An eosinophilic folliculitis may develop in an HIV-1 infected patient. This may be related to Ofuji's disease, an eosinophilic pustular folliculitis described in the Japanese (? associated with HTLV-I infection?).


Patient at risk:

(1) advanced HIV disease (high plasma RNA and/or low CD4 lymphocyte count)

(2) not receiving HAART


Clinical features:

(1) marked pruritus

(2) erythematous papules and/or urticaria

(3) centrally located (head, neck, thorax, abdomen, proximal extremities)


Laboratory findings:

(1) absolute or relative eosinophilia

(2) elevated serum IgE


Biopsy findings:

(1) eosinophilic infiltrate in and about hair follicules with CD8 positive T cells

(2) lytic degeneration of sebaceous glands


Differential diagnosis - Diagnosis requires exclusion of:

(1) bacterial folliculitis

(2) fungal folliculitis

(3) drug reaction


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