tacrolimus and Folliculitis

Eosinophilic folliculitis (EF) comprises classic eosinophilic pustular folliculitis (EPF), human immunodeficiency virus (HIV)-related EF, and infantile EPF subtypes. A fourth proposed subtype describes EF associated with hematologic malignancy. Recently, EF has occurred after bone marrow or stem cell transplantation (SCT).. We report a unique case of EF after haploidentical allogeneic SCT for acute lymphoblastic leukemia (ALL) and review the literature for similar cases.. A 56-year-old, HIV-negative ALL patient presented with an intensely pruritic papulopustular eruption. He had undergone haploidentical allogeneic SCT 65 days earlier, which he had tolerated well. Histopathology revealed a moderately dense perifollicular and perivascular lymphocytic infiltrate with many eosinophils extending from the superficial dermis to the subcutaneous fat. Fungal stains were negative. These findings were highly consistent with EF.. Therapy with a class II topical corticosteroid ointment, oral doxepin, and emollients achieved near-resolution of the lesions within eight weeks. Transition to topical tacrolimus 0.1% ointment applied twice daily to residual lesions yielded complete clearance by 12 weeks with mild post-inflammatory hyperpigmentation. The patient's ALL remains in remission.. A fourth proposed subtype of EF is associated with HIV-negative hematologic disease. This subtype is distinguished by a predictable timeframe to presentation and a relatively rapid response to therapy. Although EF is an important consideration in all patients with hematologic malignancy, clinically heightened suspicion is warranted during the 2-3 months after transplant.

Topics: Adrenal Cortex Hormones; Doxepin; Eosinophilia; Folliculitis; Histamine Antagonists; Humans; Immunosuppressive Agents; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Stem Cell Transplantation; Tacrolimus

The aim of the present study was to evaluate the efficacy and safety of narrowband UVB (NB-UVB) compared with tacrolimus ointment 0.1% in patients with bilateral vitiligo.. In this comparative study, four groups of patients were randomized. Each group was composed by 12 patients with bilateral vitiligo; in each group, every patient was irradiated with NB-UVB (length: 311 nm) twice a week for 9 months and applied tacrolimus ointment 0.1% twice a day on the other area in the same period. Before starting therapy and after 3, 6 and 9 months of therapy, a clinical and photographic evaluation of percentage of repigmentation was performed and Dermatology Life Quality Index Questionnaire was fulfilled.. A repigmentation at least partial occurred in 71% of patients after 36 weeks of treatment with tacrolimus ointment 0.1%; in the whole sample, 14 patients (29%) showed no repigmentation at all, with 2 of them discontinuing the therapy because of side effects (erythema and folliculitis-like manifestations). A homogeneous repigmentation at least partial occurred in 69% of patients after 36 weeks of treatment with NB-UVB; in the whole sample 15 patients (31%) showed no repigmentation at all, with 1 of them discontinuing the therapy because of side effects.. The present study confirmed that the efficacy of NB-UVB phototherapy in vitiligo is comparable to tacrolimus ointment 0.1% therapy. On the basis of our study, we may suggest tacrolimus ointment 0.1% as an alternative to NB-UVB therapy for treating vitiligo.

Topics: Adolescent; Adult; Aged; Child; Epidermis; Erythema; Folliculitis; Humans; Immunosuppressive Agents; Melanocytes; Middle Aged; Prospective Studies; Skin Pigmentation; Surveys and Questionnaires; Tacrolimus; Ultraviolet Therapy; Vitiligo; Young Adult

We report on a rare case of perforating folliculitis with a paradoxical presentation. An 18-year-old patient with end-stage kidney failure was undergoing continuous ambulatory peritoneal dialysis following 1 year of hemodialysis treatment. While being treated with continuous ambulatory peritoneal dialysis, he developed an itchy papular eruption on an erythematous base over his face and chest, which was diagnosed as chicken pox and treatedwith acyclovir.He also underwent successful deceased donor kidney transplant 1 year later. On day 10 posttransplant, he presented with a papular eruption over the chest, face, and forearms. A skin biopsy revealed a perforating folliculitis lesion. He was treated with prednisone and tacrolimus, as part of the kidney transplant treatment. The skin lesions resolved progressively. His urea, creatinine, and electrolyte levels remained normal and on an ever-improving trend at each visit. By 4 months posttransplant, the skin lesions had resolved almost completely.

Topics: Folliculitis; Humans; Kidney; Kidney Transplantation; Male; Tacrolimus; Treatment Outcome

Topics: Antifungal Agents; Azoles; China; Dermatomycoses; Folliculitis; Humans; Lipase; Malassezia; Microbial Sensitivity Tests; Molecular Epidemiology; Skin; Tacrolimus; Terbinafine; Tinea Versicolor

Eosinophilic pustular folliculitis (EPF), first described by Ofuji et al. in 1970, is a rare dermatosis characterized by pruritic papules and pustules on circinate erythematous plaques with eosinophilic infiltration in and around the hair follicle.. We report three cases of EPF that showed no macroscopic pustules during the total observation period. Histopathological examination revealed eosinophilic infiltration in and around the hair follicle in the lower dermis and subcutis.. EPF consists of clinical variants, one of which lacks obvious pustules.

Topics: Adult; Dermatologic Agents; Eosinophilia; Female; Folliculitis; Humans; Indomethacin; Middle Aged; Skin Diseases, Vesiculobullous; Tacrolimus; Treatment Outcome

Folliculitis decalvans is an embarrassing and challenging disease with no established treatment guidelines. In this paper, we described four patients with this disease treated successfully with Tacrolimus ointment. All of them showed significant control of the condition, stopping inflammatory lesions and progression of the disease, although weak transitory outbreaks of inflammatory lesions were observed in some cases. Alopecia and tufted hairs remained unchanged. The discontinuation of the therapy produced rapid relapses in all cases. Close monitoring of these patients is recommended due to the potential risk of malignant transformation of the disease.

Topics: Adult; Female; Folliculitis; Humans; Immunosuppressive Agents; Male; Ointments; Scalp Dermatoses; Tacrolimus; Treatment Outcome; Young Adult

Classic eosinophilic pustular folliculitis (EPF), otherwise known as Ofugi disease, is a rare condition commonly treated with topical glucocorticosteroids. If this fails, oral indomethacin is frequently the next line. Because the condition is recurrent, the use of long term steroids may cause side effects such as skin atrophy, hypertrichosis, and dyspigmentation. Topical tacrolimus is an immunosuppressant that is generally used as a steroid-sparing agent in atopic dermatitis. We report a case of classic EPF, which was recurrent over 5 years that had failed topical glucocorticosteroids but was successfully treated with topical tacrolimus 0.1 percent ointment.

Topics: Eosinophilia; Female; Folliculitis; Glucocorticoids; Humans; Immunosuppressive Agents; Indomethacin; Middle Aged; Ointments; Skin Diseases, Vesiculobullous; Tacrolimus; Treatment Outcome

Topics: Administration, Topical; Eosinophilia; Folliculitis; Humans; Immunosuppressive Agents; Infant; Male; Skin Diseases, Vesiculobullous; Tacrolimus; Treatment Outcome

Topics: Acitretin; Aged, 80 and over; Anti-Inflammatory Agents; Drug Therapy, Combination; Female; Folliculitis; Humans; Immunosuppressive Agents; Keratolytic Agents; Prednisolone; Scalp Dermatoses; Tacrolimus; Trace Elements; Treatment Outcome; Zinc

Eosinophilic pustular folliculitis is a rare dermatosis. Recently, in addition to oral indomethacin, other treatments have been applied for eosinophilic pustular folliculitis. The aim of this study was to assess the effectiveness of various therapies encompassing conventional to newly applied drugs for eosinophilic pustular folliculitis. Twenty patients with eosinophilic pustular folliculitis seen in our department were investigated. The effectiveness of each treatment was assessed by a severity score index. Eleven patients were treated with oral indomethacin, and the severity scores of all patients were decreased after the treatment. Oral cyclosporine was markedly effective in all 11 patients treated, and topical tacrolimus ointment alleviated eosinophilic pustular folliculitis in 3 of 7 with one patient showing a remarkable reduction in the severity score. In addition to indomethacin or other oral non-steroidal anti-inflammatory drugs, oral cyclosporine and topical tacrolimus may be beneficial choices when patients have been resistant to previous treatments.

Topics: Administration, Cutaneous; Administration, Oral; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Cyclosporine; Eosinophilia; Female; Folliculitis; Humans; Immunosuppressive Agents; Indomethacin; Male; Middle Aged; Tacrolimus; Treatment Outcome

Topics: Adult; Eosinophilia; Folliculitis; Humans; Immunosuppressive Agents; Male; Ointments; Tacrolimus; Treatment Outcome

Topics: Administration, Cutaneous; Antiretroviral Therapy, Highly Active; Eosinophilia; Folliculitis; HIV Infections; Humans; Immunosuppressive Agents; Tacrolimus; Uganda

Sterile eosinophilic folliculitis, a clinical entity first described by Ofuji in 1970, is a rather rare skin disorder, in particular in the non-Asian population. We report the first case of eosinophilic folliculitis associated with toxocariasis in a Caucasian patient. Topical and systemic anti-inflammatory and antiphlogistic therapy along with systemic antihelminthic treatment resulted in complete remission of the skin lesions. In addition, there was a marked decrease of antibodies to Toxocara antigens in the patient's serum following antihelminthic therapy. Given that (I) some cases of eosinophilic folliculitis have been reported which were associated with infestation with metazoan parasites; (2) infestations with the roundworm Toxocara canis are known to induce eosinophilic reactions in some tissues; and (3) therapy-induced remission of eosinophilic folliculitis was accompanied by a decrease of Toxocara-directed antibodies in the patient's serum, we propose that there is an aetiopathogenic link between toxocariasis and eosinophilic folliculitis in this patient.

Topics: Albendazole; Animals; Anthelmintics; Eosinophilia; Female; Folliculitis; Humans; Immunosuppressive Agents; Middle Aged; Pruritus; Tacrolimus; Toxocara canis; Toxocariasis; White People

Topics: Administration, Topical; Adult; Eosinophilia; Female; Folliculitis; HIV Infections; Humans; Immunosuppressive Agents; Male; Middle Aged; Tacrolimus; Treatment Outcome

We present two cases of Eosinophilic pustular folliclulitis (EPF) who were successfully treated with topical tacrolimus. Indomethacin is the most frequently used agent for the treatment of EPF, however, tacrolimus ointment may become the treatment of choice for patients with EPF.

Topics: Adolescent; Adult; Eosinophilia; Female; Folliculitis; Humans; Immunosuppressive Agents; Tacrolimus; Treatment Outcome

Topics: Adult; Eosinophilia; Female; Folliculitis; Humans; Immunosuppressive Agents; Tacrolimus

We describe a patient with eosinophilic pustular folliculitis who partially responded to oral indomethacin, but intermittently experienced new eosinophilic pustular folliculitis lesions. Treatment with tacrolimus ointment 0.1% resulted in the rapid improvement of each recurred lesion and allowed withdrawal of indomethacin. To our knowledge, this is the first report of the use of topical tacrolimus in the treatment of eosinophilic pustular folliculitis.

Topics: Administration, Oral; Anti-Inflammatory Agents, Non-Steroidal; Drug Therapy, Combination; Eosinophilia; Folliculitis; Humans; Immunosuppressive Agents; Indomethacin; Male; Middle Aged; Ointments; Recurrence; Tacrolimus; Treatment Outcome

The purpose of this study was to evaluate the risk of cutaneous infection in patients with atopic dermatitis treated with tacrolimus ointment.. Data for 1554 patients with atopic dermatitis, treated with tacrolimus ointment in 5 clinical trials, were analyzed.. In 3 controlled studies, the 12-week adjusted incidence of all cutaneous infections in patients treated with the vehicle, 0.03%, and 0.1% tacrolimus ointment, respectively, was 18.0%, 24.8%, and 17.7% for adult patients, and 20.9%, 19.6%, and 23.6% for pediatric patients. The incidence of any individual cutaneous infection was not significantly higher in the tacrolimus group than in the vehicle group, with the exception of folliculitis in adults. In two open-label studies, there was no evidence of an increased risk of cutaneous infections with long-term use of 0.1% tacrolimus ointment (up to 1 year), based on the incidence of adverse events, incidence by cumulative length of exposure, or hazard rates.. Treatment with tacrolimus ointment (0.03% or 0.1%) does not increase the risk of cutaneous bacterial, viral, or fungal infections in patients with atopic dermatitis.

Topics: Adolescent; Adult; Child; Child, Preschool; Clinical Trials as Topic; Dermatitis, Atopic; Double-Blind Method; Female; Folliculitis; Humans; Immunosuppressive Agents; Male; Opportunistic Infections; Skin Diseases, Infectious; Tacrolimus

Topics: Adult; Eosinophilia; Folliculitis; Humans; Immunosuppressive Agents; Male; Ointments; Skin; Tacrolimus