[Ofuji's diseases and pregnancy. A report of a case]

Eosinophilic pustular folliculitis, which was first described by Ofuji, is a type of dermatosis characterized by pruritic, follicular, papules and pustules that gradually extend peripherally and have central tendency. Ofuji's disease has been rarely reported, and has not been reported in pregnancy. It's possible that hypersensitivity reaction plays an important role. There is no consensus on treatment approaches. We present the case of a 27 year-old woman during the 12.5 weeks of her first pregnancy; she had developed Ofuji's disease for 17 years. Previously, she had been treated with corticosteroid and azatioprine for 15 years, which were suspended by the time she was diagnosed with pregnancy. Then, she was referred to our maternal fetal medicine department, and was treated with prednisone 25 mg a day. The patient had urinary infection and vulvovaginitis at the week 14.2, with peripheral blood eosinophilia. She had exacerbations at the weeks 35.2 and 38.1, which were treated only with prednisone and topical management; furthermore she had a total of 4 kg of weight gain during the whole pregnancy. Cesarean delivery was performed for nonreassuring fetal heart rate. Perinatal results were: woman with lower birth weight: 2,450 g, Apgar 5.8, placenta with calcifications on 60% of it and single nuchal cord. She had exacerbations in late puerperium. A healthy newborn was obtained and no clinical findings of dermatoses were found. Maternal autoimmune diseases may induce remission or exacerbation during pregnancy. Nevertheless, in this case the induced exacerbations during puerperium and the fact that a low birth weight was obtained are problems commonly associated with the prolonged use of corticosteroids during pregnancy.