Disseminate and Recurrent Infundibular Folliculitis
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Disseminate and recurrent infundibular folliculitis (DRIF) was first described in 1968 by Hitch and Lund. [1] The clinical presentation is much like miliaria or keratosis pilaris. It is mostly seen in young healthy people, and most patients have a dark skin color. It consists of generalized flesh-colored papules. Therapy has generally been unsuccessful.
The validity of disseminate and recurrent infundibular folliculitis as a separate entity has been questioned. However, it does have such a characteristic clinical picture that for the present it is accepted as an entity.
The etiology of disseminate and recurrent infundibular folliculitis is not established.
United States
Although the first case of disseminate and recurrent infundibular folliculitis was not reported until 1968, other more recent reports indicate that it is a fairly common occurrence. Clinics that see a large number of young dark-skinned patients report that disseminate and recurrent infundibular folliculitis is a common condition. Indeed, it may occur in large numbers in hot, humid weather.
International
Cases of disseminate and recurrent infundibular folliculitis have been reported from Europe and India.
Disseminate and recurrent infundibular folliculitis has been reported primarily in people of African American origin in the United States. [2] Why a number of dermatoses tend to be papular and follicular in dark-skinned people is not known. This phenomenon is well documented in atopic dermatitis.
Although most of the patients are men, disseminate and recurrent infundibular folliculitis has been reported in women.
Most of the reported disseminate and recurrent infundibular folliculitis patients have been healthy young adults.
Disseminate and recurrent infundibular folliculitis may last for years. Pruritus is the troublesome symptom of disseminate and recurrent infundibular folliculitis. In the past, this was difficult to relieve. Disseminate and recurrent infundibular folliculitis may make it uncomfortable for the patient to work in a hot, humid environment.
Hitch JM, Lund HZ. Disseminate and recurrent infundibulo-folliculitis: report of a case. Arch Dermatol. 1968 Apr. 97(4):432-5. [Medline].
Barriere H, Litoux P, Bureau B, Stalder JF. [Disseminate and recurrent infundibulo-folliculitis (Hitch and Lund)]. Ann Dermatol Venereol. 1980 Apr. 107(4):299-302. [Medline].
Hinds GA, Heald PW. A case of disseminate and recurrent infundibulofolliculitis responsive to treatment with topical steroids. Dermatol Online J. 2008 Nov 15. 14(11):11. [Medline].
Ravikumar BC, Balachandran C, Shenoi SD, Sabitha L, Ramnarayan K. Disseminate and recurrent infundibulofolliculitis: response to psoralen plus UVA therapy. Int J Dermatol. 1999 Jan. 38(1):75-6. [Medline].
Aroni K, Grapsa A, Agapitos E. Disseminate and recurrent infundibulofolliculitis: response to isotretinoin. J Drugs Dermatol. 2004 Jul-Aug. 3(4):434-5. [Medline].
Owen WR, Wood C. Disseminate and recurrent infundibulofolliculitis. Arch Dermatol. 1979 Feb. 115(2):174-5. [Medline].
El Shabrawi-Caelen L, Soyer HP. Clinical Pathologic Challenge: Patchy pityriasiform lichenoid eczema. Am J Dermatopathol. Jun 2005. 27(3):216, 258.
White SW, Rodman OG. Disseminate and recurrent infundibulofolliculitis. J Assoc Military Dermatol. 1981. 22-23.
Christopher R Gorman, MD Avenues Dermatology, Private Practice
Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.
Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society
Disclosure: Nothing to disclose.
William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine
William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology
Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD.
Acknowledgments
Medscape Drugs & Diseases wishes to recognize Stephen W White, MD† for his original contributions to this article.
Disseminate and Recurrent Infundibular Folliculitis
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