What Is Eosinophilic Folliculitis?

Jennifer Long

Eosinophilic folliculitis is a serious condition that affects the hair follicles and causes a painful rash. Also called eosinophilic pustular folliculitis or eosinophilia, this rash is very itchy and commonly found on the upper region of the body. If left untreated, dark scarring can be left when the rash heals, which may or may not disappear over time. Although the exact cause of eosinophilia is not known, it tends to occur frequently in patients with Human Immunodeficiency Virus (HIV). It can also occur in cancer patients, susceptible infants, and those with medication reactions.

Eosinophilic folliculitis occurs frequently in patients with HIV.
Eosinophilic folliculitis occurs frequently in patients with HIV.

Signs of eosinophilic folliculitis include extreme itchiness, pus-filled raised bumps, and redness around the bumps. The rash often resembles acne, so diagnosis is often delayed. Open wounds can occur if the bumps are scratched and broken. Pain often accompanies larger outbreaks.

The presence of eosinophilic folliculitis in adults often prompts doctors to test for HIV.
The presence of eosinophilic folliculitis in adults often prompts doctors to test for HIV.

Diagnosing eosinophilic folliculitis is the first important step to treating the rash. Although this skin condition mimics acne, a diagnosis can be reached through a biopsy. Doctors use a sample of skin tissue to perform tests. These tests can provide doctors with the information they need to begin treatment.

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Signs of eosinophilic folliculitis may include pus-filled raised bumps.
Signs of eosinophilic folliculitis may include pus-filled raised bumps.

There are several treatment options for eosinophilic folliculitis. While waiting for test results, a topical steroid cream is recommended to help reduce discomfort. After diagnosis confirmation, glucocorticoids ointments can help heal the rash. Antihistamines can help reduce inflammation. Antiretroviral therapy is often used for people who have weakened immune systems.

After a diagnosis confirms the condition, glucocorticoids ointments can help heal the rash.
After a diagnosis confirms the condition, glucocorticoids ointments can help heal the rash.

Some research has suggested that a mite, type of yeast, and bacteria can cause eosinophilic folliculitis. As a result of this research, many doctors have started including other types of medications in treatment plans. These medications include antifungal, antibiotic and anti-mite medications.

A rash will develop as a result of eosinophilic folliculitis.
A rash will develop as a result of eosinophilic folliculitis.

Scratching the bumps that occur with eosinophilic folliculitis can be bad. The skin condition can rapidly spread, and scratching the bumps open can cause the rash to spread even quicker. Getting treatment quickly can reduce this risk.

Eosinophilic folliculitis may be an early sign of HIV infection, which is typically treated with a cocktail of antiretroviral drugs.
Eosinophilic folliculitis may be an early sign of HIV infection, which is typically treated with a cocktail of antiretroviral drugs.

Due to the fact that eosinophilic folliculitis primarily affects people with weak immune systems, the occurrence of this rash in a patient who has no known immune problems can be a cause of alarm. If a person has not been diagnosed with HIV or cancer, the presence of the rash can be a defining symptom of these conditions. There are, however, rare instances when there are no underlying causes or weakened immune systems, yet the rash still occurs.

Eosinophilic folliculitis often mimics acne, but requires a different type of ointment to treat.
Eosinophilic folliculitis often mimics acne, but requires a different type of ointment to treat.

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