Eosinophilic pustular folliculitis (EPF) affects the skin causing itchy, red or skin-colored bumps and pustules (bumps containing pus). The papules mostly appear on the face, scalp, neck and trunk and may last for weeks or months. EPF affects males more than females.

There are several forms of EPF. Classic eosinophilic pustular folliculitis mainly occurs in Japan. Immunosuppression-associated EPF is mainly associated with HIV infection, but has also been associated with certain cancers and medications. The infantile form of EPF is seen in infants from birth or within the first year of life. The underlying cause of EFP is unknown. All of these forms have similar skin findings.

EFP is diagnosed based on the symptoms and a skin biopsy, which shows eosinophils (a kind of immune cell) located around hair follicles. Several treatments have been described with variable results, including various oral or topical medications and phototherapy. In patients with HIV-associated disease, antiretroviral therapy tends to greatly diminish symptoms or even eliminate the condition.

• an exaggerated reaction to dermatophytes (skin fungi) or saprophytic fungi, in association with a disordered immune system. This theory is supported by the effectiveness of oral itraconazole therapy in some people with EPF.
• demodex, a mite that lives in the hair follicle, as a possible trigger
• a combination of Pityrosporum (yeast) and demodex
• a change in the immune system causing eosinophils to attack the sebum (oils produced in the skin) of sebaceous gland cells.

• dapsone
• topical and systemic steroids
• isotretinoin
• itraconazole
• permethrin
• interferon
• antibiotics

• narrowband UVB phototherapy
• ultraviolet therapy with ultraviolet B or with ultraviolet A
• Psoralen plus ultraviolet A (PUVA)
• calcineurin inhibitors such as tacrolimus ointment
• colchicine
• transdermal nicotine patches