Eosinophilic folliculitis following allogeneic peripheral blood stem cell transplantation: case report and review

Abstract

Eosinophilic folliculitis is considered a heterogeneous group of disorders, with several clinical subsets, sharing a common histopathological appearance. Increasing numbers of cases, following bone marrow transplantation (BMT), have been reported in recent years. We herein present a case of eosinophilic folliculitis that appeared in a 26-year-old woman 5 months after allogeneic peripheral blood stem cell transplantation as treatment for eosinophilic acute leukemia. Our review of the published cases has shown that eosinophilic folliculitis in patients after BMT could be considered as a pattern of reaction related to immune dysregulation.

Eosinophilic folliculitis occurring after stem cell transplant for acute lymphoblastic leukemia: a case report and review

“…Thirteen previously reported cases depict EF in patients with hematologic malignancy specifically following BMT or SCT . Affected patients share similar characteristics.…”

“…Sweet’s syndrome, erythema nodosum, or EF). 22 This case of EF following haplo‐identical allogeneic SCT for ALL parallels 13 other transplant‐related EF cases with different hematological malignancies (Table ) …”

Diseases of cutaneous appendages

“…260 Pediatric (childhood) eosinophilic pustular folliculitis is usually confined to the scalp, although grouped aggregates of follicular pustules can occur on the face, extremities, and trunk in some patients. 278 Nine HIV-negative patients with an atopic diathesis have been reported with ulcerative and/or nodular plaques mainly on the face and/or extremities, sometimes in an annular configuration. 265 It is seen most frequently in white people but Japanese cases occur.…”

Eosinophilic folliculitis in association with chronic lymphocytic leukemia: A clinicopathologic series

“…Treatments with variable reported efficacies include indomethacin, topical and systemic steroids, phototherapy, isotretinoin, and, if HIV associated, highly active antiretroviral therapy. In patients with underlying hematologic malignancy, resolution with minimal specific treatment is typical, occurring after 8 weeks 1, 7…”

“…Additionally, the occurrence of EF after chemotherapy, bone marrow transplantation (BMT), or stem cell transplantation (SCT) is a commonly reported feature 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15Table IIClinicopathologic features of EF associated with underlying hematologic malignancy other than CLLStudyAge, ySexUnderlying hematologic malignancyTreatment for malignancyPeripheral eosinophiliaClinical descriptionDistributionNotable histologic featuresTakamura et al 6 77MMantle cell lymphomaChemotherapy13%Pruritic, erythematous papulesFace, neckEosinophils around follicles and sebaceous glandsTakamura et al 6 60MMantle cell lymphomaChemotherapy3.7%Pruritic, follicular reddish papulesFaceEosinophils around follicles and sebaceous glandsBhandare et al 8 64FSplenic marginal zone lymphomaChemotherapy2968/mL 3 Pruritic, follicular papules and pustulesScalp, back, proximal extremitiesFollicular spongiosis with eosinophilsZitelli et al 1 56MAcute lymphoblastic leukemiaAutologous SCT6.4%Pruritic papules and pustulesFace, chest, and backIntrafollicular collections of eosinophilsSugaya et al 9 42MSézary syndromeN/A9.5%Pruritic reddish follicular papulesCheeksProminent follicular exocytosis of eosinophilsRashid et al 10 74MChronic myelomonocytic leukemiaChemotherapyN/APruritic perifollicular papulesNeck and chestPerifollicular infiltrates with eosinophils, follicular mucinGoiriz et al 7 25FAcute eosinophilic leukemiaAllogene...…”