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March 2013

Indomethacin for Refractory Infantile Eosinophilic Pustular Folliculitis

Author Affiliations

Author Affiliations: Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

JAMA Dermatol. 2013;149(3):367-368. doi:10.1001/2013.jamadermatol.591

Eosinophilic pustular folliculitis (EPF) in infancy is a rare disease. In infantile EPF, the lesions tend to resolve spontaneously or to respond well to topical corticosteroid treatment. We present herein a case of infantile EPF that was resistant to topical corticosteroid but showed great improvement after administration of oral indomethacin.

A 3-year-old Japanese girl was referred to our hospital with recurrent episodes of pruritic vesicles, pustules, and secondary crusting, initially on the scalp and cheeks, but later on the palms and soles (Figure 1). The eruptions had started at age 3 months and continued for years. The patient had difficulty walking due to the lesions on the soles. Peripheral blood eosinophilia was present at age 2 years (white blood cell count, 3730/μL), and IgE values were within normal limits. (To convert white bloods cells to number × 109/L, multiply by 0.001.)