FOLLICULITIS Flashcards
Inflammation of a hair follicle that can occur anywhere on the body where hair
is found.
Folliculitis
Most commonly infectious etiology
(a) Bacterial
(b) Fungal
(c) Viral
(d) Parasitic
(e) Non-Infectious
What kind of infectious etiology is this?
1) Most frequently due to S. aureus (+/- MRSA)
2) Streptococcus species, Pseudomonas (H20 contamination)
Bacterial
What kind of infectious etiology is this?
1) Dermatophytic (tinea capitis, tinea corporis, tinea pedis)
2) Pityrosporum (affecting teenagers and men) on upper chest and
back
3) Candida albicans
Fungal
What kind of infectious etiology is this?
1) Herpes Simplex Virus (HSV)
2) Molluscum contagiosum
Viral
What kind of infectious etiology is this?
1) Demodex spp. Mites
2) Schistosomes (swimmer’s itch)
Parasitic
What kind of infectious etiology is this?
1) Pseudo-folliculitis barbae (PFB)
2) Mechanical Folliculitis (Skinny Jeans Syndrome)
Non-Infectious
Folliculitis Risk Factors
(1) Hair removal (shaving, plucking, waxing, epilating agents)
(2) Other pruritic skin conditions: eczema, scabies
(3) Occlusive dressing or clothing
(4) Personal carrier or contact with MRSA-infected persons
(5) Diabetes mellitus
(6) Immunosuppression
(7) Use of hot tubs or saunas
(8) Chronic antibiotic use (gram-negative folliculitis)
(9) Tattoo recipient
(10) Poor Hygiene
Folliculitis Presentation
(1) Abrupt onset of follicular erythematous papules or pustules, with pruritus & pain
in hairy areas.
(2) Rash occurs on hair-bearing skin, especially the face (beard), proximal limbs,
scalp, and pubis.
(3) Pseudomonal folliculitis appears as a widespread rash, mainly on the trunk and
limbs.
(4) The clinical hallmark of folliculitis is hair emanating from the center of the
pustule.
Diagnostic Tests and Interpretation
(1) Diagnosis is usually made clinically, taking risk factors, history, and locations
of lesions into account.
(2) Culture and Gram stain may be done for larger lesions lancing or unroofing the
pustule.
(3) KOH preparation as well as Wood lamp fluorescence to identify Candida or
yeast.
General Treatment and Prevention
(1) Antiseptic and supportive care is usually enough. Systemic antibiotics may be
used with questionable efficacy.
(2) Good hygiene practices.
(3) Wash hands frequently.
(4) Wash towels, clothes, and linens frequently with hot water to avoid reinfection.
(5) Good hair removal practices.
(6) Use witch hazel, alcohol, or Tend Skin afterward.
Therapeutic Interventions
(1) ANTISEPTIC/SUPPORTIVE CARE IS USUALLY ENOUGH.
Therapeutic Interventions
Staphylococcal folliculitis
(a) Mupirocin ointment applied TID for 10 days
(b) Cephalexin: 250-500 mg PO QID (7-10 days)
(c) Dicloxacillin: 250-500 mg PO QID (7-10 days)
Therapeutic Interventions
MRSA
(a) Bactrim DS: 1-2 tablets BID PO (5-10 days)
(b) Clindamycin: 300 mg PO TID (10 to 14 days)
(c) Doxycycline: 50-100 mg PO BID (5-10 days)
Therapeutic Interventions
Pseudomonas folliculitis
(a) Ciprofloxacin: 500 to 750 mg PO BID for 7 to 14 days if lesions are
persistent
(b) High-potency topical corticosteroids for inflammation
(c) Antihistamines (hydroxyzine, cetirizine) to control itching
