Two cases of eosinophilic pustular folliculitis associated with pregnancy

lated to play an important role in the pathogenesis of PG. A marked persistent leukocytosis (White blood cells, >50 000/lL) with bandemia, when the cause is other than leukemia, defines a leukemoid reaction. The major causes of leukemoid reactions include severe infections, intoxications and malignancies. A previous report showed that severe PG with extensive ulceration may have leukocytosis. That study evaluated 111 PG cases and only two cases presented with a leukemoid reaction. In our case, we speculate that an exacerbation of PG resulted in a leukemoid reaction while an exacerbation of PG by the hyperactivation of neutrophils due to a leukemoid reaction might have been possible, and that the delay of a treatment for the PG induced both a leukemoid reaction and a severe PG. A leukemoid reaction tends to be a sign of poor prognosis in various diseases. In the evaluation of the prognostic impact for PG patients, a statistical rigorous analysis is difficult due to the limited number of cases. Observations of individual cases (including our case) may suggest that a neutrophilic leukemoid reaction is an important sign that a patient is in a progressive course.