From the Research
Eosinophilic folliculitis should be treated with oral indomethacin as the first-line therapy, especially for classic cases, with an efficacy of 84% as reported in the most recent and highest quality study 1. The condition is a chronic, pruritic skin condition characterized by recurrent crops of follicular papules and pustules with significant eosinophilic infiltration.
Key Considerations
- The diagnosis of eosinophilic folliculitis can be challenging due to its similarity to other skin conditions, and a biopsy may be necessary to confirm the diagnosis 2.
- Treatment options may vary depending on the subtype of eosinophilic folliculitis, with topical corticosteroids and oral antihistamines being considered for milder cases.
- For moderate to severe disease, systemic therapy such as oral itraconazole, UVB phototherapy, or antiretroviral therapy in HIV-associated cases may be necessary.
- Patients should avoid exacerbating factors such as hot showers, excessive sweating, and occlusive clothing, and use gentle, non-irritating cleansers.
Therapeutic Options
- Topical corticosteroids like triamcinolone 0.1% cream applied twice daily to affected areas for 2-4 weeks to reduce inflammation.
- Oral antihistamines such as cetirizine 10mg daily or hydroxyzine 25mg three times daily to control itching.
- Topical tacrolimus 0.1% ointment twice daily as a steroid-sparing agent for insufficient first-line treatments.
- Oral indomethacin, particularly effective for classic eosinophilic folliculitis, with an efficacy of 84% 1.
- Isotretinoin 0.5mg/kg/day for 4-5 months can be effective for refractory cases.