Pathergy in atypical eosinophilic pustular folliculitis

Anti-p200 pemphigoid (anti-laminin-γ1 pemphigoid) demonstrating pathergy

Anti-p200 pemphigoid, also called anti-laminin-γ1 pemphigoid, is a recently defined entity. First reported in 1996, the incidence is relatively rare, with approximately 70 reports in the literature. Clinical presentation is heterogeneous, but the disease most commonly mimics bullous pemphigoid with urticarial papules, plaques, or tense bullae on the trunk or extremities. Described here is a case with additional features of pathergy that have not yet been reported in the literature.

Negative evaluation of a pathergy test in hepatitis B surface antigen carriers

The different cutaneous manifestations of hepatitis B virus infection have been described in different studies. We proposed to evaluate the frequency of skin pathergy positivity in hepatitis B surface antigen carriers. The study group consisted of 92 hepatitis B surface antigen carriers and 76 healthy individuals as a control group. The pathergy test was applied intradermally to both forearms of the patients and the control subjects. The results of the pathergy test were evaluated. Papule or pustule formation was noted as positive. Four and one of the 92 hepatitis patients and 76 control subjects, respectively, were positive for the pathergy reaction. Evidently, this pathergy test that shows non-specific skin hyper-reactivity cannot be used as a clinical marker to indicate hepatitis B surface antigen carriers. The test cannot be used to predict the cutaneous manifestations of hepatitis B infection either.

Eosinophilic pustular folliculitis: a 40 year retrospect

Eosinophilic pustular folliculitis (EPF) is a noninfectious eosinophilic infiltration of hair follicles first described 40 years ago. There are 3 variants: classic EPF, immunosuppression-associated (mostly HIV-related), and infancy-associated EPF. EPF has been classified as an AIDS-defining illness. In both children and adults EPF should be viewed as a possible cutaneous sign of immunosuppression. However, it may also be seen in persons with normal immune status. We review EPF on the 40th anniversary of its original description.