[Eosinophilic pustular folliculitis in childhood]

Eosinophilic pustular folliculitis (EPF) is an inflammatory disorder of unknown etiology. In infants this disorder is characterized by recurrent episodes of sterile pustules primarily or exclusively involving the scalp with occasional involvement of the face, trunk and extremities. There are few reports of EPF in children.

To describe the clinical features and evolution of four pediatric patients and to discuss the main differential diagnoses.

Biopsy specimens were examined, pustules were cultured and laboratory tests were analyzed.

Four patients (3 males and 1 female) aged 7-18 months presented with self limiting recurrent pruritic papules and pustules on the scalp. In one patient, the lesions were mainly localized on the extremities. Cultures for bacteria, fungi and viruses were negative. No systemic disease was found. Topical steroids were effective in three patients but pustules recurred after treatment was stopped. Cetirizine and Hydroxacen were administered in two corticoid-resistant patients with fair response. No other systemic therapy was administered. Peripheral eosinophilia was detected in three patients.

EPF in infants seems to be a clearly defined entity. Although few cases have been described in children, this dermatosis is undoubtedly more frequent than suggested by the literature. Consequently, pediatricians should be aware of its existence.