Eosinophilic pustular folliculitis of infancy: A series of 15 cases and review of the literature  Angela Hern andez-Mart  ın, MD, a Almudena Nu~ no-Gonz alez, MD, a Isabel Colmenero, MD, b and Antonio Torrelo, MD a Madrid, Spain Background: Eosinophilic pustular folliculitis (EPF) of infancy is characterized by the presence of pustular lesions containing eosinophils. It is the least well-characterized of the EPF diseases. Objectives: We sought to define the clinical and histopathologic features of the condition. Methods: We conducted a retrospective review of the clinical data and histologic findings of 15 patients given the diagnosis of EPF of infancy at the Hospital Ni ~ no Jes us, Madrid, Spain, from 1995 to 2011, and of patient data published in MEDLINE with such a diagnosis from the disease description (1984-2011). Results: A total of 61 cases were collected. The disease was more common in males than females (ratio 4:1), and presented before 14 months of life in 95% of cases (mean 6.1 months; median 5 months). All patients had recurrent outbreaks and scalp involvement, and 65% had lesions on areas of the body other than the scalp. Tissue eosinophilia was present in all cases; however, true follicular involvement was observed only in 62% of cases in which histologic study was available. More than 80% of the patients were cured by 3 years of age (mean 25.3 months; median 18 months). Topical steroids were effective in 90% of cases. Limitations: This was a retrospective study. Conclusions: EPF of infancy presents most often in the first 14 months of life and usually resolves by 3 years of age. All patients showed scalp involvement, tissue eosinophilia, and recurrent outbreaks. The condition does not require aggressive treatment, as it is benign and self-limiting. ( J Am Acad Dermatol 2013;68:150-5.) Key words: eosinophil; folliculitis; infancy; pustular. I nfants may present different types of inflamma- tory lesions of eosinophilic nature that are usu- ally recognizable with ease on clinical grounds. Age of onset, location of lesions, and coexistence of infections or immunodeficiency are diagnostic keys. Eosinophilic pustular folliculitis (EPF) of infancy (EPFI) usually presents in early infancy and localizes on the scalp and other sites on the body surface. The lesions consist of recurrent crops of isolated or grouped papules and pustules that typically lack the annular or polycyclic ring characteristic of adult EPF. The condition is pruriginous, but patients remain in good health and do not have any associated disease. The recognition of EPFI and its distinction from other types of pustular lesions is critical to avoiding unnecessary diagnostic proce- dures and inappropriate treatments. In this study we report 15 new cases of the disease and review the literature to further characterize the disease. METHODS We performed a retrospective study of all cases of EPFI in the Hospital Ni ~ no Jes us, Madrid, Spain, between 1995 and 2011. We included only cases in which infectious processes had been ruled out and that showed tissue eosinophilia confirmed by means From the Departments of Dermatology a and Pathology, b Hospital Ni~ no Jes us. Funding sources: None. Conflicts of interest: None declared. Reprints not available from the authors. Correspondence to:  Angela Hern andez-Mart  ın, MD, Department of Dermatology, Hospital Ni~ no Jes us, Avda Men endez Pelayo, 65, 28009 Madrid, Spain. E-mail: ahernandez_hnj@yahoo.es. Published online July 23, 2012. 0190-9622/$36.00 Ó 2012 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2012.05.025 150