Fushimi M, Tokura Y, Sachi Y, Hashizume H, Sudo H, Wakita H, Furukawa F, Takigawa M
Department of Dermatology, Hamamatsu University School of Medicine, Japan.
Br J Dermatol. 1996 Apr;134(4):766-72.
Eosinophilic pustular folliculitis (EPF) is characterized clinically by pruritic grouped follicular papules and pustules on the trunk, limbs, and face, and, histologically, by follicular infiltration with eosinophils. The blood eosinophil count is elevated in most patients. Oral minocycline, nonsteroidal anti-inflammatory drugs, diaminodiphenylsulphone, and corticosteroids may induce remission. We report two Japanese men with EPF who responded poorly to the usual therapy. Intravenous injections of recombinant interferon-gamma (rIFN-gamma), 5 x 10(5) to 2 x 10(6) Japan Reference Unit (JRU) (1 JRU roughly corresponds to 4 NIH units) daily for 7 days, cleared the skin lesions and returned the peripheral eosinophil counts to normal in both patients. However, the lesions recurred 2-3 days after rIFN-gamma was stopped. Both patients have received intravenous rIFN-gamma once or twice a week for nearly 1 year without systemic side-effects. Reverse transcriptase-polymerase chain reaction revealed a decreased expression of interleukin 5 (IL-5) mRNA in peripheral mononuclear cells after the rIFN-gamma therapy. rIFN-gamma may become the treatment of choice in recalcitrant EPF, although further studies are needed. It may work by interfering with the immunological function of type 2 T-helper cells, including IL-5 production responsible for the growth and differentiation of eosinophils.
嗜酸性脓疱性毛囊炎（EPF）的临床特征为躯干、四肢和面部出现瘙痒性成簇的毛囊丘疹和脓疱，组织学特征为毛囊嗜酸性粒细胞浸润。大多数患者血液嗜酸性粒细胞计数升高。口服米诺环素、非甾体抗炎药、二氨基二苯砜和皮质类固醇可能诱导病情缓解。我们报告了两名患有EPF的日本男性，他们对常规治疗反应不佳。静脉注射重组干扰素-γ（rIFN-γ），每天5×10⁵至2×10⁶日本参考单位（JRU）（1 JRU大致相当于4 NIH单位），共7天，清除了两名患者的皮肤病变并使外周嗜酸性粒细胞计数恢复正常。然而，rIFN-γ停药后2 - 3天病变复发。两名患者每周接受1或2次静脉注射rIFN-γ近1年，无全身副作用。逆转录聚合酶链反应显示rIFN-γ治疗后外周单个核细胞中白细胞介素5（IL-5）mRNA表达降低。尽管需要进一步研究，但rIFN-γ可能成为难治性EPF的治疗选择。它可能通过干扰2型辅助性T细胞的免疫功能起作用，包括负责嗜酸性粒细胞生长和分化的IL-5产生。
