Folliculitis

Question 1

Features

Answer 1

Usually presents as mild itchy pustules

• on an erythematous base
• on any part of hair-bearing skin,

Typically caused by:

1. S. aureus
2. Pseudomonas aeruginosa

Question 2

Pseudomonas folliculitis can cause confusion, the typical features being:

Answer 2

rapidly spreading rash

mainly on trunk, buttocks and thighs

itchy

small pustules surrounded by circular red-purple halo

follows immersion in a hot spa bath or tub

Treatment is based on the sensitivity of the cultured organisms (e.g. ciprofloxacin).

Question 3

Folliculitis: of groin area

Answer 3

is common in women who shave and tends to recur.

Prior to shaving, wash the skin with warm water and a soap substitute

If persistent, use

benzoyl peroxide 5% gel or solution topically, twice daily

If severe, use:

mupirocin 2% (Bactroban) ointment or

oral antibiotics, di(flu)cloxacillin 500 mg or

cephalexin 500 mg (o), qid for 5–7 d, or

clindamycin 450 mg tds for 5–7 d

Question 4

Folliculitis: of trunk

Answer 4

from spa baths

Due to Pseudomonas aeruginosa or S. aureus

• in poorly chlorinated water maintained at 37–40°C

Rx—ciprofloxacin 500 mg (o) bd for 7 d;

• alternative—cephalexin or clindamycin