Eosinophilic folliculitis
Introduction
Eosinophilic folliculitis (ee-ow-suh-nuh-fi-luhk fo-luh-kyoo-lai-tuhs) or infantile eosinophilic pustular folliculitis is a rare skin condition that causes itchy pustules (pimples), usually on the head of babies.
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Red spotty rash on the chest in a child with eosinophilic folliculitis
Who gets it?
Children between the age of 6 months to 3 years can get eosinophilic folliculitis. Boys are four times more likely affected than girls.
In adults it is sometimes called Ofuji disease and is usually a sign of underlying health problem such as low immune function, due to HIV infection, cancer or certain medications. This is NOT the case in children. Children with eosinophilic folliculitis are usually completely healthy and well, apart from having this rash.
What causes it?
The exact cause of eosinophilic folliculitis is unknown. Some scientists believe that the presence of a hair mite called demodex folliculorum or fungus called malassezia can cause the condition. But these bugs are commonly present on the skin of healthy babies who do not get eosinophilic folliculitis. It has also been suggested that it could be caused by cells of the immune system called eosinophils attacking hair follicles.
What does it look and feel like?
Looks like…
Eosinophilic folliculitis looks like red or white pus filled pimples with a red base around hair follicles. It can also look like acne.
It usually occurs on the scalp and face, but can occur on the arms and legs.
Feels like…
Skin can become bumpy.
It is usually itchy.
What tests might be needed?
A dermatologist may perform a skin biopsy where they take a tiny peice of your child's skin for testing under the microscope, if eosinophilic folliculitis is deemed a likely diagnosis. The biopsy usually shows immune cells called eosinophils surrounding hair follicles. Sometimes a blood test is done to look for increased eosinophils in the blood.
What treatments are available?
What can I do?
Continue to feed and look after your child as normal. Simple moisturisers and avoiding irritants such as soaps and detergents may assist in relieving the condition.
Medical therapies
All medical therapies for this condition should be prescribed by a doctor, usually a dermatologist.
Creams: Prescription and non-prescription creams can assist in controlling eosinophilic folliculitis. These include moisturisers and steroid creams. Your child’s doctor will tell you about the options that are best for your child.
What happens after treatment?
Skin lesions usually clear up with a course of steroid cream, sometimes this can take up to 6-8 weeks. It is common for children to experience ongoing flares that require repeat treatment up to the age of three or older.
What support is available?
Your GP and dermatologist will work together to look after your child and improve their eosinophilic folliculitis. The NIH rare diseases website https://rarediseases.info.nih.gov/diseases/8534/eosinophilic-pustular-folliculitis may provide you and your family with support/information.
Authors/Reviewers:
Author: Dr Thomas Guy
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
