13.3 Pathogenesis Of Folliculitis

Question 1

Acne-form rashes

Answer 1

• When you see pustules (slide 2); but doesn’t mean it is ache

Groups
- Folliculitis
- Acne vulgaris (teenage)
- Rosacea

Only classify as vulgaris when you see black heads / comedomes

Question 2

Pathogenesis of folliculitis

Answer 2

= inflammation/infection in hair follicle
- Can be infectious or non-infectious
- Folliculitis is a descriptive term and not a diagnosis
- No comedones (blackheads) – therefore not acne vulgaris
- superficial or deep
- present with small pustule
- infectious / non-infectious

Question 3

Define:
Furuncle
Furunculosis
Carbuncle

Answer 3

• Furuncle = deep staphylococcus folliculitis
• Furunculosis = recurrent staphylococcus folliculitis
• Carbuncle = cluster (group) of staphylococcus deep folliculitis

Question 4

Pathogenesis of Acne Vulgaris

Answer 4

Comedomes are important for diagnosis
- small inflam pustules + comedomes (blackheads / white heads)
- black heads = closed
- white head = open
- greasy skin
- condition of hair follicle + sebaceous gland (as a unit)

1. Sebaceous lobule become more active due to androgens in puberty (oil gland gets large)
2. Upper part of hair follicle {infundibulum} is hyperkeratotic; plug forms
3. Top part of hair follicle swells {close comedome}
4. Secretion get more and more
5. Develop environment with keratin fragments, oil, warm
6. Cutibacterium acnes the proliferate in this environment
7. Immune response
8. Inflammation -> red papule
9. Neutrophils comes in = pustule

Slides 10-13

Question 5

4 Key pathogenic factors in acne vulgaris

Answer 5

1. Keratinocyte and follicular proliferation
   ➕
2. Androgen driven sebum production
   ⬇️
   Ductal obstruction
   ⬇️
3. Proliferation of cutibacterium acnes
   ⬇️
4. Inflammation

Question 6

Rosacea
Symptoms

Answer 6

Symptoms
- Redness on cheeks and nose
- inflam pustules
- no comedomes
- blood vessels prolifertion(redness)
- ocular rosscea (redness around eye)
- thinking of skin (nose=rhinopehyma)
- sensitive skin (burny)

Question 7

Pathogenesis of Rosacea

Answer 7

Pathway 1 - Inflam pathway
- Innate immune system
Stim: UV light + demodex
⬇️produces
TLR 2➡️ Inflam response
- Anti-microbial factors on skin (helps cause inflam)

Pathway 2 - Neurogenic pathway
- leads to sensitivity
- Stimulations: spices, stress, exercise, alcohol, heat
⬇️stim
TRPV/TRPA1 channels (neurogenic receptors)
- leads to: flushing, stinging, papules/pustules, phymatous changes, erythema

Question 8

Rosacea triggers

Answer 8

Inborn condition with a-lot of triggers:
- sun exposure
- emotional stress
- hot weather
- wind
- heavy exercise
- alcohol
- hot baths
- cold weather
- spicy foods
- medications
- medical conditions
- certain fruits + meats
- dairy products
- humidity
- indoor heat