Infantile Eosinophilic Pustular Folliculitis

BACKGROUND: Eosinophilic pustular folliculitis (EPF) is a cutaneous inflammatory follicular disorder of unknown etiology. The diagnosis is established on the basis of clinical and histopathologic features. In only a few instances has EPF been described in children. OBJECTIVE AND METHODS: We describe the clinical and histopathologic features of a recurrent follicular eosinophilic pustular eruption involving the scalp in 2 children. Previously reported cases of EPF in childhood below 14 years of age are reviewed. RESULTS: Two patients (9-month-old and 6-month-old boys) presented current crops of follicular pustules on the scalp of 4 and 5 months' evolution. The lesions resolved spontaneously without scarring. Histopathologic examination revealed an acute follicular inflammatory infiltrate with abundant eosinophils. Scraping from the lesions showed abundant eosinophils in 1 case. A peripheral eosinophilia was also detected in both patients. CONCLUSION: EPF in children below 1 year of age seems to represent a unique disorder bearing distinctive clinical (constant involvement of the scalp), evolutive (self-healing recurrent crops) and prognostic (the lesions may last until 3 years of age) features. A possible relationship between this disorder and other idiopathic pustular dermatoses of early childhood (especially with infantile acropustulosis) is suggested.