Fallah Haady, Dunlop Kate, Kossard Steven
Skin and Cancer Foundation Australia, Darlinghurst, New South Wales, Australia.
Australas J Dermatol. 2006 Nov;47(4):281-5. doi: 10.1111/j.1440-0960.2006.00296.x.
A 56-year-old man presented with a 4-month history of a painful and pruritic eruption consisting of crusted plaques and blisters on his face, scalp and chest. The patient suffered from headaches and malaise but was afebrile. Two skin biopsies revealed an epidermis which was eroded and covered by locules of serum and neutrophils. In the underlying dermis, there was a marked mixed inflammatory reaction including lymphocytes, neutrophils and numerous eosinophils. There was exocytosis of eosinophils into several follicles with areas of follicular mucinosis. A diagnosis of necrotizing eosinophilic folliculitis was made based upon the clinical and histopathological findings. The diagnosis was supported by the rapid response to a combination of indomethacin and cephalexin. The patient has taken continuous indomethacin (with rabeprazole and misoprostol cover) and cephalexin for 2 years. If treatment is withdrawn he experiences a flare of his disease within 2 weeks. This case highlights the potentially chronic nature of this disease.
一名56岁男性，面部、头皮和胸部出现疼痛性及瘙痒性皮疹4个月，表现为结痂斑块和水疱。患者有头痛和不适，但无发热。两次皮肤活检显示表皮糜烂，被血清和中性粒细胞小腔覆盖。在真皮深层，有明显的混合性炎症反应，包括淋巴细胞、中性粒细胞和大量嗜酸性粒细胞。嗜酸性粒细胞向几个毛囊内浸润，伴有毛囊黏蛋白沉积区域。根据临床和组织病理学表现，诊断为坏死性嗜酸性毛囊炎。吲哚美辛和头孢氨苄联合使用反应迅速，支持了该诊断。患者连续服用吲哚美辛（联合雷贝拉唑和米索前列醇）和头孢氨苄2年。若停药，2周内病情就会复发。该病例突出了这种疾病潜在的慢性特点。
