MDT Part 1 Flashcards
What is folliculitis?
Inflammation of a hair follicle that can occur anywhere on the body where hair is found
What is the most common bacterial cause of folliculitis?
- Most frequently due to S. Aureus
- Streptococcus species
What is the most common fungal cause of folliculitis?
- Dermatophytic (tinea capitis, corporis, pedis)
- Pityrosporum (affecting teenagers and men) on upper chest and back
- Candida albicans
What is the most common viral cause of folliculitis?
- HSV (Herpes simplex virus)
- Molluscum contagiosum
What is the most common cause of parasitic folliculitis?
- Mites
- Schistosomes (swimmer’s itch)
What is the most common cause of non-infectious folliculitis?
- Pseudo-folliculitis barbae (PFB)
- Mechanical folliculitis (skinny jeans)
What are some folliculitis risk factors?
- Hair removal
- Occlusive dressing/clothing
- Diabetes Mellitus
- Immunosuppresion
- Use of hot tubs/sauna
- Chronic antibiotic use
- Tattoo
What is the presentation of folliculitis?
- Abrupt onset of follicular erythematous papules or pustules, with pruritis and pain in hairy areas
- Rash on hair-bearing skin
- Hallmark: Hair emanating from center of pustule**
General treatment and prevention of folliculitis?
- Antiseptic and supportive care (usually enough)
- Good hygiene
- Wash hands, towels, clothes, linens frequently
- Good hair removal practice
- Use witch hazel, alcohol, or tend skin
Therapeutic care of Staph folliculitis?
- Mupirocin ointment
- Cephalexin
- Dicloxacillin
Therapeutic care of MRSA folliculitis?
- Bactrim
- Clindamycin
- Doxy
Therapeutic care of Pseudomonas folliculitis?
- Cipro
- High potency topical corticosteroids
- Antihistamines
Therapeutic care of fungal folliculitis?
- Topical antifungals
- “Zole” medications, ketoconazole, fluconazole
Therapeutic care of parasitic folliculitis?
5% permethrin
Therapeutic care of herpetic folliculitis?
- Valacyclovir
- Acyclovir
What is pseudofolliculitis barbae?
- Condition caused by ingrown hairs
- Affects people with curly hair
- Sharp, shaved, tapered hair re-enters the skin as it grows from below the skin surface
Presentation of PFB?
- Red papules or pustules can be pruritic and/or painful
- Occurs where hair is shaved
- Scarring and hyperpigmentation may result
What is the Treatment approach 1 with mild to moderate PFB?
- APplication of medicated creams
- Shaving with gentle equipment (PFB razor with foil guard)
- Either topical retinoid or eflornithine
- Temporary no shave up to 60 days
What is treatment approach 2 with moderate to severe PFB?
- Laser hair reduction with grooming modifications
- Series of at least 3 treatments with 30-45 days between treatments
What is impetigo?
Contagious, superficial, intra-epidermal infection occurring prominently on exposed areas of the face and extremities
What is primary impetigo?
- Pyoderma
- Invasion of previously normal skin
What is secondary impetigo?
- Impetiginization
- Invasion at sites of minor trauma
- Can be considered to be S. aureus impetigo of hair follicles
General information of impetigo?
- Infected patients usually have multiple lesions
- Staph aureus alone or combined with group A beta-hemolytic strep
- Systemic symptoms infrequent
What is the most common form of impetigo?
Nonbollous impetigo
What are risk factors of impetigo?
- Warm, humid environment
- Tropical/subtropical climate
- Summer/fall season
- Poor hygiene
- Familial spread
- Children in daycare
Treatment of impetigo?
- Avoidance of infection
- Handwashing
- Prevent with mupirocin ointment TID
- Remove crust, clean 2-3x daily with gentle washing and antibacterial soap