Folliculitis Flashcards

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1
Q

What is folliculitis?

A

Folliculitis means an inflamed hair follicle due to any cause. The result is a tender red spot, often with a surface pustule.

Folliculitis may be superficial or deep. It can affect anywhere there are hairs, including chest, back, buttocks, arms, and legs. Acne and its variants are also types of folliculitis.

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2
Q

What can cause folliculitis?

A

Folliculitis can be due to infection, occlusion (blockage), irritation and various skin diseases.

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3
Q

What bacteria cause folliculitis?

A

The most common cause of superficial folliculitis is Staphylococcus aureus.

Gram-negative species implicated include Klebsiella, Enterobacter and Proteus. These organisms can be seen in acne vulgaris when long-term systemic antibiotic therapy is being given. Pseudomonas aeruginosa, a gram-negative bacteria, causes hot tub folliculitis.

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4
Q

What fungi cause folliculitis?

A

Fungal folliculitis is typically caused by infection with dermatophytes, Malassezia and Candida species; it is often seen in young men on the upper chest and back.

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5
Q

What is viruses cause folliculitis?

A

Herpes simplex, Varicella zoster and Molluscum contagiosum viruses are commonly responsible for viral folliculitis.

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6
Q

What is eosinophilic folliculitis?

A

Eosinophilic folliculitis is a specific type of folliculitis that may arise in some immune-suppressed individuals such as those infected by human immunodeficiency virus (HIV) or those who have cancer.

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7
Q

What are the clinical features of folliculitis?

A

Patients with folliculitis typically present with multiple erythematous, folliculocentric papules and pustules in the hair-bearing regions. Most cases of superficial folliculitis are associated with pruritus and only mild discomfort. However, when the inflammatory infiltrate extends deeply and becomes extensive, painful furuncles or carbuncles can form.

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8
Q

How does folliculitis present on examination?

A

Physical examination reveals erythematous papules, pustules, or cysts around the ostia of the hair follicles, with or without the presence of a hair shaft extending from the ostia.

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9
Q

What investigations should be ordered for folliculitis?

A

Diagnosis is almost always clinical although laboratory tests requested include skin swabs sent for bacterial fungal culture. If herpetic infection is suspected, swabs may also be sent for viral polymerase chain reaction (PCR). Skin biopsy may be considered in persistent or unusual cases (e.g., if eosinophilic folliculitis is suspected).

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10
Q

What is the treatment for uncomplicated folliculitis?

A

Uncomplicated folliculitis is self-limited and usually does not require medical intervention. While the causative organism is unknown, Staphylococcus aureus is likely to be involved.

Simple preventative measures, such as use of antibacterial soaps or wearing loose clothing, may be all that is required.

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11
Q

What is the treatment for folliculitis due to Staphylococcus aureus infection?

A

Cephalosporins are penicillinase-resistant antibiotics that are commonly used to treat S aureus soft tissue infections, including S aureus folliculitis. The most commonly used agent is cefalexin, a first-generation cephalosporin.

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12
Q

What is the treatment for folliculitis due to gram negative bacteria?

A

Topical benzoyl peroxide.

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13
Q

What differentials should be considered for folliculitis?

A
  • Pseudofolliculitis barbae
  • Acne vulgaris
  • Acne rosacea
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14
Q

What is shown in the image?

A

Folliculitis

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15
Q

What is shown in the image?

A

Folliculitis

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16
Q

What is shown in the image?

A

Folliculitis