ABSTRACT
Eosinophilic pustular folliculitis of Ofuji is a recalcitrant disease typified by non-infective eosinophilic spongiosis involving the infundibular region of the hair follicle. We present a case of a 49-year-old Chinese man with known palmoplantar pustulosis and acrodermatitis continua of Hallopeau which was promptly resolved with methotrexate therapy. He returned with an erythematous papulopustular eruption with coalescence to annular plaques, occurring over the face, chest and back with active palmoplantar pustulation. Histology from skin biopsy of the palmar lesion was in keeping with palmoplantar psoriasis, while biopsy of the facial and truncal lesions revealed florid perifollicular eosinophilic congregation diagnostic of eosinophilic pustular folliculitis of Ofuji. Indomethacin was initiated with partial improvement of lesions with cyclical flares. A trial of narrowband ultraviolet-B phototherapy at a frequency of thrice weekly achieved sustained clearance of both eosinophilic pustular folliculitis and palmoplantar lesions. Indomethacin was tailed down and eventually discontinued with maintenance of narrowband ultraviolet-B therapy; this achieved successful control of the disease.
Subject(s)
Acrodermatitis/radiotherapy , Eosinophilia/radiotherapy , Folliculitis/radiotherapy , Skin Diseases, Vesiculobullous/radiotherapy , Ultraviolet Therapy/methods , Acrodermatitis/pathology , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Asian People , Eosinophilia/pathology , Folliculitis/pathology , Humans , Indomethacin/administration & dosage , Male , Skin Diseases, Vesiculobullous/pathology , Ultraviolet RaysABSTRACT
Acrodermatitis continua of Hallopeau (ACH) consists of a relapsing pustular eruption of the distal portions of hands and feet. We described a case of a 9-year-old boy affected by ACH, successfully treated with targeted ultraviolet B 311 nm phototherapy, which seems to be an effective and safe therapy for this condition.
Subject(s)
Acrodermatitis/radiotherapy , Epidermolysis Bullosa Dystrophica/radiotherapy , Ultraviolet Therapy/methods , Acrodermatitis/pathology , Child , Epidermolysis Bullosa Dystrophica/pathology , Humans , MaleABSTRACT
Acrodermatitis Continua of Hallopeau is a rare, chronic, recurrent disorder classified as a form of pustular psoriasis, and most cases affect one or two digits. It tends to be resistant to both topical and systemic treatments for psoriasis. We present an infant with Acrodermatitis Continua of Hallopeau affecting nineteen nails, with an excellent response to the combination of thalidomide and ultraviolet B phototherapy.
Subject(s)
Acrodermatitis/drug therapy , Acrodermatitis/radiotherapy , Immunosuppressive Agents/administration & dosage , Thalidomide/administration & dosage , Ultraviolet Therapy , Child, Preschool , Combined Modality Therapy , Foot Dermatoses/drug therapy , Foot Dermatoses/radiotherapy , Hand Dermatoses/drug therapy , Hand Dermatoses/radiotherapy , Humans , Infant , Male , Psoriasis/drug therapy , Psoriasis/radiotherapyABSTRACT
Frictional hyperkeratotic hand dermatitis (FHHD) is an unusual form of chronic eczema relating to repeated frictional trauma. This form of hand eczema is often occupationally related and recalcitrant to therapy. We describe the case of FHHD in a 48-year-old dermatologic surgeon. The eruption was resistant to all topical and protective modalities, but responded completely to 6 sessions of Grenz ray treatment. No recurrence has been noted for over 4 years since completion of therapy. We suggest that Grenz ray treatment is a safe and effective option in treating this form of chronic hand dermatitis.
