Uncommon localisation of Ofuji disease in a Moroccan patient

A Moroccan 18-year-old patient with a history of left mastectomy because of naevoid keratosis of the nipple arrived presenting pruritic papulopustular lesions located on the surgical scar as well as his extremities, without any associated systemic signs. Occasionally, additional histological results are observed, such as focal destruction of the outer follicular sheath; neutrophil and basophil infiltration may also be reported, while CD8+ lymphocytes are most frequently seen in the HIV-associated type.3 This being said, this pathophysiology remains unknown. Clinical differential diagnoses include infectious diseases such tinea faciei, inflammatory diseases like acne, rosacea, lupus miliaris disseminatus faciei and even a folliculotropic mycosis fungoides, a rare variant of cutaneous T cell lymphoma.3 Several treatments might be suggested to the patient, including corticosteroids, retinoids, dapsone, colchicine, cyclosporine and minocycline. In case of allergy to NSAIDs (as for our patient), dapsone presents a good alternative, with positive feedback on its effectiveness from several teams.5 However, a notable element would be that the old scars’ resistance could be explained by the presence of a deeper eosinophilic infiltration due to the alteration of the skin surface.