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Takei S, Hayashi R, Tomii K, Deguchi T, Fujikawa H, Shinkuma S, Abe R. Two cases of infancy associated eosinophilic pustular folliculitis (I-EPF) comparing the profile of infiltrating cells with classic EPF by immunohistochemical study. J Dermatol 2024; 51:125-129. [PMID: 37789597 DOI: 10.1111/1346-8138.16985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023]
Abstract
Infancy associated eosinophilic pustular folliculitis (I-EPF) is a clinical variant of EPF that develops in childhood. Previous studies have suggested that I-EPF exhibits clinical and histological differences distinct from other variants, including classic EPF. Herein, we report two patients with I-EPF treated with topical indomethacin. These two cases exhibited less perifollicular and more perivascular eosinophilic infiltration, which is different in distribution from that of classic EPF. Immunohistochemical study demonstrated that the infiltrating mononuclear cells were CD4-dominant T cells in classic EPF and I-EPF, whereas the number of CD68-positive cells was significantly higher in classic EPF than in I-EPF. Immunohistochemical staining was also performed for eosinophilic pustular folliculitis (HPGDS), which has been reported to induce eosinophils and is a therapeutic target of indomethacin in classic EPF. HPGDS-positive cells were also observed in I-EPF, which may explain the effectiveness of topical indomethacin. Although clinical and histopathological features of I-EPF are different from other variants, the arachidonic acid pathway could be involved in eosinophil infiltration, not only in classic EPF but also in I-EPF.
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Affiliation(s)
- Shingo Takei
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryota Hayashi
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Tomii
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tokiko Deguchi
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroki Fujikawa
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoru Shinkuma
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Dermatology, Nara Medical University, Kashihara, Japan
| | - Riichiro Abe
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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2
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Reyes-Hadsall S, Park L, Frauenfelder A, Fayiga FF, Graneiro A, Duarte AM. Concerning Newborn Rashes and Developmental Abnormalities: Part I: Common and Benign Findings. Pediatr Rev 2023; 44:426-446. [PMID: 37525308 DOI: 10.1542/pir.2022-005726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Affiliation(s)
- Sophia Reyes-Hadsall
- University of Miami Miller School of Medicine, Miami, FL
- Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL
| | - Lily Park
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
- Nova Southeastern University, Fort Lauderdale, FL
| | | | - Folasade F Fayiga
- University of Miami Miller School of Medicine, Miami, FL
- Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL
- Wright State University Boonshoft School of Medicine, Fairborn, OH
| | - Ana Graneiro
- Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL
| | - Ana M Duarte
- Division of Dermatology, Department of Pediatrics, Nicklaus Children's Hospital, Miami, FL
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
- Nova Southeastern University, Fort Lauderdale, FL
- Children's Skin Center, Miami, FL
- Florida International University, Miami, FL
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3
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Shi W, Lu Y, Zhou F, He H, Jiang J, Xue X. Infantile Eosinophilic Pustular Folliculitis in a Child Aged 7 Years: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:717-720. [PMID: 36987401 PMCID: PMC10040162 DOI: 10.2147/ccid.s404316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
Eosinophilic pustular folliculitis (EPF) is a rare, chronic, itchy, aseptic disease. Although most cases of infantile EPF (I-EPF) are detected in infants, we found that a 7-year-old child with I-EPF, who received treatment with oral azithromycin in combination with topical narrow bound Ultra Violet B light (NB-UVB) irradiation, with no recurrence at follow-up. Our experience with the successful treatment of this patient can provide a reference for more pediatric patients.
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Affiliation(s)
- Weikang Shi
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Department of Dermatology, Jinhua Maternal & Child Health Care Hospital, Jinhua, People’s Republic of China
| | - Yuwen Lu
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Fangyan Zhou
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Huiyi He
- Department of Dermatology, Ruian People’s Hospital, Wenzhou, People’s Republic of China
| | - Jicong Jiang
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Ximao Xue
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Correspondence: Ximao Xue, Email
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4
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Guo W, Qian G, Zhang C. Eosinophilic pustular folliculitis of infancy. Arch Dis Child Fetal Neonatal Ed 2022:archdischild-2022-323930. [PMID: 35728924 DOI: 10.1136/archdischild-2022-323930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 06/03/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Wu Guo
- Department of Dermatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Ge Qian
- Department of Dermatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Chang'e Zhang
- Department of Dermatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
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5
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Eosinophilic Pustular Folliculitis of Infancy: A Histologic Assessment of 43 Cases. Am J Dermatopathol 2022; 44:395-403. [PMID: 35583404 DOI: 10.1097/dad.0000000000002006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Eosinophilic pustular folliculitis of infancy is a sterile, inflammatory dermatosis that mainly affects children younger than 36 months. The underlying physiopathologic mechanism is unclear. Clinical diagnosis is challenging, and a skin biopsy may be necessary. The literature data are sometimes contradictory, and a histologic series of eosinophilic pustular folliculitis of infancy cases has not been previously published.
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6
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Ramondetta A, Giuffrida G, Di Vincenzo S, De Pasquale R. A case of EosinophilicPustular Folliculitis (EPF) successfully treated with adalimumab. Dermatol Ther 2022; 35:e15550. [PMID: 35508711 DOI: 10.1111/dth.15550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
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7
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A Dermatitis Mimicker: A Case of Infantile Eosinophilic Pustular Folliculitis. Dermatitis 2022; 33:e1. [PMID: 35029352 DOI: 10.1097/der.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Metin Z, Metin M. Role of food allergy in the etiology of infantile eosinophilic pustular folliculitis. Pediatr Allergy Immunol 2022; 33:e13687. [PMID: 34761443 DOI: 10.1111/pai.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/30/2021] [Accepted: 10/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Zuhal Metin
- Department of Dermatology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey
| | - Mustafa Metin
- Department of Family Medicine, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
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Frølunde AS, Olesen AB, Riber‐Hansen R, Pallesen KAU. Eosinophilic pustular folliculitis of infancy: A rare diagnosis in children. Clin Case Rep 2021; 9:e04167. [PMID: 34026179 PMCID: PMC8117823 DOI: 10.1002/ccr3.4167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/31/2022] Open
Abstract
Remember EPFI as a differential diagnosis in children with a rash on the scalp and no effect of antibiotic treatment.
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10
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Saylam Kurtipek G, Zekey E, Tuncez Akyurek F, Demirbas A, Harmankaya İ. Infantile Eosinophilic Pustular Folliculitis: A Case Report. J Cosmet Dermatol 2021; 21:1143-1146. [PMID: 33876873 DOI: 10.1111/jocd.14161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/31/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infantile eosinophilic pustular folliculitis (I-EPF) is a rare disease characterized by pruritic vesicles and sterile pustules on the erythematous surface of the scalp and facial localization, usually seen in the neonatal period. It is essential to show the presence of dense eosinophils in the diagnosis of pustules. Histopathological examination of the hair follicles by eosinophils infiltration is determined. AIM Here, we reported a 5-month-old baby boy diagnosed infantile eosinophilic pustular folliculitis. PATIENT A 5-month-old baby boy was consulted to our polyclinic by his family because of pustules on the scalp, face, and neck developing in two week after birth. In dermatological examination, the pustular lesions of 1-2 mm in diameter on the scalp, face, and neck on an erythematous background were determined. RESULTS There was no growth in the culture taken from the pustule. In the laboratory tests of the patient; upon detection of eosinophilia in the hemogram. The eosinophil count at the patient's first admission was 1.48 K/μl. (0.05 0.50). Eosinophil count was 0.02 K/μl after treatment. It was decreased. The patient was evaluated for other pustular dermatoses. In the differential diagnosis of the patient; causing bacterial/non-bacterial pustulosis were included. Bacterial culture was negative. CONCLUSION Eosinophilic folliculitis defines as a group of papulopustular diseases with unknown etiology characterized histologically by eosinophilic infiltrates. First, Ofuji reported a female patient with recurrent follicular pustules and peripheral eosinophilia as a variant of folliculitis in 1965. Its etiopathogenesis is not clearly known. In the differential diagnosis of EPF includes the other pustular lesions of the newborn such as erythematoxicum neonatarum, transient neonatal pustular dermatosis, infantile acropustulosis, scabies, dermatophytosis, and langerhans cell histiocytosis. Treatment options includes topical corticosteroids and calcineurin inhibitors, antihistamines, systemic antibacterial and anti-inflammatory agents, and dapson.
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Affiliation(s)
| | - Emre Zekey
- Department of Dermatology, Selcuk University Faculty of Medicine, Konya, Turkey
| | | | | | - İsmail Harmankaya
- Department of Pathology, Selcuk University Faculty of Medicine, Konya, Turkey
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11
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Quieros C, Santos MC, Pimenta R, Tapadinhas C, Filipe P. Transient Cutaneous Alterations of the Newborn. EUROPEAN MEDICAL JOURNAL 2021. [DOI: 10.33590/emj/20-00162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Neonatal cutaneous alterations are common, usually appearing at birth or during the first few days of life. Most of these conditions are physiological, benign, and transient, arising from a combination of immaturity of the newborn skin with environmental factors. Nonetheless, some of them may eventually be a clue to underlying disorders. Physicians should therefore be aware of these clinical manifestations so that parents can be reassured and, when necessary, complementary investigations can be undertaken.
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Affiliation(s)
- Catarina Quieros
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal
| | | | - Rita Pimenta
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal
| | - Cristina Tapadinhas
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal
| | - Paulo Filipe
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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12
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Chuh A. Eosinophilic folliculitis due to wearing protective gear in citizens volunteering for sanitation services during the COVID-19 pandemic - an original epidemiological, clinical, dermoscopic, and laboratory-based study. Int J Dermatol 2020; 59:1468-1474. [PMID: 33040344 PMCID: PMC7675530 DOI: 10.1111/ijd.15227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND An association between wearing protective gear and eosinophilic folliculitis has not been reported. We aimed to investigate such during the COVID-19 pandemic. METHODS In three outpatient clinics, we hand-reviewed records of all patients having consulted us during a Study Period (90 days) in the early phase of the pandemic. Our inclusion criteria for Study Subjects were: (i) clear clinical diagnosis, (ii) dermoscopic confirmation, (iii) differential diagnoses excluded, (iv) eosinophilia, (v) protective gear worn during sanitation services, (vi) temporal correlation, (vii) distributional correlation, (viii) physician-assessed association, and (ix) patient-assessed association. Control Periods in the same season were elected. RESULTS Twenty-five study subjects fulfilled all inclusion criteria. The incidence was significantly higher than in the control periods (IR: 3.57, 95% CI: 1.79-7.43). Male predominance was significant (P < 0.001). Such for patients in the control periods were insignificant. Study subjects were 21.2 (95% CI: 11.0-31.4) years younger than patients in the control periods. For the study subjects, the distribution of erythematous or skin-colored folliculocentric dome-shaped papules and pustules were all compatible with body parts covered by the gear. Lesional biopsy performed on two patients revealed eosinophilic dermal infiltrates within and around the pilosebaceous units. Polarized dermoscopy revealed folliculitis with peri-/interfollicular vascular proliferation. Lesion onsets were 6.4 (SD: 2.1) days after wearing gear. Remissions were 16.7 (SD: 7.5) days after ceasing to wear gear and treatments. CONCLUSIONS Wearing protective gear in volunteered sanitizing works could be associated with eosinophilic folliculitis. Owing to the significant temporal and distributional correlations, the association might be causal.
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Affiliation(s)
- Antonio Chuh
- Department of Family Medicine and Primary Care, The University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong.,Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
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13
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Hashida Y, Higuchi T, Nakajima S, Nakajima K, Ujihara T, Kabashima K, Sano S, Daibata M. Human Polyomavirus 6 Detected in Cases of Eosinophilic Pustular Folliculitis. J Infect Dis 2020; 223:1724-1732. [PMID: 32989462 DOI: 10.1093/infdis/jiaa607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Human polyomaviruses (HPyVs) have been associated with several cutaneous inflammatory conditions. More investigation is needed to identify further presentations of cutaneous pathology associated with HPyVs. Our aim was to investigate the possible association of skin-tropic HPyVs with folliculitis, particularly eosinophilic pustular folliculitis (EPF). METHODS This study included 55 Japanese patients, comprising 13 patients with EPF and 42 patients with suppurative folliculitis. HPyV DNAs were detected by quantitative polymerase chain reaction. Expression of viral antigen and geographically related viral genotypes were also assessed. RESULTS Human polyomavirus 6 (HPyV6) DNA was found in 9 of 13 (69%) patients with EPF, a rate significantly higher than that found in suppurative folliculitis (1/42; 2%). Of the 7 HPyV6 DNA-positive EPF specimens analyzed, 4 were positive for HPyV6 small tumor antigen. All the HPyV6 strains detected in this study were of the Asian/Japanese genotype. CONCLUSIONS The predominant detection of HPyV6 DNA and the expression of viral antigen suggest a possible association between HPyV6 infection and EPF in a subset of patients. Worldwide studies are warranted to determine whether Asian/Japanese genotype HPyV6 is associated preferentially with the incidence and pathogenesis of this eosinophil-related skin disease that has an ethnic predilection for the East Asian population.
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Affiliation(s)
- Yumiko Hashida
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tomonori Higuchi
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
| | - Saeko Nakajima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Takako Ujihara
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan.,Science Research Center, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Singapore Immunology Network and Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Masanori Daibata
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kochi, Japan
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14
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Abstract
Eosinophilic dermatoses encompass a broad spectrum of diseases of different etiologies hallmarked by eosinophilic infiltration of the skin and/or mucous membranes, with or without associated blood eosinophilia. The wide range of dermatological manifestations of this spectrum, including nodules and plaques, pustules, blisters, ulcers, and urticarial lesions, is reflected in a non-univocal classification system. We identified six groups of eosinophilic dermatoses based on the predominant anatomic level of involvement: (1) epidermal; (2) of the dermal-epidermal junction; (3) dermal; (4) of the hypodermis and muscle fascia; (5) of the pilosebaceous unit; and (6) vascular/perivascular. We review clinicopathologic features and management of diseases belonging to each group, particularly: (1) pemphigus herpetiformis and atopic dermatitis as prototypes of the epidermal group; (2) bullous pemphigoid as prototypic eosinophilic dermatosis of the dermal-epidermal junction; (3) eosinophilic cellulitis (Wells syndrome), hypereosinophilic syndromes, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, eosinophilic dermatosis of hematologic malignancy and chronic spontaneous urticaria as paradigmatic dermal eosinophilic dermatoses; (4) eosinophilic fasciitis as an eosinophilic dermatosis with predominant involvement of the hypodermis and muscle fascia; (5) eosinophilic pustular folliculitis as a model of the pilosebaceous unit involvement; and (6) granuloma faciale, angiolymphoid hyperplasia with eosinophilia, and eosinophilic granulomatosis with polyangiitis, belonging to the vascular/perivascular group.
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15
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Lalor LE, Chiu YE. Rare Vesiculopustular Eruptions of the Neonatal Period. Clin Perinatol 2020; 47:53-75. [PMID: 32000929 DOI: 10.1016/j.clp.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Numerous disorders present with vesiculopustular eruptions in the neonatal period, ranging from benign to life-threatening. Accurate and prompt diagnosis is imperative to avoid unnecessary testing and treatment for benign eruptions, while allowing for adequate treatment of potentially fatal disorders. In this review, we highlight several rare blistering diseases of the newborn. A diagnostic approach is outlined to provide clinicians with a framework for approaching a neonate with vesicles, pustules, or ulcers.
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Affiliation(s)
- Leah E Lalor
- Department of Dermatology (Pediatric Dermatology), Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Yvonne E Chiu
- Department of Dermatology (Pediatric Dermatology), Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
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16
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Theiler M, Schwieger-Briel A, Weibel L. [Acute skin infections and their imitators in children : A photo quiz]. Hautarzt 2019; 68:774-783. [PMID: 28914333 DOI: 10.1007/s00105-017-4036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed. OBJECTIVES To illustrate frequent pediatric skin infections and pitfalls in view of imitators and differential diagnoses. MATERIALS AND METHODS A photo quiz is presented with the discussion of a selection of acute pediatric skin infections in comparison to their infectious or noninfectious differential diagnoses. RESULTS The following infectious skin conditions and imitators are described and clinical clues for differentiation highlighted: eczema herpeticum and bacterial superinfection of atopic dermatitis; exanthematous hand, foot and mouth disease and varicella infection; erythema chronicum multilocularis and anular urticaria; Gianotti-Crosti syndrome and Gianotti-Crosti-like reaction; bacterial folliculitis of the scalp and kerion celsi and eosinophilic pustular folliculitis of the scalp; cutaneous Leishmaniasis and idiopathic facial aseptic granuloma; allergic and bacterial lymphangitis; bullous impetigo contagiosa and nonaccidental scalding. CONCLUSIONS Careful anamnesis and skin examination with attention to the here illustrated differential diagnoses are essential to avoid pitfalls in the evaluation of acute pediatric skin infections.
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Affiliation(s)
- M Theiler
- Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz.,Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz
| | - A Schwieger-Briel
- Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz
| | - L Weibel
- Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz. .,Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz.
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17
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Odyakmaz Demirsoy E, Demirsoy U, Ozod U, Kiran R. Eosinophilic pustular folliculitis of infancy suppressed with cetirizine. Pediatr Dermatol 2019; 36:395-396. [PMID: 30791150 DOI: 10.1111/pde.13764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Eosinophilic pustular folliculitis of infancy is a rare inflammatory disease characterized by recurrent, itchy sterile pustules mainly located on the scalp. Topical agents are mostly effective to suppress the symptoms in the majority of cases. However, systemic agents that are safe for long-term use are required for patients with widespread or resistant lesions. We present a case with eosinophilic pustular folliculitis of infancy whose disease was suppressed with cetirizine but recurred after ceasing the drug.
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Affiliation(s)
| | - Uğur Demirsoy
- Department of Paediatrics, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Umay Ozod
- Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Rebiay Kiran
- Department of Dermatology, Kocaeli University School of Medicine, Kocaeli, Turkey
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18
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O'Brennan EA, Shukla R, Parslew RAG. Cropped studded pustules in an infant. Clin Exp Dermatol 2019; 44:912-914. [PMID: 30604461 DOI: 10.1111/ced.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/27/2022]
Affiliation(s)
- E A O'Brennan
- Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - R Shukla
- Department of Paediatric Histopathology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - R A G Parslew
- Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
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Abstract
Inflammatory dermatoses encompass a variety of histologic patterns that affect different portions of the skin. In spongiotic, psoriasiform, lichenoid, pityriasiform, and blistering disorders, there are predominately epidermal and junctional activities with variable superficial dermal inflammation. Hypersensitivity reactions can show either epidermal or mostly dermal changes depending on whether the exposure of the exogenous allergen occurs through an external or internal route, respectively. Exceptions include erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis, where the etiology is often due to infection or ingested medications, but the histologic features are almost exclusively confined to the epidermis and dermoepidermal junction. Autoimmune disorders are unique in that lesions typically incorporate a mixture of epidermal and dermal inflammatory patterns with periadnexal inflammation, while the vast majority of vasculitis/vasculopathy and alopecia have changes limited to only the vessels and hair follicles, respectively. It is critical to recognize that a relatively limited number of histologic patterns are seen in a large array of clinical entities. Therefore, clinicopathologic correlation and careful examination of histologic details are of the utmost importance when evaluating skin biopsies for inflammatory disorders.
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Affiliation(s)
- Andy C Hsi
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Ilana S Rosman
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.,2 Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri
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20
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Sun KL, Chang JM. Special types of folliculitis which should be differentiated from acne. DERMATO-ENDOCRINOLOGY 2017; 9:e1356519. [PMID: 29484091 PMCID: PMC5821164 DOI: 10.1080/19381980.2017.1356519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/11/2017] [Indexed: 10/27/2022]
Abstract
Because both acne vulgaris and folliculitis can present as inflammatory erythematous papules, pustules or nodules, they are often hard to distinguish. The importance to distinguish between these 2 shall be stressed as their pathogenesis and therapies are different and misdiagnosis or missed diagnosis may lead to improper treatment. We will introduce several special types of folliculitis that should be differentiated from acne to increase our knowledge of the disorders with an acne-like manifestation.
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Affiliation(s)
- Kai-Lv Sun
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Dongdan, Dongcheng District, Beijing, China
| | - Jian-Min Chang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, Dongdan, Dongcheng District, Beijing, China
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21
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Theiler M, Oza VS, Mathes EF, Dvorak CC, McCalmont TH, Yeh I, Sidbury R, Cordoro KM. Eosinophilic Pustular Folliculitis in Children after Stem Cell Transplantation: An Eruption Distinct from Graft-Versus-Host Disease. Pediatr Dermatol 2017; 34:326-330. [PMID: 28317161 DOI: 10.1111/pde.13108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Eosinophilic pustular folliculitis (EPF) is a rare cutaneous disorder that typically occurs in three clinical contexts: men, individuals who are immunosuppressed or have human immunodeficiency virus, and infants. A fourth subtype occurring 2 to 3 months after hematopoietic stem cell transplantation (HSCT) has recently been described in several adults. We report two cases of EPF arising in children after HSCT. It is important to recognize this form of EPF after HSCT and differentiate it from graft-versus-host disease since it responds readily to topical steroids and appears to have an excellent prognosis.
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Affiliation(s)
- Martin Theiler
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Vikash S Oza
- Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York
| | - Erin F Mathes
- Department of Pediatrics, University of California, San Francisco, California.,Department of Dermatology, University of California, San Francisco, California
| | | | - Timothy H McCalmont
- Department of Dermatology, University of California, San Francisco, California.,Department of Pathology, University of California, San Francisco, California
| | - Iwei Yeh
- Department of Dermatology, University of California, San Francisco, California.,Department of Pathology, University of California, San Francisco, California
| | - Robert Sidbury
- Department of Pediatrics, Division of Dermatology, Seattle Children's Hospital and School of Medicine, University of Washington, Seattle, Washington
| | - Kelly M Cordoro
- Department of Pediatrics, University of California, San Francisco, California.,Department of Dermatology, University of California, San Francisco, California
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22
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Palacios-Alvarez I, Rubio-Mediavilla S, Lezcano-Biosca V, Simal G. Pustulosis eosinofílica infantil. An Pediatr (Barc) 2015; 83:447-8. [DOI: 10.1016/j.anpedi.2015.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/23/2015] [Accepted: 03/31/2015] [Indexed: 11/28/2022] Open
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23
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Porriño-Bustamante ML, Sánchez-López J, Aneiros-Fernández J, Burkhardt P, Naranjo-Sintes R. Recurrent pustules on an infant's scalp with neonatal onset. Int J Dermatol 2015; 55:505-8. [PMID: 26266955 DOI: 10.1111/ijd.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Pilar Burkhardt
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
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24
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Lee JH, Kang JH, Cho BK, Park HJ. Generalized Eosinophilic Pustular Folliculitis of Infancy Responding to Hydroxyzine. Ann Dermatol 2015; 27:458-60. [PMID: 26273169 PMCID: PMC4530163 DOI: 10.5021/ad.2015.27.4.458] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/26/2014] [Accepted: 08/26/2014] [Indexed: 12/05/2022] Open
Affiliation(s)
- Joo Hyun Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Hee Kang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Baik Kee Cho
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Jeong Park
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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26
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Nomura T, Katoh M, Yamamoto Y, Kabashima K, Miyachi Y. Eosinophilic pustular folliculitis: the transition in sex differences and interracial characteristics between 1965 and 2013. J Dermatol 2015; 42:343-52. [PMID: 25675987 DOI: 10.1111/1346-8138.12783] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
Eosinophilic pustular folliculitis (EPF) is characterized by a non-infectious infiltration of eosinophils in the hair follicles. It has three variants: (i) classic EPF; (ii) immunosuppression-associated EPF, which herein is subdivided into HIV-associated (IS/HIV) and non-HIV-associated (IS/non-HIV); and (iii) infancy-associated EPF (I-EPF). The rarity of EPF has hindered our understanding of this entity. To examine the characteristics of EPF, with respect to age, sex, race, and chronology, published in case reports to date, we queried PubMed using the following terms: ("eosinophilic pustular folliculitis" [All Fields] OR "eosinophilic folliculitis" [All Fields]) AND ("1965/1/1" [PDAT]: "2013/12/31" [PDAT]). Additional Japanese cases were collected from Igaku Chuo Zasshi through Ichushi-Web, JDream III, and secondhand quotations from domestic periodicals published in Japan. Proceedings were excluded. The PubMed search produced 275 citations containing 358 cases of EPF (224 men, 132 women, and two of unspecified sex); these cases involved classic EPF (101 Japanese and 81 non-Japanese), IS/HIV (4 Japanese and 85 non-Japanese), IS/non-HIV (4 Japanese and 20 non-Japanese), and I-EPF (4 Japanese and 59 non-Japanese). Ichushi generated an additional 148 citations containing 207 cases of Japanese (148 men and 59 women), which included cases of classic EPF (181 cases), IS/HIV (14 cases), IS/non-HIV (9 cases), and I-EPF (3 cases). There was no sex difference in the classic EPF cases reported between 2003 and 2013, whereas IS/HIV, IS/non-HIV, and I-EPF were predominated by men. There is room for reconsideration of sex differences, particularly with regard to classic EPF. The rarity and specificity of I-EPF in Japan may reflect a state of uncertainty about this entity.
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Affiliation(s)
- Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Dermatology, Ijinkai Takeda General Hospital, Kyoto, Japan
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27
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Yamamoto Y, Nomura T, Kabashima K, Miyachi Y. Clinical Epidemiology of Eosinophilic Pustular Folliculitis: Results from a Nationwide Survey in Japan. Dermatology 2014; 230:87-92. [DOI: 10.1159/000368774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/19/2014] [Indexed: 11/19/2022] Open
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28
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Ramos-e-Silva M, Pirmez R. Red face revisited: Disorders of hair growth and the pilosebaceous unit. Clin Dermatol 2014; 32:784-99. [DOI: 10.1016/j.clindermatol.2014.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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29
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Almodovar-Real A, Molina-Leyva A, Espiñeira-Carmona MJ, Ríos-Pelegrina R, Naranjo-Sintes R, Husein El-Ahmed H. Widespread eosinophilic pustular folliculitis in a nonimmunocompromised patient. Med Princ Pract 2014; 23:475-7. [PMID: 24751524 PMCID: PMC5586909 DOI: 10.1159/000361049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 03/03/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We present a case of eosinophilic pustular folliculitis, a rare dermatosis which is often associated with HIV infection or internal malignancies. CLINICAL PRESENTATION AND INTERVENTION We report the case of a 66-year-old man with a medical history of hypertension. Histopathological examination showed a dense follicular inflammatory infiltrate with abundant eosinophils. The clinical response to indomethacin was excellent with no recurrence during the follow-up. CONCLUSION The patient responded well to indomethacin treatment.
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Affiliation(s)
- Ana Almodovar-Real
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain
- *Ana Almodovar-Real, Department of Dermatology, San Cecilio University Hospital, 2 Avenida Doctor Olóriz 16, ES-18012 Granada (Spain), E-Mail
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Abstract
A 10-week old preterm infant boy presented with a pustular eruption of the face and blood eosinophilia. Histology demonstrated eosinophils without predominant follicular involvement. The lesions healed without intervention within 2 months. The presentation was consistent with neonatal eosinophilic pustulosis. We discuss the similarities between cases described in the literature and suggest that this entity affects a unique patient population of preterm infants.
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Affiliation(s)
- Nika Finelt
- Department of Dermatology, Stony Brook University, Stony Brook, New York
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31
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Fujiyama T, Tokura Y. Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis. J Dermatol 2013; 40:419-23. [DOI: 10.1111/1346-8138.12125] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Toshiharu Fujiyama
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu; Japan
| | - Yoshiki Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu; Japan
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