II. Pathophysiology

  1. Usually caused by Bacterial Infection
  2. Superficial inflammation of Hair Follicle
    1. Only upper Hair Follicle involved
    2. Contrast with Deep Folliculitis

III. Risk Factors

  1. Local Trauma
    1. Abrasion
    2. Surgical wounds or draining abscess
    3. Shaving
      1. Aggravates Staphylococcus aureus Folliculitis
  2. Exposure to Occlusive Dressing
    1. Tar
    2. Adhesive plaster
    3. Plastic Occlusive Dressings

IV. Causes

  1. See Folliculitis
  2. Staphylococcal Folliculitis (most common)
    1. Affects beard area (Folliculitis barbae)
    2. Also affects axillae and legs
    3. Aggravated by shaving
  3. Pseudofolliculitis Barbae
  4. Superficial Fungal Infection
  5. Cutaneous Candidiasis (Candida albicans)
    1. Seen in febrile hospitalized patients
  6. Acne Vulgaris
  7. Keratosis Pilaris

V. Symptoms

  1. Non-tender or minimally tender
  2. Variably pruritic

VI. Signs

  1. Characteristics
    1. Pustule confined to Hair Follicle
    2. Hair Shaft may be seen at center of lesion
    3. Yellow or gray coloration with erythema
  2. Distribution: Any skin bearing hair
    1. Head and neck
    2. Trunk
    3. Buttocks
    4. Extremities
  3. Absent features
    1. No associated fever or systemic symptoms

VII. Differential Diagnosis

  1. Beard area Folliculitis
    1. See Beard Dermatitis
  2. Trunk Folliculitis
    1. Tinea Corporis (Ringworm)
    2. Pustular Miliaria
      1. Not perifollicular
      2. Occurs in hot, humid weather

VIII. Management

  1. General
    1. Eliminate provocative agents (tar, Mineral Oil)
    2. Keep affected areas clean
    3. Apply Mupirocin ointment to affected areas
    4. Consider warm, wet Burow's Solution
  2. Antibiotics
    1. Dicloxacillin 250-500 mg PO qid for 10 days
    2. Erythromycin 250-500 mg PO qid for 10 days
  3. Topical Corticosteroids
    1. Indicated for associated significant inflammation
  4. Prevention (Suppression of infection)
    1. Cleocin T after shaving
    2. Mupirocin (Bactroban) in nostrils

IX. Course

  1. Heals without scarring

X. References

  1. Fitzpatrick (1992) Color Atlas Dermatology
  2. Habif (1996) Dermatology, p. 248-51
  3. Stulberg (2002) Am Fam Physician 66(1):119-24 [PubMed]

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Ontology: Folliculitis (C0016436)

Definition (NCI_NCI-GLOSS) Inflammation of a follicle (a sac or pouch-like cavity), usually a hair follicle.
Definition (NCI) Inflammation of the hair follicles. Causes include excessive perspiration, skin infections, and skin wounds.
Definition (MSH) Inflammation of follicles, primarily hair follicles.
Concepts Disease or Syndrome (T047)
MSH D005499
SnomedCT 156411003, 267863007, 201177005, 201183008, 13600006
English Folliculitides, Folliculitis, FOLLICULITIS, folliculitis (diagnosis), folliculitis, Folliculitis [Disease/Finding], folliculitis nos, inflammation of hair follicles, Folliculitis NOS (disorder), Follicle inflamed, Hair follicle inflamed, Inflammation of hair follicle, Folliculitis (disorder), Folliculitis NOS
French FOLLICULITE, Folliculite
Portuguese FOLICULITE, Foliculite
Spanish FOLICULITIS, foliculitis, SAI (trastorno), foliculitis, SAI, foliculitis (trastorno), foliculitis, Foliculitis
German FOLLIKULITIS, Follikulitis, Haarfollikelentzündung
Japanese 毛包炎, モウホウエン
Swedish Follikelinflammation
Czech folikulitida, Folikulitida
Finnish Follikuliitti
Russian FOLLIKULIT, SIKOZ, СИКОЗ, ФОЛЛИКУЛИТ
Polish Zapalenie mieszka włosowego
Hungarian folliculitis
Norwegian Follikulitt, Hårsekkbetennelse, Hårkjertelbetennelse
Dutch folliculitis, Folliculitis
Italian Follicolite