Eosinophilic folliculitis  is an itchy rash with an unknown cause that is most common among individuals with HIV, though it can occur in HIV-negative individuals where it is known by the eponym Ofuji disease. EF consists of itchy red bumps (papules) centered on hair follicles and typically found on the upper body, sparing the abdomen and legs. The name eosinophilic folliculitis refers to the predominant immune cells associated with the disease (eosinophils) and the involvement of the hair follicles. Pathophysiology
The cause of EF is unknown. A variety of microorganisms have been implicated, including the mite Demodex, the yeast Pityrosporum, and bacteria. An autoimmune process has what is this also been investigated. Diagnosis
Eosinophilic folliculitis may be suspected clinically when an individual with HIV exhibits the classic symptoms. 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. Treatment
Treatment of eosinophilic folliculitis in people with HIV typically begins with the initiation of Highly Active Anti-Retroviral Therapy in order to help reconstitute the immune system. Direct treatment of the EF itself focuses on decreasing the inflammation and itching. Topical corticosteroids and oral antihistamines can alleviate the itching and decrease the size and number of lesions. Treatment with the antifungal drug itraconazole, the antibiotic metronidazole, and the anti-mite drug permethrin may lead to some improvement of symptoms. Other therapies include PUVA, topical tacrolimus, and isotretinoin.
Cevimeline (trade name Evoxac) is a synthetic analog of the natural alkaloid muscarine with a particular agonistic effect on M1 and M3 receptors. It is used in the treatment of dry mouth and Sjögrens syndrome. Medical uses
Cevimeline is used in the treatment of xerostomia (dry mouth), and Sjögrens syndrome. It increases the production of saliva. Side effects
Known side effects include nausea, vomiting, diarrhea, excessive sweating, rash, headache, runny nose, cough, drowsiness, hot flashes, blurred vision, and difficulty sleeping.Contraindications include asthma and angle closure glaucoma. Mechanism of action
Cevimeline is a cholinergic agonist. It has a particular effect on M1 and M3 receptors. By activating the M3 receptors of the parasympathetic nervous system, cevimeline stimulates secretion by the salivary glands, thereby alleviating dry mouth. See also
Pilocarpine — a similar parasympathomimetic medication for dry mouth (xerostomia)
Bethanechol — a similar muscarinic parasympathomimetic with longer-lasting effect

References
External links
Evoxac (cevimeline HCl hydrate capsules) Full Prescribing Information