RESUMEN
La foliculitis eosinofílica pustulosa, descrita por primera vez por Ofuji, es una dermatosis que se distingue por pápulas y pústulas, pruríticas y foliculares, con tendencia central y que poco a poco se extienden periféricamente. Existen pocos casos reportados, sin que alguno se relacione con el embarazo; se desconoce el tratamiento específico. Es probable que la reacción de hipersensibilidad desempeñe un papel importante en ésta. Se comunica el caso de una primigesta de 27 años, con embarazo de 12.5 semanas, enfermedad de Ofuji de 17 años de evolución, con tratamiento desde 15 años antes con corticoesteroides y azatioprina, suspendidos al diagnosticar el embarazo. El control se realizó en el servicio de medicina materno fetal, donde se le prescribió prednisona a razón de 25 mg diarios. Manifestó infección de las vías urinarias y vulvovaginitis a las 14.2 semanas de embarazo, además de eosinofilia en sangre periférica. Tuvo periodos de exacerbación dermatológica a las 35.2 y 38.1 semanas de embarazo, que se trataron con prednisona y medidas locales; aumentó 4 kg durante el embarazo. Se le realizó operación cesárea a las 38.1 semanas de embarazo, por manifestar estado fetal inquietante. Tuvo una niña hipotrófica, de 2,450 g, Apgar de 5.8, placenta con calcificaciones en 60% de la misma y circular del cordón al cuello. En el puerperio tardío tuvo exacerbación de lesiones foliculares y aparición de pústulas. Las enfermedades inmunológicas pueden mejorar o empeorar durante el embarazo; en este caso hubo exacerbación en el puerperio e inhibición del crecimiento fetoplacentario, debido quizá al tratamiento.
Palabras clave: foliculitis eosinofílica pustulosa, enfermedad de Ofuji, embarazo.
Nivel de evidencia: II-3

ABSTRACT    

Eosinophilic pustular folliculitis, which was first described by Ofuji, is a type of dermatosis characterized by pruritic, follicular, papules and pustules that gradually extend peripherally and have central tendency. Ofuji’s disease has been rarely reported, and has not been reported in pregnancy. It’s possible that hypersensitivity reaction plays an important role. There is no consensus on treatment approaches. We present the case of a 27 year-old woman during the 12.5 weeks of her first pregnancy; she had developed Ofuji’s disease for 17 years. Previously, she had been treated with corticosteroid and azatioprine for 15 years, which were suspended by the time she was diagnosed with pregnancy. Then, she was referred to our maternal fetal medicine department, and was treated with prednisone 25 mg a day. The patient had urinary infection and vulvovaginitis at the week 14.2, with peripheral blood eosinophilia. She had exacerbations at the weeks 35.2 and 38.1, which were treated only with prednisone and topical management; furthermore she had a total of 4 kg of weight gain during the whole pregnancy. Cesarean delivery was performed for nonreassuring fetal heart rate. Perinatal results were: woman with lower birth weight: 2,450 g, Apgar 5.8, placenta with calcifications on 60% of it and single nuchal cord. She had exacerbations in late puerperium. A healthy newborn was obtained and no clinical findings of dermatoses were found. Maternal autoimmune diseases may induce remission or exacerbation during pregnancy. Nevertheless, in this case the induced exacerbations during puerperium and the fact that a low birth weight was obtained are problems commonly associated with the prolonged use of corticosteroids during pregnancy.
Key words: eosinophilic pustular folliculitis, Ofuji’s disease, pregnancy.
Level of evidencce:  II-3