Folliculitis

Signs and symptoms

• rash
• itching skin
• pimples or pustules located around a hair or follicle; may be confused with chicken pox
• *may crust over
• *typically occur on neck, armpit, or groin
• *may present as genital lesions
• spreading from leg to arm to body through improper treatment with antibiotics

  Causes

Bacterial

• Staphylococcus aureus folliculitis.
• Hot-tub folliculitis is caused by the bacterium Pseudomonas aeruginosa. The folliculitis usually occurs after sitting in a hot tub that was not properly cleaned before use. Symptoms are found around the body parts that sit in the hot tub: the legs, hips, chest, buttocks, and surrounding areas. Symptoms are amplified around regions that were covered by wet clothing, such as bathing suits.
• Sycosis vulgaris, Sycosis barbae or Barber's itch is a staphylococcus infection of the hair follicles in the bearded area of the face, usually the upper lip. Shaving aggravates the condition.
• Gram-negative folliculitis may appear after prolonged acne treatment with antibiotics.

  Fungal

• Tinea barbae is similar to barber's itch, but the infection is caused by the fungus T. rubrum.
• Malassezia folliculitis, formerly known as Pityrosporum folliculitis, is caused by yeasts of the genus Malassezia

  Viral

• Herpetic folliculitis rarer, but may occur when herpes simplex virus infection spreads to nearby hair follicles appearing in groups or clusters, mostly around the mouth.

  Non-infectious

• Pseudofolliculitis barbae is a disorder occurring when hair curves back into the skin and causes inflammation.
• Eosinophilic folliculitis may appear in persons with impaired immune systems.
• Folliculitis decalvans or tufted folliculitis usually affects the scalp. Several hairs arise from the same hair follicle. Scarring and permanent hair loss may follow. The cause is unknown.
• Reaction to Demodex mite infestation may occasionally be misdiagnosed as folliculitis.
• Folliculitis keloidalis scarring on the nape of the neck. Most common among males with curly hair.
• Oil folliculitis is inflammation of hair follicles due to exposure to various oils and typically occurs on forearms or thighs. It is common in refinery workers, road workers, mechanics, and sheep shearers. Even makeup may cause it.
• Malignancy may also be represented by recalcitrant cases.

  Complications

Treatment

1. Topical antiseptic treatment is adequate for most cases
2. Topical antibiotics, such as mupirocin or Neomycin/polymyxin B/bacitracin ointment may be prescribed. Oral antibiotics may also be used.
3. Some patients may benefit from systemic narrow-spectrum penicillinase-resistant penicillins
4. Fungal folliculitis may require an oral antifungal such as Fluconazole. Topical antifungals such as Econazole Nitrate may also be effective.