Folliculitis

Synonym(s)

None

Definition

Inflammation of the hair follicles caused by infection or physical or chemical irritation

Pathogenesis

Inflammatory process caused by obstruction or disruption of individual hair follicles and the associated pilosebaceous units

Clinical manifestation

Primary lesion a perifollicular papule or pustule; often appears as grid-like pattern of multiple red papules and/or pustules on hair-bearing areas, such as the face, scalp, thighs, axilla, and inguinal area; predisposing factors: friction; perspiration; occlusion; shaving; hyperhidrosis; diabetes melli-tus or immunologic disorders; Staphylococcal nasal carriage; skin injuries; abrasions; surgical wounds; draining abscesses; skin occlusion for topical corticosteroid therapy

Folliculitis, eosinophilic pustular 247

Clinical variants:

• Hot tub folliculitis: caused by psedo-monas organisms in tub or pool water; pruritic, edematous, erythematous papules or pustules in areas of skin occluded by a bathing suit

• Pityrosporum folliculitis: pruritic acne-form papules on the upper back, chest, upper arms, neck, chin, and sides of the face; caused by yeast forms of Pityrospo-rum ovale

• Fungal folliculitis: caused by candidal species and dermatophytes; principle etio-logic agents: Trichophyton verrucosum and Trichophyton mentagrophytes; affects the coarse hairs in the mustache and beard area in men

• taphylococcal folliculitis: follicular-based red papules and pustules, caused by Staphylococcal aureus

Differential diagnosis

Erythema toxicum; miliaria; insect bite reaction; scabies; acne; rosacea; perioral dermatitis; keratosis pilaris; acquired perforating disease; pemphigus foliaceus; Darier disease; Hailey-Hailey disease; pseudofol-liculitis barbae

Therapy

Treatment of infection as per culture results; removal of inciting factors, such as tight-fitting clothing; anti-inflammatory therapy: tetracycline; doxycycline; minocy-cline; dapsone

References

Sadick NS (1997) Current aspects of bacterial infections of the skin. Dermatologic Clinics i5(2):34i-349

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