Eosinophilic Pustular Folliculitis Starting Initially only with Palmoplantar Pustular Lesions
Eosinophilic Pustular Folliculitis Starting Initially only with Palmoplantar Pustular Lesions
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嗜酸粒细胞性脓疱性毛囊炎最初仅伴掌跖脓疱性病变
作者：
H. Aoyama;H. Tagami
我们报告一位23岁的日本男性，以掌跖皮疹开始，罹患嗜酸性脓疱性毛囊炎（EPF）。只有在31个月后双侧脸颊出现毛囊性脓疱时，我们才将最初的掌跖脓疱病（PPP）诊断修改为EPF，所有皮疹大部分用吲哚美辛清除。回顾日本近20年来的文献，发现在207例EPF病例中，38例（18%）出现掌跖脓疱性病变。其中16例（8%）皮损始于掌跖部，平均病程26个月，以后再出现其它皮疹。当皮肤病变仅局限于掌跖区域时，没有一个被诊断为EPF。当我们在掌跖部发现脓疱时，我们应怀疑EPF和PPP早期病变的可能性。组织病理学显示掌跖脓疱病变中位于上表皮的多房性脓疱含有大量嗜酸性粒细胞，以及对吲哚美辛的显著治疗反应极大地有利于EPF的诊断。
We report a 23-year-old Japanese male with eosinophilic pustular folliculitis (EPF) that had started with palmoplantar rash. Only when follicular pustules appeared on the bilateral cheek 31 months later, we revised our initial diagnosis of pustulosis palmaris et plantaris (PPP) to EPF, and all the skin eruptions cleared mostly with indomethacin. A review of the Japanese literature for the past 20 years disclosed that in 207 cases of EPF so far reported, palmoplantar pustular lesion was noted in 38 (18%). Among them, in 16 cases (8%) the skin lesions started first from the palmoplantar region with the average period of 26 months until the appearance of other eruptions of EPF. None of them was diagnosed as EPF when skin lesions were localized only to the palmoplantar region. When we find pustules on the palmoplantar region, we should suspect the possibility of early lesions of EPF as well as PPP. Histopathologic demonstration of multilocular pustules located in the upper epidermis containing numerous eosinophils in the palmoplantar pustular lesions, together with the dramatic therapeutic response to indomethacin greatly favor the diagnosis of EPF.