Rosazea mit eosinophilen Follikulitiden als „presenting sign“ bei einer HIV-infizierten Patientin

Zusammenfassung

Wir stellen eine 58-jährige Patientin mit disseminierten papulo-pustulösen Hautveränderungen im Gesichts-Halsbereich vor. In der Biopsie zeigte sich eine klassische sog. eosinophile Follikulitis, welche im Verlauf schnell auf die systemische Behandlung mit Antibiotika und lokalem Metronidazol ansprach. Serologisch stellten wir erstmals das Vorliegen einer HIV-Erkrankung fest. Rosazea-artige eosinophile Follikulitiden im Gesichtsbereich können also auch „presenting sign“ einer HIV-Infektion sein.

Abstract

We present a 58-year-old patient which suffered from disseminated papules and pustules affecting the head and neck. A biopsy specimen revealed a classical so-called eosinophilic folliculitis. The clinical symptoms underwent a rapid remission after treatment with antibiotics and topical metronidazol. By serology the presence of HIV infection was revealed for the first time. Thus rosacea-like eosinophilic folliculitides affecting the face could be a presenting sign of an HIV infection.

• Literatur

• 1 Rosenthal D, LeBoit PE, Klumpp L. et al. Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection. Arch Dermatol 1991; 127 (Suppl. 02) 206
• 2 Majors MJ, Berger TG, Blauvelt A. et al. HIV-related eosinophilic folliculitis: a panel discussion. Semin Cutan Med Surg 1997; 16 (Suppl. 03) 219
• 3 Magro CM, Crowson AN. Eosinophilic pustular follicular reaction: a paradigm of immune dysregulation. Int J Dermatol 1994; 33 (Suppl. 03) 172
• 4 Bodokh I, Lacour JP, Perrin C. et al. Papular eruption in AIDS: role of demodectic mites?. Acta Derm Venereol 1994; 74 (Suppl. 04) 320
• 5 Blauvelt A, Plott RT, Spooner K. et al. Eosinophilic folliculitis associated with the acquired immunodeficiency syndrome responds well to permethrin. Arch Dermatol 1995; 131 (Suppl. 03) 360
• 6 Fearfield LA, Rowe A, Francis N. et al. Itchy folliculitis and human immunodeficiency virus infection: clinicopathological and immunological features, pathogenesis and treatment. Br J Dermatol 1999; 141 (Suppl. 01) 3
• 7 McCalmont TH, Altemus D, Maurer T. et al. Eosinophilic folliculitis. The histologic spectrum. Am J Dermatopathol 1995; 17 (Suppl. 05) 439
• 8 Smith KJ, Skelton HG, Yeager J. et al. Metronidazole for eosinophilic pustular folliculitis in human immunodeficiency virus type 1-positive patients. Arch Dermatol 1995; 131 (Suppl. 09) 1089
• 9 Soeprono FF, Schinella RA. Eosinophilic pustular folliculitis in patients with acquired immunodeficiency syndrome. Report of three cases. J Am Acad Dermatol 1986; 14 (Suppl. 06) 1020
• 10 Fearfield LA, Rowe A, Francis N. et al. Itchy folliculitis and human immunodeficiency virus infection: clinicopathological and immunological features, pathogenesis and treatment. Br J Dermatol 1999; 141 (Suppl. 01) 3
• 11 Rajendran PM, Dolev JC, Heaphy Jr MR. et al. Eosinophilic folliculitis: before and after the introduction of antiretroviral therapy. Arch Dermatol 2005; 141 (Suppl. 10) 1227
• 12 Springinsfeld G, Roth B, Martinot M. et al. Immune reconstitution inflammatory syndrome associated with eosinophilic pustular folliculitis in an HIV-infected patient. Lettres à la rédaction/Médecine et maladies infectieuses 2011; 41 (Suppl. 01) 49
• 13 Nomura T, Katoh M, Yamamoto Y. et al. Eosinophilic pustular folliculitis: A published work-based comprehensive analysis of therapeutic responsiveness. J Dermatol 2016; 43 (Suppl. 08) 919-927 [Epub 2016 Feb 15]
• 14 Toutous-Trellu L, Abraham S, Pechère M. et al. Topical tacrolimus for effective treatment of eosinophilic folliculitis associated with human immunodeficiency virus infection. Arch Dermatol 2005; 141 (Suppl. 10) 1203
• 15 Buchness MR, Lim HW, Hatcher VA. et al. Eosinophilic pustular folliculitis in the acquired immunodeficiency syndrome. Treatment with ultraviolet B phototherapy. N Engl J Med 1988; 318 (Suppl. 18) 1183
• 16 Yamaoka T, Murota H, Tani M. et al. Severe rosacea with prominent Demodex folliculorum in a patient with HIV. J Dermatol 2014; 41 (Suppl. 02) 195-196