太藤氏病(Ofuji’s disease, OD)，又名為嗜伊紅球性膿疱性毛囊炎(eosinophilic pustular fol-liculitis, EPF)，特色為反覆發作、具癢感之毛囊丘疹及環狀板塊，並有膿疱散佈其上，好發在臉上。
HIV-associated eosinophilic folliculitis (HIV-EF)臨床上則為許多散在性、毛孔一致性之的蕁麻疹樣丘疹，通常發在上半身。
Ofuji’s disease (OD), also named eosinophilic pustular folliculitis (EPF), is characterized by recur- rent pruritic folliculopapules and discoid or annular plaques studded with pustules, which occurs mainly on the face. HIV-associated eosinophilic folliculitis (HIV-EF) typically manifests discrete urticarial fol- liculopapules, mostly on the upper trunk. Both forms of EF are characterized by sterile pustular eosinophilic folliculitis. In the past 13 years, a total of 23 cases of EF were diagnosed in our department based on the characteristic clinical and pathological findings. Of these, 16 were non-HIV EF (5 males, 11 females, aged 12-50 yrs, with a mean of 33 yrs), while 7 were HIV-EF (7 males, aged 35-67 yrs, with a mean of 48 yrs). In the non-HIV group, 13 showed clinical pictures of OD, the other 3 had les- sons popular EF lesions similar to HIV-EF. Ten of the 23 EF patients had eosinophilia, and HIV-EF patients had decreased CD4 counts (mean 133/mm3). Microscopically, all EF cases showed eosinophilic folliculitis and perifolliculitis with pilosebaceous pustules or/and microabscess histopatho- logically. Interestingly, 6 cases with OD were associated with follicular mucinosis. Treatments include- ing prednisolone, indomethacin, naproxen,diclofenac, doxycycline, dapsone, ultraviolet B. Fifteen patients were treated with prednisolone and it was effective except 2 HIV-EF. Indomethacin was effect- tive in 4 patients. The rest seemed ineffective. Spontaneous remission was noted in 2 years in about half of the non-HIV patients, but in none of HIV patients. Our study suggests that EF is not rare in Taiwan, and EF should be differentiated from dermatophytosis, rosacea and follicular mucinosis clinically and pathologically.
蔡 雅 敏 ‧ 醫 師 │ 皮 膚 專 科
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