Folliculitis and other follicular disorders Flashcards
Four major types of infectious folliculitis?
Bacterial, Fungal, Viral, Other (demodex)
3 major types of bacterial folliculitis?
Staphylococcal aureus infxn, Gram-negative bacili, Hot tub folliculitis
3 major fungal folliculitis organisims?
Dermatophyte, Malassezia spp. (pityrosporum), Candida spp
2 major types of viral folliculitis?
HSV, VSV
5 major types of non-infectious folliculitis?
Culture-negative/normal flora, Irritant, drug-induced, Eosinophilic (3 types within it), disseminate and recurrent infundibulofolliculitis
5 major types of deep folliculitides?
Furuncles, Syncosis, Pseudofolliculitis barbae, acne keloidalis, follicular occlusion tetrad (1. Acne conglobata, Hidradenitis suppurativa, dissecting cellulitis of the scalp, pilonidal sinus/cyst)
How does folliculitis present clinically?
Follicular-based papules and pustules on an erythematous base. Often itchy and sometimes painful
What is the most common type of folliculitis?
Culture-negative, followed by bacterial folliculitis 2/2 to S. aureus
What are the 3 most common causes of gram-negative folliculitis?
Klebsiella, enterobacter, proteus
- Also E. Coli
What is the most common location for bacterial folliculitis?
Face, trunk, axillae, buttocks
(areas under occlusion)
How to treat for S. aureus folliculitis?
Tx for nasal carriage with mupirocin TID x 7-10 days
Elston discusses using clindamycin as beta-lactams, TCN and Bactrim don’t penetrate the nose well
Common patient population to see gram-negative bacterial folliculitis in?
Favor acne pts on long-term abxs –> Pustules in T-zone and perinasal regions
What can be given in patients with severe gram-negative folliculitis/acne?
- First: Topicals –> Gentamicin, BP
- Second: Systemics –> Quinolones (cipro)
- If severe and reucurrent –> Isotretinoin 0.5-1mg/kg/day
When does hot tub folliculitis occur after exposure?
Occurs after 12-48 hrs after hot tub/public facilities use
How does hot tub folliculitis present?
Presents with edematous pink-red follicular papules and pustules
- Favors the trunk
- Pruritic
Treatment for hot tub folliculitis?
Self-limited in most patients, in immunocompromised can do ciprofloxacin 500mg BID for 7-14 days
What organisms cause tinea barbae?
T. Mentagrophytes or T. verrucosum
Clinical of tinea barbae?
inflammatory papulopustules in beard area >> mustache with crusting, loosened hair can be removed w/o pain
Treatment of tinea barbae?
Tx with oral antifungals (griseofulvin, terbinafine, itraconazole)
What organism is often involved in Majocchi granuloma?
T. Rubrum
Clinical of Majocchi granuloma?
Presents with follicular pustules or nodules, pustules at edges of tinea cruris or corporis
Treatment of Majocchi granuloma?
Oral antifungals
Where can you often see Majocchi granuloma?
Women who shave their legs w/ blade razor
Clinical of malassezia folliculitis?
Presents with follicular papulopustules mainly on back, chest, and shoulders