Author: Dr Ben Tallon, Dermatology Registrar, Greenlane Hospital, Auckland, New Zealand, 2006. Reviewed by Clare Morrison, Copy Editor, April 2014.
Disseminate and recurrent infundibulofolliculitis (DRIF) is a rare itchy follicular skin condition of unknown cause that occurs mainly in people of African descent.
It is also known as "Hitch and Lund disease" after the pair who first described this condition in 1968.
Disseminate and recurrent infundibulofolliculitis typically presents as a widespread, mildly itchy, follicular rash (arising within the hair follicle). It has been described as "goose bumps through a magnifying glass". The rash is slightly pink in appearance, often with a brown, pigmented edge. The torso, neck and arms are most affected.
It is mainly found in young healthy people with dark skin colour and is more common in hot, humid climates.
A skin biopsy may be taken to help in diagnosis. There is oedema (swelling) and lymphocytic infiltration (inflammation) around the infundibulum and basal region of the hair follicle. There is widening and proliferation of cells in the upper part of the follicle with variable amounts of scale formation. The skin biopsy direct immunofluorescence test is negative, ie antibodies cannot be detected around the hair follicle.
Other than its appearance and in some, the itch, there are no serious consequences of this rash. Despite the name, not everyone has recurrent episodes, as a persistent rash is more usual. It generally resolves by itself after some years.
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