A case of eosinophilic pustular folliculitis successfully treated with tacrolimus ointment

We report a case of eosinophilic pustular folliculitis (EPF) that was successfully treated with topical tacrolimus ointment. A 43-year-old Japanese woman presented with a 3-month history of a pruritic eruption on the left side of the face. She had been treated at a previous clinic with topical steroids and oral prednisolone (15 mg/day). The eruption responded to oral prednisolone, but she had moon face due to the side effect of steroid, so oral prednisolone was stopped. A histological examination of a skin lesion revealed infiltration of eosinophils in and around the hair follicles and sebaceous glands. White blood cell count was 5,200/μl (8.3% eosinophils). From the clinical examination and histological findings, we diagnosed the patient as EPF. The patient was treated with topical tacrolimus ointment. After 2 weeks, the eruption had improved markedly, and she is now free from symptoms. Tacrolimus ointment may become the treatment of choice for patients with EPF.