OSCE — Eosinophilic folliculitis

Brief (to candidate)

You will assess a patient with a presentation consistent with Eosinophilic folliculitis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Eosinophilic folliculitis is a chronic, intensely pruritic follicular disorder defined histologically by an eosinophil-rich infiltrate within and around hair follicles. Four variants exist: (1) classic Ofuji disease (annular, serpiginous plaques with peripheral extension and central clearing in non-HIV adults, classically Japanese), (2) HIV- or immunosuppression-associated (intensely pruritic urticarial follicular papules on the face and upper trunk, CD4 under 200-300), (3) infancy-associated, and (4) pregnancy-associated. Histology shows eosinophilic spongiosis and perifollicular eosinophilia; peripheral eosinophilia and elevated IgE are common. Optimisation of antiretroviral therapy is the

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[1]