Ofuji's disease with unusual histological features.

A 20-year-old lady presented with a 3-month history of an itchy eruption affecting her face and trunk. Erythematous annular plaques with follicular papules and pustules at the margins were present on her face consistent with Ofuji's disease. A perifollicular and perivascular eosinophil-rich infiltrate was seen histologically, with infiltration of the follicular epithelium by eosinophils and formation of eosinophilic microabscesses. An unusual feature was the presence of follicular mucinosis. Treatment with dapsone resulted in an improvement in the eruption after 2 weeks. Ofuji's eosinophilic pustular folliculitis is becoming increasingly frequently recognized, and may not be as rare as initial reports suggested. In 1965, Ise and Ofuji reported the case of a Japanese woman who had recurrent episodes of follicular pustules affecting her face and back accompanied by a peripheral eosinophilia. Following this, in 1970 Ofuji et al. reported three further cases and proposed the name eosinophilic pustular folliculitis. Although many of the early cases were in Japanese patients, reports of this disease affecting individuals from Europe and the United States have been increasing.