Ofuji's disease: diagnostic and therapeutic problems. A report of three cases

Background Ofuji's disease is an eosinophilic dermatosis affecting mostly male subjects. It is characterized by the appearance of follicular papulopustules, at times on an erytemathous base, which tend to form an annular configuration. The evolution is relapsing remitting. The histopathological examination demonstrates a dense dermal infiltrate with a prevalence of perifollicular and perivascular eosinophilia. Peripheral blood eosinophilia is observed in a high percentage of cases. The pathogenesis is unclear. Methods We report three cases of patients affected by Ofuji's disease with presentation on different sites. Our case reports concern three male subjects otherwise in good health and whose hematologic results were normal. Before they came to our observation, an erroneous diagnosis had been made and they had been subjected to improper treatment. Results To make a definite diagnosis it was necessary to evaluate the following features as a whole: the clinical aspect, the evolution, the result of the histological examination, the negativity of cutaneous cultures and the lack of response to previous treatments. All three patients were treated with dapsone 100 mg/day with regression of the clinical manifestations. In one case there was a relapse which was treated with isotretinoin 0.5 mg/kg/day. Conclusions From our experience we can deduce that in cases of follicular pathologies which do not respond to conventional therapies, it is necessary to take into consideration the possibility of Ofuji's disease and, in that case, patients should be monitored because of the frequent relapses.