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what causes this

any idea what would cause esinophilic folliculitis?
217 Responses
1415174 tn?1453246703
COMMUNITY LEADER
Firstly, we are not doctors on here but I can give you some information.

Why do you think you have eosinphilic folliculitis? Did a doctor tell you that you have this? Regular folliculitis is cased by a bacterial infection and follows the follicules.

Eosinophilic folliculitis is Itcy red bumps on the upper part of the body. it is most often seen in people with HIV or in HIV negative but immunosuppressed  or those with low T helper cells. Also, those with leukemia and lymphoma. HIV negative normal individuals in Japan can also get this.

Have you been tested for HIV? If HIV negative have you had a complete blood count? If so you would see very high red blood cells too. The diagnosis can be supported by the finding of eosinophilia but a skin biopsy is necessary to establish it. Skin biopsies reveal lymphocytic and eosinophilic inflammation around the hair follicles

The causes of infection are mite Demodex, the yeast Pityrosporum, and bacteria An autoimmune process has also been investigated.

mkh9
Avatar universal
a dermatologist diagnosed me and gave a topical steroid.we biopsied to diagnose.she did not give me antibiotics.she asked if i was preparing myself.also if my doctor was going to keep testing. i said i wasnt sure .i figured he must have a plan.she asked if i wanted her to call him and tell him to keep testing and i told her thats all right i can tell him since i had an appointment coming up.tested at 7 months still positive for nothing.hearing is starting to degrade eyesight diminishing.severe headache after long periods of physical activity muscle twitching ,muscle wasting ,numbness on side of face,burning feet ,sensitivity to loud noise .i dont understand why doctors dont help while testing they could make people aware of natural remedies to help alleviate pain from symptoms.but instead they are telling everyone its allergies or anxiety.all that did for me was cause me to lose trust and faith in my doctors so i fired them and got a new team of doctors who seem to be moving a little faster.in 8 months of research i found that the public is being misinformed about transmission of hiv.the top doctors in the world state that if the person giving oral has hiv there is a small risk of contracting the virus.they also state that during seroconversion that person would be highly contagious .therefore making the risk much greater.same thing with anal and vaginal.also people are being told that if they wear a condom there was no risk for vaginal and anal .how can anyone tell if the person has a high viral load unless you carry a rna test kit in your pocket .it would seem to be misinformation of sort for people to be told there is no risk when people are contracting hiv in these manners.i find alot of conflicting information which says that hiv does not live long outside the body but there are charts stateing that hiv can be transmitted through sharing and exchanging sex toys.providing they are not covered with a protective barrier or being cleaned before sharing.i was told myself oral was no risk .so here i am preparing myself for the worst and hoping for the best.even though it seems evident.you have helped me with answers in trhe past and i have apreciated your honest answers . the answers you provided gave me hope that if there were one person who could be honest about this topic.someone who does not skirt the issue .then there must be others and i might get an answer it just seemed to be a round about way trying to get there but i feel i am getting there ,because of your truthful answers i didnt give up . thank you mkh9
1415174 tn?1453246703
COMMUNITY LEADER
Yes, thank you. Sorry you have gotten the run around. I have had that in the past too and it isn't fun. I am a scientist (microbiologist) not a doctor, so I state the facts as I see them. I don't want to scare people but you need to be informed of all possibilities. However, anxiety does come from pain, and from some diseases. I have had it from the pain cycle and it goes hand in hand no matter how hard to you try to avoid it. I find biofeed back breathing exercises helpful. But that doesn't mean that it is the cause of your problem just like anxiety wasn't the cause of my back pain or migraines. But if you have had a 4th generation HIV test and it was negative, I would really trust that provided you had it after 17 days. If you wait for 3 months that is good too. There is no "window period with this test" because it doesn't need to wait for  you to seroconvert". But it does take some time for the antigen to get high enough.  Realize that it could be something else that you are missing. Yes, I think HIV dies in the environment but if there are body fluids then it may last longer as long as the virus is protected in the body fluids and doesn't get dried out. I think you need some follow up testing to see what your complete blood count and CD4 count looks like and also perhaps have to get the skin biopsy. Maybe see a hematologist.

The question is, is the Eosinophilic folliculitis only on the upper part of the body. That seems to be diagnostic. In any case I would think they would give you a topical. But the thing is if it is due to a mite instead of a bacteria it won't help. You would need a different treatment. So you need a good doctor to do the biopsy and see what is the underlying cause. So that you can get treatment. Maybe the dermatologist that gave you the diagnosis would be willing to do it and send it in to pathology that way you can get treated. At least the skin level. If the cause though is something worse such as lymphoma or leukemia that is another type of treatment. I hate to mention these possibilities. The way to find out is did you already have a complete blood count and was it normal? If not you need to get one done and maybe a bone marrow. So that is why a hematologist is important if your 4th generation test is negative. The P24 part of the 4th gen duo test tells you if you have the HIV antigen so you really don't need to quantitate the RNA.  If you were immunocompromised your RNA level would go up on this test. That is why it is good. If the antibody part of the test is not working due to low immunity the P24 antigen is detected. Hope this helps. But I'm sure you are worried. I am not an alarmist and usually don't like to mention thinks like lymphoma and so forth. But, if your diagnosis is correct you need to follow this up to see what is going on. If these are clear then go from there.
mkh9
Avatar universal
i am not so much worried for myself but for my family members .my sons white blood cell count is below normal range .his doctor says she is not concerned.cbc
                                 in range   out of range    reference range                    
white blood count                           4.0              4.5-14.5          thou/ul            
red blood count           5.11                                4.00-6.20          mil/ul            
hemaglobin                 14.4                               10.6-14.6            g/dl            
hematocrit                   39.9                               32.0-43.8            %
mcv                             78                                  73-89                  fl
mch                             28.2                               23.0-31.0            pg        
mchc                                             36.1h           30.0-36.0            g/dl      
rdw                              12.4                               11.5-14.5             %        
platlet count                 376                                200-700           thou/ul
mpv                             10.5                               9.4-12.5               fl          
neutrophil                    31.8                               28.0-58.0             %    
immature granulocyte 0.2                                 0.0-1.0                 %            
lymphocyte                 55.9                               28.0-65.0             %            
monocyte                    8.7                                1.0-15.0                %    
esinophil                     3.2                                 0.0-10.0               %      
basophil                      0.2                                 0.0-1.0                 %  
neutrophil absolute                        1.28l           1.50-8.50          thou/ul    
immature granulocyte absolute
                                    0.01                              0.00-0.10          thou/ul  
lymphocyte absolute   2.26                              1.50-6.50          thou/ul  
monocyte absolute     0.35                               0.20-1.50          thou/ul  
eosinophil absolute     0.13                              0.00-0.70          thou/ul  
basophil absolute        0.01                              00.0-0.20          thou/ul  

what do you make of this mkh9 can you give me some insight i dont care about my self at this point .this is my sons cbc any help would be greatly appreciated
1415174 tn?1453246703
COMMUNITY LEADER
The WBC (white blood cell) count is only very slightly low and the  MCHC is really normal even though it is one tenth off. The Absolute neutrophil count is somewhat low. But since the WBC count is normal it is saying that fraction of the WBC's that fight infections like bacterial infection is a little low. The lymphocytes which usually fight off viruses is normal. The rest is normal. Values can fluctuate somewhat. Ask your doctor if you are concerned about it. The ranges are different from lab to lab as to how far off they can go. There are no atypical cells seen so that is really good.

mkh9
Avatar universal
what are atypical cells ? can bacterial infections cause the neutrophils to go low?or would it be more likely that it was something viral?

1415174 tn?1453246703
COMMUNITY LEADER
Sorry, atypical cells are cells that "look' different than normal. They are seen with leukemia, anemia, lead poisoning, some genetic diseases etc.  

Neutrophils usually go high with bacterial infections, viral infections can lower the neutrophils. Best not to speculate. I would ask a doctor. I still think you should see a hematologist and get this worked out.
mkh9
Avatar universal
my concern is that my son started showing symptoms after 21/2 to 3 months after my exposure a strange allergic reaction sneezing runny nose and each each week something else has surfaced .my doctors told me i was not contagious . i have lesions on my chest and i was seroconverting i did not understand at the time you are highly contagious .i stayed away from him for 21/2 to 3 months i did not let him come anywhere near me but i felt really bad because we were very close and he couldnt understand why i wouldnt hug him anymore .when i came home from work one day he ran over to me while i was changing my shirt and hugged me bare chested. i fear i may have infected him with something through repeated exposure.i warned to never touch my toothbrush ,and not to touch my towel.i know this isnt just a coincedence .i checked the roof of his mouth and he had red dots .then it progreessed to an orange palate then it turned purple and veiny on both sides now he has a bump on the back of his throat and veins also the taste buds on the back of his tongue have become huge.so we took him to see the doctor she says he is allergic to mold .then he started having trouble with speech he pauses in the middle of a word and during sentences he has to think to be able to finish the sentence he started his hearing became sensitive .he would freak out when he heard loud noises.his skin became dry he developed a rash on his face .he has become unusally clumsy and more emotional.his dr didnt even make us aware of his cbc i had to go back and request a copy im a little dissapointed we werent alerted about it.i think this should be cause for concern encephalitic conditions along with the cbc.
Avatar universal
i stuck with my original doctors for 61/2 months .they tested at the wrong intervals they made note that i had certain indicators of hiv and even said that i might actually surprise the hell out of them .the id ithe practice looked in my throat and it prompted her to ask if i had any lesions.i said yes on my chest she said ithink i rember seeing that oh well ill just stick to my original diagnosis your welcome to get a second opinion .they did a p24 at a month and ahalf and were using elisa and western blot for the rest of my testing.none took into account that i am a construction worker and my job is very physical .i never rested i powered through my sero .suffering greatly by the time i got home everday .i was in so much pain . im going to a new id tommorrow some of the best in the area.i will ask them about the p24.i also predict a confection or superinfection. took some time of from work in the hopes of starting antibody production we tested for everything and had slight movment on hep titer and syph titer.they wouldnt show me my hiv results so i dont know what they said other than they were neg.the only reason i need a positive is so i can persaude my sons doctor to test him because it appears to me that hrough household transmission he has what i have and he could be running out of time .i dont want to start treatment i will need the money to get him diagnosed and for him to recieve help.
1415174 tn?1453246703
COMMUNITY LEADER
Well from what I see from what you just told me is that you had the P24 test at 1 month and a half which is about 45 days. If you look at this article regarding the 4th generation assay and there is a graph. If you click on the graph it will become larger. It shows that the P 24 drops about about 42-43 days. But the antibody level will still be high.

http://emedicine.medscape.com/article/1982802-overview

So even if your P 24 level drops your antibody level would show up.

So if you were negative with the antibody at a month and a half you are negative. Also, did you retest the HIV antibody or any test after that at 3 months? It doesn't look like you are positive for HIV. It may be something else that is causing your problem. It is good to talk to a specialist since you are having this problem but also your son is having some problems as well. BUt his CBC is pretty normal with some slight drop in his Neutrophils. Your son wouldn't get HIV the way you described it unless he had open wounds on his chest to start with . If he had normal intact skin and you had open wounds and had HIV (which you don't)  he wouldn't just get it from touch his skin to your open wounds. he has to have open skin to get it. So there may be something else going on. Folliculitis itself is contagious. Espcially if it is regular folliculitis caused by Staph aureus. Then he could get that. So I wonder if that one doctor misdiagnosed the type of folluculitis you have? You also don't HIV by just saliva you have to have bloody gums and that kind of thing (regarding your tooth brush). But you are talking about the folliculitis? It is contagious and depends on what bacteria is in the follicules.  It is usually Staph. But with the eosinophilic It can also be yeast or mites. They need to test the wounds if they haven't yet. If you can find out what the follicules have it would be helpful. What was your CBC like?
mkh9
Avatar universal
at one point my lymphocytes dropped from 30% to 7.7% i was concerned that this may be a reinfection due to the fact ive had prostatitis for years and bruxism.also blood in my urine and my liver has shown signs of problems for years.my son also had bruxism i noticed a couple of years ago.if this were reinfection and i was ten years out antigens would be low possibly?and if iwere suffering aids conditions lymphocytes below 12 %.i probably wouldnt produce antibodies making standard testing come up negative.?is it possible that reinfection could occur much easier than initial infection?i still think the staff auerus makes great sense .since its been going on so long we both have itchy noses and if it got into our bodies it could really raise heck couldnt it inflammation and such.i just went to one of the better id's in the state today .she surprised me in her testing choices now i will know for sure if i have any virus itself in my blood.she said she didnt think that being this far out i would get a positive  .she said after 5 months.she also said that she noemally dosent run so many tests .but that i had so many symptoms she was going ot run more tests.it must have been close to 8 ounces .there were 4 large bottles we had to switch from my right arm to my left.my right ran out or something .here is a list im not sure what some of these will detect .

creatine kinase
erythrocyte sediment rate

phlebotomy

hcv rt-pcr quantitative

hiv1 rna viral load,qn

anaplasma phagocytophilium ab(erlichia)

babesia microti ab igg/igm titer

culture,blood

cd 4 profile

ant-nuclear antibody screen,reflex titer

c-reactive protein

rheumatoid factor

syphilis mia reflex rpr titer and tppa

htlv 1/2 ab reflex confirmation               i asked about it so she put it on there even though we arent in a location where it would be likely

i think it will be 2 weeks before i hear results.
1415174 tn?1453246703
COMMUNITY LEADER
Hi and well she did order a lot of blood work. I am surprised that she ordered Babesia but not lymes disease. Funny. I also don't know why she ordered the
anaplasma test in particular.  The Syphilis antibody test is a good idea. I always question the RPR type test as they have a high false negative but you don't have the symptoms for secondary syphilis or even tertiary.  When you first got tested for HIV what what the time frame after exposure? Which test was it at that time? I am also surprised they don't culture your folliculitis. It is strange to me to run all the expensive lab tests and not do a simple culture. Doctors love to do the expensive lab tests first. I just had a $1,000 in lab tests too and about 20 tubes taken from me. I'm glad to know I don't have a genetic reason for getting my blood clots but geese. She is doing some autoimmune check on you. FYI, I wouldn't believe a diagnosis of lupus based on the small amount of lab work. I don't think that is what she is after though.

If Staph Aurues was in your blood you would have a  high fever.
So it will be good to see the answers to the results. I am sure you will have inflammation due to the skin infection. So the CRP and ESR will be high. The rest will probably be negative.

Have you ever been bitten by a tick? Do you hike a lot and go out without tick repellant? What state do you live in?

Since your son has has some symptoms it could be genetic or that you transferred some of the staph or other organism to him. I don't think you transferred HIV but a bacteria or mite. The lymphocytes being low on both of you implies hereditary disease or contagious/infectious. But I haven't heard from you that you have done anything to transfer anything to him. So, it is good to get these tests done to prove to you what is going on. Hopefully you can put it  in the past.  Your past low lympocyte count is very low. Why it came back up is strange. Do you live near a toxic dump or something? Work at a place that has hazardous materials?
mkh9

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