Folliculitis Flashcards
What is folliculitis?
Folliculitis means an inflamed hair follicle due to any cause. The result is a tender red spot, often with a surface pustule.
Where can folliculitis be found?
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.
What causes folliculitis?
- Infection (Most common)
- Occlusion
- Irritation
- Various skin diseases
What is bacterial folliculitis usually caused by?
Staphylococcus aureus
What happens if the infection involves a deep part of the follicle?
A painful boil results
Name two non-infectious types of folliculitis:
1) Eosinophilic folliculitis
2) Folliculitis decalvans
How does eosinophilic folliculitis present?
itchy, red bumps centred on hair follicles typically on the upper body, sparing the legs
What disease is a major risk factor for eosinophilic folliculitis?
HIV
What is folliculitis decalvans?
rare, chronic inflammation of scalp hair
Describe the presentation seen in folliculitis decalvans?
itching, redness with pustular discharge resulting in alopecia and scarring
Describe the general presentation seen in folliculitis:
erythematous papules or pustules found around the hair follicles
Where is folliculitis most commonly found? (3)
in areas with terminal hair growth such as
1) head and neck
2) axillae
3) groin and buttocks
Give 5 risk factors for folliculitis:
1) shaving and hair extraction
2) using hot tubs
3) diabetes or immunosuppression
4) hyperhidrosis
5) steroid cream use
What is the name given to chronic folliculitis of the beard area in men?
sycosis barbae
What is sycosis barbae?
chronic crusted and painful skin in the beard area of the face
What bacteria causes hot tub/ Spa folliculitis?
Pseudomonas aeruginosa
What is the most common yeast to cause folliculitis?
Pityrosporum ovale, also known as Malassezia.
What is Malassezia folliculitis?
is an itchy acne-like condition usually affecting the upper trunk of a young adult.
How would you manage and treat malassezia folliculitis?
Treatment includes avoiding moisturisers, stopping any antibiotics and using topical antifungal or oral antifungal medication for several weeks.
What does candid albicans provoke?
a folliculitis in skin folds (intertrigo) or the beard area. It is treated with appropriate topical or oral antifungal agents.
What contact/irritants may cause folliculitis?
- Shaving/Waxing
- Occlusion via moisturisers, plasters etc
- Chemicals such as coal tar, cutting oils
- over use of Topical steroids
Name 4 inflammatory diseases that involve folliculitis?
- Lichen planus
- Discoid lupus erythematous
- Folliculitis decalvans
- Folliculitis keloidalis
Name 5 acne variants of folliculitis?
- Acne vulgaris
- Nodulocystic acne
- Rosacea
- Scalp folliculitis
- Chloracne
Define superficial folliculitis.
many cases of folliculitis are very mild, superficial, self-limiting and of little clinical importance. Patients with superficial folliculitis usually present with multiple small papules and pustules on an erythematous base that are pierced by a central hair, although the hair may not always be visualised
Define deep folliculitis.
deeper lesions manifest as painful, erythematous, often fluctuant, nodules and may have suppurative drainage. Persistent or recurrent lesions may result in scarring and permanent hair loss. When deep-seated folliculitis occurs on the beard areas of the face it is referred to as sycosis barbae, when it occurs elsewhere it is referred to as a furuncle or carbuncle
What is a furuncle?
is a deeper, and more pronounced infection of the hair follicle in which purulent material extends through the dermis into the subcutaneous tissue, where a small abscess forms.
what is a carbuncle?
is a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles
What factors cause malassezia folliculitis?
The yeast tends to overgrow in hot, humid environments. Sweating can also be encouraged by wearing occlusive clothing, sunscreens and greasy emollients, which may occlude the follicles
Patients with Down’s syndrome appear to be at an increased risk
Oily skin, obesity, pregnancy, systemic illness (eg diabetes mellitus, immunodeficiency), broad spectrum oral antibiotics (often prescribed for acne), and prednisolone are also risk factors
What investigations are carried out for folliculitis?
- Skin swabs
- Nasal swabs - folloculitis barbae
- Blood screen - recurrent carbuncles and furuncles
- Screen for HIV - eosinophillic folliculitis
What patients are at particular risk of Gram negative folliculitis?
patients treated with long term antibiotics for acne
What is another name for pseudo-folliculitis?
razor bumps
What causes pseudo-folliculitis?
ingrowing hairs
What type of hair increases risk of pseudo-folliculitis?
curly or Afro Caribbean hair
Give 3 general medications used to manage folliculitis (based on cause and severity):
1) emollients
2) fusidic acid
3) oral antibiotics
