions within 2 months.
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Affiliation(s)
- V Brazzelli
- Clinica Dermatologica, Università di Pavia, IRCCS-Policlinico S. Matteo, Piazza C. Golgi 2, 27100 Pavia, Italy.
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Rodríguez-Díaz E, Álvarez-Cuesta C, Blanco S, Galache C, Requena C. Dermatosis eosinofílicas (y II). ACTAS DERMO-SIFILIOGRAFICAS 2003. [DOI: 10.1016/s0001-7310(03)76659-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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