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L’Orphelin JM. An occurrence of eosinophilic folliculitis and alopecia associated with a sustained complete response to mogamulizumab in Sézary syndrome: a case report. Ther Adv Hematol 2024; 15:20406207241235777. [PMID: 38456078 PMCID: PMC10919142 DOI: 10.1177/20406207241235777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
Mogamulizumab is a monoclonal antibody that binds to C-C chemokine receptor 4 (CCR4), initiating antibody-dependent cellular cytotoxicity. CCR4 is highly expressed in the cutaneous T-cell lymphoma subtypes mycosis fungoides and Sézary syndrome (SS), and mogamulizumab has been shown to be effective in patients with these conditions who were refractory to at least one prior systemic treatment. One of the more common adverse events encountered with mogamulizumab is rash, which may mimic disease progression and lead to premature discontinuation. Moreover, there has been some evidence to suggest that mogamulizumab-associated rash (MAR) is associated with improved outcomes in some patients, particularly those with SS. This report presents the case of a 72-year-old woman with SS, which manifested with macular and papular lesions and abnormal blood cytometry, who was treated with mogamulizumab after failure of bexarotene and photopheresis combination therapy. She achieved a complete response (CR), but experienced lymphopenia associated with histologically proven eosinophilic folliculitis (EF) of the scalp and alopecia. The EF responded well to initial topical corticosteroids, defined by regression of erythema and pustular involvement and reduction in pruritus-like symptoms, but without hair regrowth. Mogamulizumab was withdrawn after 32 cycles, but CR was maintained. To date, EF persists in the form of diffuse erythema without pustules or pruritus. A link between cluster of differentiation 4 lymphopenia and EF has previously been established; therefore, EF should be considered in patients who develop rash and lymphopenia while receiving treatment with mogamulizumab. MAR has been associated with clinical response to mogamulizumab, and this case report adds to the evidence that EF may also be associated with sustained clinical response following treatment cessation. However, regular monitoring is required to prevent a relapse of SS. Prospective studies are needed to confirm whether such an association between EF and CR following mogamulizumab exists.
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Affiliation(s)
- Jean-Matthieu L’Orphelin
- Department of Dermatology, Caen-Normandie University Hospital, Avenue de la Côte de Nacre, 14003 Caen, France
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Li Y, Wu M, Hu X, Chen G, Yao X, Zhou X, Lu J. The Role of Reflectance Confocal Microscopy in the Diagnosis and Therapeutic Evaluation of Rare Disease Eosinophilic Pustular Folliculitis. Clin Cosmet Investig Dermatol 2023; 16:2309-2314. [PMID: 37649569 PMCID: PMC10464821 DOI: 10.2147/ccid.s423973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
Eosinophilic pustular folliculitis (EPF) is a rare skin disease for which the gold standard of diagnosis relies on the invasive examination of pathological tissue sections. However, due to its invasive nature, many patients tend to refuse this diagnostic test. In such situations, reflectance confocal microscopy (RCM) can be a valuable diagnosis tool. Reflectance confocal microscopy (RCM) can accurately identify the specific structures for biopsy and provide objective imaging data to evaluate clinical symptoms following treatment. Therefore, we present a case report demonstrating the utility of RCM in diagnosing and assessing the treatment of the rare disease EPF for reference.
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Affiliation(s)
- Yuan Li
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Miaoting Wu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xiaohuan Hu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Gaihe Chen
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xiaojuan Yao
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xin Zhou
- Medical Administration Department, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Jiejie Lu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
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Shi W, Lu Y, Zhou F, He H, Jiang J, Xue X. Infantile Eosinophilic Pustular Folliculitis in a Child Aged 7 Years: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:717-720. [PMID: 36987401 PMCID: PMC10040162 DOI: 10.2147/ccid.s404316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
Eosinophilic pustular folliculitis (EPF) is a rare, chronic, itchy, aseptic disease. Although most cases of infantile EPF (I-EPF) are detected in infants, we found that a 7-year-old child with I-EPF, who received treatment with oral azithromycin in combination with topical narrow bound Ultra Violet B light (NB-UVB) irradiation, with no recurrence at follow-up. Our experience with the successful treatment of this patient can provide a reference for more pediatric patients.
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Affiliation(s)
- Weikang Shi
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Department of Dermatology, Jinhua Maternal & Child Health Care Hospital, Jinhua, People’s Republic of China
| | - Yuwen Lu
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Fangyan Zhou
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Huiyi He
- Department of Dermatology, Ruian People’s Hospital, Wenzhou, People’s Republic of China
| | - Jicong Jiang
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Ximao Xue
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Correspondence: Ximao Xue, Email
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Hashida Y, Higuchi T, Nakajima S, Nakajima K, Ujihara T, Kabashima K, Sano S, Daibata M. Human Polyomavirus 6 Detected in Cases of Eosinophilic Pustular Folliculitis. J Infect Dis 2020; 223:1724-1732. [PMID: 32989462 DOI: 10.1093/infdis/jiaa607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Human polyomaviruses (HPyVs) have been associated with several cutaneous inflammatory conditions. More investigation is needed to identify further presentations of cutaneous pathology associated with HPyVs. Our aim was to investigate the possible association of skin-tropic HPyVs with folliculitis, particularly eosinophilic pustular folliculitis (EPF). METHODS This study included 55 Japanese patients, comprising 13 patients with EPF and 42 patients with suppurative folliculitis. HPyV DNAs were detected by quantitative polymerase chain reaction. Expression of viral antigen and geographically related viral genotypes were also assessed. RESULTS Human polyomavirus 6 (HPyV6) DNA was found in 9 of 13 (69%) patients with EPF, a rate significantly higher than that found in suppurative folliculitis (1/42; 2%). Of the 7 HPyV6 DNA-positive EPF specimens analyzed, 4 were positive for HPyV6 small tumor antigen. All the HPyV6 strains detected in this study were of the Asian/Japanese genotype. CONCLUSIONS The predominant detection of HPyV6 DNA and the expression of viral antigen suggest a possible association between HPyV6 infection and EPF in a subset of patients. Worldwide studies are warranted to determine whether Asian/Japanese genotype HPyV6 is associated preferentially with the incidence and pathogenesis of this eosinophil-related skin disease that has an ethnic predilection for the East Asian population.
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Affiliation(s)
- Yumiko Hashida
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tomonori Higuchi
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Saeko Nakajima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Takako Ujihara
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan.,Science Research Center, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Singapore Immunology Network and Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masanori Daibata
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
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Kinoshita Y, Kono T, Ansai SI, Saeki H. An aggressive case of granulomatous eosinophilic pustular folliculitis on the face. JAAD Case Rep 2019; 5:237-239. [PMID: 30847380 PMCID: PMC6389553 DOI: 10.1016/j.jdcr.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yuri Kinoshita
- Department of Dermatology, Nippon Medical School Chiba Hokuso Hospital, Chiba, Japan
- Correspondence to: Yuri Kinoshita, MD, MSc, Department of Dermatology, Nippon Medical School Chiba Hokuso Hospital, 1715 Yabukari, Inzai, Chiba, 270-1613, Japan.
| | - Takeshi Kono
- Department of Dermatology, Nippon Medical School Chiba Hokuso Hospital, Chiba, Japan
| | - Shin-ichi Ansai
- Division of Dermatology and Dermatopathology, Nippon Medical School, Musashi Kosugi Hospital, Kawasaki, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
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de Brito FF, Martelli ACC, Cavalcante MLLL, Pinto ACVD, Itimura G, Soares CT. Ofuji disease: a rare dermatosis and its challenging therapeutic approach. An Bras Dermatol 2016; 91:646-648. [PMID: 27828641 PMCID: PMC5087226 DOI: 10.1590/abd1806-4841.20164778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/20/2015] [Indexed: 11/21/2022] Open
Abstract
Eosinophilic pustular folliculitis (EPF) or Ofuji disease is a rare dermatosis, prone to recurrence and chronicity. The peak incidence occurs in the third decade of life and its exact etiology remains unknown. Evidence suggests that the expression of adhesion molecules and the production of cytokines activate the follicular unit, but the stimulus that triggers these changes remains unclear. The three clinical variants reported in the literature include classic EPF, immunosuppression-associated EPF, and infancy-associated EPF. We report a case of eosinophilic pustular folliculitis with peculiar epidemiological characteristics, which represents a challenging therapeutic scenario.
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Sabater-Marco V, Escutia-Muñoz B, Botella-Estrada R. Eosinophilic follicular reaction induced byDemodex folliculorummite: a different disease from eosinophilic folliculitis. Clin Exp Dermatol 2015; 40:413-5. [DOI: 10.1111/ced.12566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2014] [Indexed: 12/01/2022]
Affiliation(s)
- V. Sabater-Marco
- Department of Pathology; University General Hospital; Valencia Spain
| | - B. Escutia-Muñoz
- Department of Dermatology; University Hospital La Fe; Valencia Spain
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Ghahramani GK, Abraham NF, Burkemper NM, Frater JL, Hurley MY. Recurrent pustules on the scalp of an infant. J Cutan Pathol 2012. [DOI: 10.1111/cup.12000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Grant K. Ghahramani
- Department of Dermatology; Saint Louis University School of Medicine; Saint Louis Missouri
| | - Nina F. Abraham
- Department of Dermatology; Saint Louis University School of Medicine; Saint Louis Missouri
| | - Nicole M. Burkemper
- Department of Dermatology; Saint Louis University School of Medicine; Saint Louis Missouri
| | - John L. Frater
- Department of Pathology & Immunology; Washington University School of Medicine; Saint Louis Missouri
| | - M. Yadira Hurley
- Department of Dermatology; Saint Louis University School of Medicine; Saint Louis Missouri
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Razera F, Olm GS, Bonamigo RR. Dermatoses neutrofílicas: parte II. An Bras Dermatol 2011; 86:195-209; quiz 210-1. [DOI: 10.1590/s0365-05962011000200001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Indexed: 11/22/2022] Open
Abstract
Neste artigo são abordadas as dermatoses neutrofílicas, complementando o artigo anterior (parte I). São apresentadas e comentadas as seguintes dermatoses: pustulose subcórnea de Sneddon-Wilkinson, dermatite crural pustulosa e atrófica, pustulose exantemática generalizada aguda, acroder matite contínua de Hallopeau, pustulose palmoplantar, acropustulose infantil, bacteride pustular de Andrews e foliculite pustulosa eosinofílica. Uma breve revisão das dermatoses neutrofílicas em pacientes pediátricos também é realizada.
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Affiliation(s)
- Fernanda Razera
- Universidade Federal de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Hospital Mãe de Deus, Brasil
| | - Gislaine Silveira Olm
- Hospital Mãe de Deus, Brasil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brasil
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Scavo S, Magro G, Caltabiano R. Erythematous and edematous eruption of the face. Eosinophilic pustular folliculitis. Int J Dermatol 2010; 49:975-7. [PMID: 20883260 DOI: 10.1111/j.1365-4632.2010.04491.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: 12/01/2022]
Affiliation(s)
- Sebastiano Scavo
- Section of Dermatology, Department of Medicine and Surgery, University of Catania, Catania, Italy
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