Materiały źródłowe

• #1 Folliculitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK547754/

  Folliculitis is a common skin condition that usually involves infection of the hair follicle. While this condition is typically benign, prompt recognition can aid in the improvement of quality of life of patients with this condition. This activity reviews the evaluation and treatment of folliculitis and highlights the role of the interprofessional health care team in evaluating and treating patients with this condition. […] The diagnosis of folliculitis is clinical. In general, no diagnostic testing or radiographic evaluation is necessary to diagnose this condition in lieu of a thorough history and physical exam. […] A complete history, as well as a focused physical exam, is usually enough to elucidate the diagnosis. Essential elements of history should include: Recent increase of scratching due to pruritus, History of increased sweating, Use of topical corticosteroids, Recent and/or long term use of oral antibiotics, Any hot tub and/or swimming pool exposure, History of HIV with CD4 count less than 250 or immunosuppression.

• #1 Folliculitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/282

  Causes of folliculitis include bacterial, fungal, viral, and parasitic microorganisms. […] Most commonly superficial and resulting from infection by Staphylococcus aureus; use of antibacterial soaps may suffice as treatment for uncomplicated folliculitis, which is self-limited. […] Deeper infection and inflammation of hair follicles from Staphylococcus aureus generally require systemic antibiotic therapy based on culture sensitivities. […] Folliculitis can occur in patients with acne undergoing long-term oral antibiotic therapy and may mimic an acne flare. […] Treatment is tailored to the underlying cause; hygienic measures, MRSA eradication, and symptomatic therapies are other important treatment modalities to consider. […] Folliculitis manifests clinically as erythematous papules or pustules around hair follicles.

• #1 Folliculitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK547754/?report=reader

  Essential elements of history should include: Recent increase of scratching due to pruritus, History of increased sweating, Use of topical corticosteroids, Recent and/or long term use of oral antibiotics, Any hot tub and/or swimming pool exposure, History of HIV with CD4 count less than 250 or immunosuppression. […] Physical exam should include close inspection of hair-bearing areas, including the bilateral upper and lower extremities as well as the chest, back, face, and scalp. On exam, the clinician should look for small pustules in these areas with peri-follicular inflammation. […] Should these cases prove to be too extensive, do not resolve on their own, or dont resolve after medical management referral to a dermatologist is recommended.

• #1 Folliculitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/282

  Depending on the aetiology and chronicity of the condition, histological examination reveals various populations of inflammatory cells around the pilosebaceous unit. […] Folliculitis commonly occurs in areas with terminal hair growth, such as the head and neck region, axillae, groin and buttocks; it also favours areas under occlusion. […] Key diagnostic factors include recent history of immersion in spa water and new medication commenced known to be associated with folliculitis. […] Investigations to consider include bacterial skin swab, viral skin swab, skin scraping for mycology, tissue culture, and skin biopsy.

• #1 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  When folliculitis is suspected, clinical history along with morphology and distribution of the lesions play an essential role in narrowing the differential diagnosis, but occasionally gram stain, cultures, potassium chloride (KOH) preparation or 3-4mm punch biopsy may be required to determine exact etiology in atypical cases or in patients resistant to standard treatments. […] Gram stain and bacterial culture are best performed by unroofing an entire pustule with a No. 15 blade and depositing material onto a glass slide and a sterile cotton swab. In typical cases, Gram stain shows gram-positive cocci, and culture grows S aureus. Pseudomonas species can be cultured from the pustules of hot tub folliculitis. […] Nasal culture of family members to look for S aureus colonization may be needed in chronic cases.

• #1 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  KOH inspection, fungal culture, or both can be useful for diagnosing dermatophyte infections. Pityrosporum yeast forms are best appreciated on biopsy specimens in cases of Malassezia (Pityrosporum) folliculitis. […] Viral culture or punch biopsy can assist in the identification of folliculitis caused by herpes simplex virus. […] A complete blood cell count often reveals leukocytosis and eosinophilia, with elevated immunoglobulin E levels in patients with eosinophilic folliculitis. […] For deep infections, incision and drainage can be therapeutic and can provide material to be sent for culture. […] Histologically, all cases of superficial folliculitis have a similar appearance in that they show a moderately intense infiltrate of inflammatory cells in the follicular ostium and upper regions of the follicle. In most cases, the inflammation initially consists of neutrophils and then becomes more mixed with the addition of lymphocytes and macrophages. If the folliculitis is from an infectious cause, then various organisms can be identified within the follicle.

• #1 Folliculitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK547754/

  In the vast majority of cases of folliculitis, histopathology is not needed for diagnosis as this condition is a clinical diagnosis. However, in the case of eosinophilic folliculitis skin biopsy should be done for confirmation of the diagnosis. […] Should these cases prove to be too extensive, do not resolve on their own, or don’t resolve after medical management referral to a dermatologist is recommended.

• #1 Folliculitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/folliculitis/diagnosis-treatment/drc-20361662

  Your health care provider will likely be able to tell whether you have folliculitis by looking at your skin and asking about your medical history. […] If early treatments don’t clear up your infection, your health care provider may run some tests. These tests might include: […] Obtaining a swab for culture to determine the cause of infection. […] Rarely, doing a skin biopsy to rule out other conditions. […] You’re likely to start by seeing your primary care provider. You may then be referred to a doctor who specializes in the diagnosis and treatment of skin conditions (dermatologist). […] Do I need any tests? […] Your health care provider is likely to ask you a few questions. […] What treatments or self-care steps have you tried so far? Have any been effective?

• #1 Folliculitis: Diagnosis and treatment – Dermatology Surgery Center – Niceville, FL (Bluewater Bay)

  https://www.dermsurgctr.com/skin-conditions/folliculitis-diagnosis-and-treatment/

  Folliculitis – Diagnosis and treatment […] It can be helpful to see a dermatologist to make sure you have folliculitis. The infected hair follicles can look like another skin condition, such as acne. A board-certified dermatologist can tell you whether you have folliculitis and give you tips to help clear it. Some people need medication, such as an antibiotic, to clear the folliculitis. […] A board-certified dermatologist can tell you whether you have folliculitis and help you feel more comfortable.

• #1 Pathology Outlines – Folliculitis

  https://www.pathologyoutlines.com/topic/skinnontumorfolliculitis.html

  Differential diagnosis: Acne vulgaris […] Acneiform eruptions […] Arthropod bites […] Cutaneous candidacies […] Coccidiomycosis […] Dermatologic manifestations of renal disease […] Erythema toxic neonatorum […] Fox-Fordyce disease […] Graham-Little-Piccardi-Lasseur syndrome […] Id-reaction (autoeczematization) […] Impetigo […] Irritant contact dermatitis […] Milia […] Perioral dermatitis […] Papular urticaria […] Pruritic papular eruption of HIV disease (Indian J Sex Transm Dis AIDS 2018;39:44) […] Rosacea […] Seabathers eruption […] Subcorneal pustular dermatosis.

• #1 Folliculitis: diagnosis and management of subtypes | Medicine Today

  https://medicinetoday.com.au/mt/2021/october/feature-article/folliculitis-diagnosis-and-management-subtypes

  Folliculitis is a common disorder, although the exact prevalence is unknown. It presents as erythematous pustules surrounding hair follicles. It may be due to a superficial or deep infection of the follicle, or may be secondary to trauma. Deeper infections present as sycosis and folliculitis decalvans. Good grooming and hygiene are key to treatment and long-term resolution, alongside pharmacological therapies. […] Folliculitis is characterised by inflammation of the hair follicle, with formation of a pustule. […] The mainstays of treatment are hygiene and grooming, alongside antibiotics or antifungals depending on the causative agent and subtype. […] Investigations are usually not required, although swabs can be taken to assess sensitivity of the causative organism. […] Most cases of folliculitis can be managed through avoidance of irritants and good hygiene; however, some patients may also benefit from pharmacological treatment.

• #1 Folliculitis

  https://dermnetnz.org/topics/folliculitis

  Folliculitis means an inflamed hair follicle due to any cause. The result is a tender red spot, often with a surface pustule. […] Swabs should be taken from the pustules for cytology and culture in the laboratory to determine if folliculitis is due to an infection. […] Eosinophilic folliculitis is a specific type of folliculitis that may arise in some immune-suppressed individuals such as those infected by human immunodeficiency virus (HIV) or those who have cancer. […] Treatment depends on the underlying condition and its severity. A skin biopsy is often necessary to establish the diagnosis.

• #1 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  The light microscopic features of eosinophilic folliculitis include perifollicular infiltrates of lymphocytes and eosinophils associated with follicular eosinophilic spongiosis. This type of folliculitis is often associated with follicular mucinosis. […] The histological features of a papulopustular eruption due to epidermal growth factor receptor inhibitors is that of a superficial purulent folliculitis, which, in most cases, is sterile but can occasionally be associated with S aureus infection.

• #1 Folliculitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21873

  Folliculitis is a common, generally benign, skin condition in which the hair follicle becomes infected/inflamed and forms a pustule or erythematous papule of overlying hair-covered skin. […] The diagnosis of folliculitis is clinical. In general, no diagnostic testing or radiographic evaluation is necessary to diagnose this condition in lieu of a thorough history and physical exam. […] In the vast majority of cases of folliculitis, histopathology is not needed for diagnosis as this condition is a clinical diagnosis. However, in the case of eosinophilic folliculitis skin biopsy should be done for confirmation of the diagnosis. […] A complete history, as well as a focused physical exam, is usually enough to elucidate the diagnosis. […] Essential elements of history should include recent increase of scratching due to pruritus, history of increased sweating, use of topical corticosteroids, recent and/or long term use of oral antibiotics, any hot tub and/or swimming pool exposure, history of HIV with CD4 count less than 250 or immunosuppression. […] The diagnosis of folliculitis is clinical. […] A standard KOH preparation can be used to visualize hyphae and spores associated with folliculitis caused by Malassezia. […] A skin biopsy is usually required to confirm the diagnosis of eosinophilic folliculitis.

• #1 Folliculitis – wikidoc

  https://www.wikidoc.org/index.php/Folliculitis

  Folliculitis is a clinical diagnosis so the laboratory tests are generally done in cases of treatment resistance. CBC suggestive of leukocytosis and eosinophilia, with elevated immunoglobulin E levels in patients with eosinophilic folliculitis. […] Folliculitis may also be diagnosed using skin biopsy and histology. Findings on biopsy and histology varies depending upon the causative agent and type of folliculitis. Eosinophilic folliculitis shows perifollicular infiltrates of lymphocytes and eosinophils associated with follicular eosinophilic spongiosis. Bacterial and fungal folliculitis neutrophils infiltrating the walls and lumen of the hair follicles, with variable admix of lymphocytes and macrophages depending on chronicity of the folliculitis. Histological picture of viral folliculitis suggestive of lymphocyte infiltrate in the walls and lumen of the hair follicles. Demodex folliculitis shows perifollicular lymphohistiocytic inflammation is often seen along with mite Demodex folliculorum within the hair follicle.

• #1 Folliculitis decalvans – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/folliculitis-decalvans/

  Folliculitis decalvans is a rare long-term condition of the scalp causing inflammation and hair loss. […] A dermatologist often makes the diagnosis by examining your skin. […] In some cases, a skin swab may be taken using a cotton wool bud which is then sent to the laboratory to check for other germs. […] Sometimes a small skin sample (skin biopsy) may be taken and checked under a microscope to confirm the diagnosis. […] There are many different treatments available to control the inflammation, but unfortunately no cure has been found. […] Treatment aims to reduce inflammation and prevent further scarring. […] Treatment is usually a combination of some of the following: medicated shampoos, anti-inflammatory and antibacterial scalp solutions and/or oral antibiotics, most commonly tetracyclines.

• #1 Folliculitis: diagnosis and management of subtypes | Medicine Today

  https://medicinetoday.com.au/mt/2021/december/supplements/feature-article/folliculitis-diagnosis-and-management-subtypes

  The mainstays of treatment are hygiene and grooming, alongside antibiotics or antifungals depending on the causative agent and subtype. […] Investigations are usually not required, although swabs can be taken to assess sensitivity of the causative organism. Most cases of folliculitis can be managed through avoidance of irritants and good hygiene; however, some patients may also benefit from pharmacological treatment. […] Folliculitis decalvans initially presents as painful follicular pustules that become crusted. […] Treatment is mainly aimed at eradicating S. aureus. Antiseptic shampoos and topical clindamycin are sufficient to treat mild cases. […] There is some evidence, however, that maximal treatment effect is obtained through rifampicin and clindamycin, tetracyclines and intralesional corticosteroids, although individual clinician treatment choices vary widely.

• #1 Folliculitis, Gram-Negative – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/folliculitis-gram-negative/

  Gram-negative folliculitis can be divided into two main categories. Type 1 lesions are seen in 80% of the cases and appear as superficial pustules without the presence of comedonal lesions. Type 2 is characterized by deep nodular or cystic lesions. In approximately 20% of patients, the most common organism isolated is Proteus species. […] While the diagnosis of gram-negative folliculitis can usually be made on history and clinical exam, an aerobic bacterial culture should be obtained to confirm the diagnosis. A fresh pustule makes the best sample. […] It is important to think about this clinical entity when patients have a sudden flare or worsening of their acne, or when they are not responding to therapy, especially if they have been treated with long-term systemic antibiotics. […] Gram-negative folliculitis is seen in 4% of patients who are on systemic antibiotics for a prolonged period.

• #1 Folliculitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/folliculitis/symptoms-causes/syc-20361634

  Folliculitis is often caused when hair follicles are infected with bacteria, commonly Staphylococcus aureus (staph). […] Make an appointment with your health care provider if your condition is widespread or the symptoms don’t go away after a week or two of self-care measures. You may need a prescription-strength antibiotic or antifungal medication to help control the condition. […] Seek immediate medical care if you experience signs of a spreading infection. These include a sudden increase in redness or pain, fever, chills, and a feeling of being unwell (malaise).

• #1 Folliculitis: Symptoms, Causes, Treatment, Pictures

  https://www.medicinenet.com/folliculitis/article.htm

  How do doctors diagnose folliculitis? […] The diagnosis of folliculitis is generally based on the appearance of the skin. In some situations, a microbial culture of pus from the pustule will help identify an infection. It may be necessary to pull out some of the affected hairs and examine them microscopically using potassium hydroxide to detect fungal infections or other infectious organisms. Occasionally, a small skin biopsy may be used to help the doctor confirm the diagnosis. Infectious causes include bacteria, fungi, viruses, and parasites. Usually, no specific blood tests are needed in the diagnosis of common folliculitis. […] When to see the doctor for folliculitis […] You should seek medical advice if the folliculitis: […] Doesn’t go away after a few days […] How do doctors diagnose folliculitis? […] The diagnosis of folliculitis is generally based on the appearance of the skin.

• #1 Folliculitis: Appearance, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17692-folliculitis

  Folliculitis is usually diagnosed during a physical exam with your healthcare provider. This can be done during an appointment and in most cases, you do not need to see a skincare specialist. Your primary care physician is usually able to diagnose folliculitis and provide a treatment plan. In certain, severe or persistent cases, an appointment with a dermatologist is recommended. […] In some more severe cases, your provider may refer you to a dermatologist for additional tests to make sure your folliculitis isn’t another medical condition. One test that can be done is a biopsy. This is a test where a small sample of your skin is removed and then taken to a lab where it’s studied.

• #1 Bacterial Folliculitis — DermNet

  https://dermnetnz.org/topics/bacterial-folliculitis

  Bacterial folliculitis is usually diagnosed clinically but can be confirmed by bacterial swabs sent for microscopy, culture and sensitivity. […] Blood count may reveal neutrophil leucocytosis when folliculitis is widespread. […] Skin biopsy is rarely necessary. Histology shows dense neutrophilic infiltrate in the subcutaneous tissue and foreign body reaction around a hair shaft.

• #1 Folliculitis – Skin Deep

  https://dftbskindeep.com/all-diagnoses/folliculitis/

  Folliculitis is due to inflammation of hair follicles and can therefore be found in any region of the body with hair. It is characterised by an erythematous papule, often with a pustule. It may be pruritic. […] The most common cause of folliculitis is infection, most commonly bacterial. […] The most common bacterial pathogen is Staphylococcus aureus. Empirical treatment with topical antibiotics is therefore often used, although a mild folliculitis will often resolve spontaneously. […] Hot tub folliculitis is often due to Pseudomonas aeruginosa. It is often self-limiting and resolves withing 7 to 10 days with good skin hygiene and avoiding contaminated water. […] Fungal causes are also relatively common, and can be treated with a topical or oral antifungal. […] Less common are viral / parasitic causes and drug-induced folliculitis.

• #1 Pityrosporum (Malassezia) Folliculitis: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22833-pityrosporum-folliculitis

  Pityrosporum (Malassezia) folliculitis happens when yeast that occurs as part of your skins natural flora multiplies and infects the hair follicles. Healthcare providers treat this fungal infection with topical and systemic antifungal medications. […] To confirm a diagnosis of pityrosporum folliculitis, your provider may gently scrape your skin to gather some skin cells. They examine these cells under a microscope to look for signs of excess Malassezia yeast. If needed, your provider may do a skin biopsy. […] Healthcare providers treat pityrosporum folliculitis with topical antifungal creams and antifungal medications.

• #1 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  The histopathological evaluation of herpes folliculitis can be subtle and nonspecific and often requires that deeper histological sections are obtained in order to see the characteristic histological changes. Typically, a dense lymphohistiocytic infiltrate is noted, often admixed with neutrophils that surround and frequently destroy the hair follicle. The characteristic changes of a herpes infection, namely balloon degeneration of the keratinocytes of the follicle, scattered multinucleated cells, and keratinocytes with enlarged gray nuclei that have peripheral margination of the chromatin, are seen in approximately half the cases on which a biopsy has been performed. […] In pseudofolliculitis barbae and acne keloidalis nuchae, the inflammatory infiltrate is initially perifollicular and is composed of neutrophils and lymphocytes; however, later, the predominant cells are monocytes and plasma cells. Often, free hair shafts without the accompanying follicle can be identified within the dermis. The hair shafts are typically surrounded by acute or granulomatous inflammation and fibrosis. Hypertrophic scar is often present.

• #1 Infectious folliculitis – UpToDate

  https://www.uptodate.com/contents/infectious-folliculitis

  Infectious folliculitis […] A correct diagnosis of infectious folliculitis is essential for appropriate management. The patient history and physical examination, particularly the assessment of the distribution of folliculitis, help to narrow the differential diagnosis. Detection of the causative organism confirms the diagnosis and may help direct therapy. […] The etiologies, clinical manifestations, diagnosis, and management of infectious folliculitis will be reviewed here.

• #1 Folliculitis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/folliculitis-pro

  Folliculitis is inflammation of the hair follicles. […] Investigations: None is usually needed. […] If there is atypical response to therapy or episodes are recurrent, consider punch biopsy, Gram-staining of skin swabs/scrapings, scrapings for fungal culture or potassium hydroxide test. […] If HSV folliculitis is suspected then it may be worth sending vesicopustular fluid for viral culture to confirm the diagnosis. […] Skin biopsy shows different types of infiltrate in the walls and lumen of the hair follicle, dependent on cause. […] Cytology is being used by dermatologists increasingly frequently in the differential diagnosis of folliculitis.

• #1 Folliculitis – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/folliculitis

  Folliculitis is an infection of hair follicles. Diagnosis is clinical. Treatment for most cases of bacterial folliculitis is with topical mupirocin or clindamycin. […] The primary skin finding in folliculitis is a pustule and perifollicular inflammation. […] Microbiologic testing is not routinely indicated. […] If these measures do not result in a cure, or folliculitis recurs, pustules are Gram stained and cultured to rule out gram-negative or methicillin-resistant S. aureus (MRSA) etiology, and nares are cultured to rule out nasal staphylococcal carriage. […] Potassium hydroxide wet mount should be done on a plucked hair to rule out fungal folliculitis.

• #2 Folliculitis: diagnosis and management of subtypes | Medicine Today

  https://medicinetoday.com.au/mt/2021/october/feature-article/folliculitis-diagnosis-and-management-subtypes

  Folliculitis is a common disorder, although the exact prevalence is unknown. It presents as erythematous pustules surrounding hair follicles. It may be due to a superficial or deep infection of the follicle, or may be secondary to trauma. Deeper infections present as sycosis and folliculitis decalvans. Good grooming and hygiene are key to treatment and long-term resolution, alongside pharmacological therapies. […] Folliculitis is characterised by inflammation of the hair follicle, with formation of a pustule. […] The mainstays of treatment are hygiene and grooming, alongside antibiotics or antifungals depending on the causative agent and subtype. […] Investigations are usually not required, although swabs can be taken to assess sensitivity of the causative organism. […] Most cases of folliculitis can be managed through avoidance of irritants and good hygiene; however, some patients may also benefit from pharmacological treatment.

• #2 Folliculitis: Appearance, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17692-folliculitis

  Folliculitis is usually diagnosed during a physical exam with your healthcare provider. This can be done during an appointment and in most cases, you do not need to see a skincare specialist. Your primary care physician is usually able to diagnose folliculitis and provide a treatment plan. In certain, severe or persistent cases, an appointment with a dermatologist is recommended. […] In some more severe cases, your provider may refer you to a dermatologist for additional tests to make sure your folliculitis isn’t another medical condition. One test that can be done is a biopsy. This is a test where a small sample of your skin is removed and then taken to a lab where it’s studied.

• #2 Folliculitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK547754/?report=reader

  Essential elements of history should include: Recent increase of scratching due to pruritus, History of increased sweating, Use of topical corticosteroids, Recent and/or long term use of oral antibiotics, Any hot tub and/or swimming pool exposure, History of HIV with CD4 count less than 250 or immunosuppression. […] Physical exam should include close inspection of hair-bearing areas, including the bilateral upper and lower extremities as well as the chest, back, face, and scalp. On exam, the clinician should look for small pustules in these areas with peri-follicular inflammation. […] Should these cases prove to be too extensive, do not resolve on their own, or dont resolve after medical management referral to a dermatologist is recommended.

• #2 Folliculitis – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/folliculitis

  Folliculitis is an infection of hair follicles. Diagnosis is clinical. Treatment for most cases of bacterial folliculitis is with topical mupirocin or clindamycin. […] The primary skin finding in folliculitis is a pustule and perifollicular inflammation. […] Microbiologic testing is not routinely indicated. […] If these measures do not result in a cure, or folliculitis recurs, pustules are Gram stained and cultured to rule out gram-negative or methicillin-resistant S. aureus (MRSA) etiology, and nares are cultured to rule out nasal staphylococcal carriage. […] Potassium hydroxide wet mount should be done on a plucked hair to rule out fungal folliculitis.

• #2 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  KOH inspection, fungal culture, or both can be useful for diagnosing dermatophyte infections. Pityrosporum yeast forms are best appreciated on biopsy specimens in cases of Malassezia (Pityrosporum) folliculitis. […] Viral culture or punch biopsy can assist in the identification of folliculitis caused by herpes simplex virus. […] A complete blood cell count often reveals leukocytosis and eosinophilia, with elevated immunoglobulin E levels in patients with eosinophilic folliculitis. […] For deep infections, incision and drainage can be therapeutic and can provide material to be sent for culture. […] Histologically, all cases of superficial folliculitis have a similar appearance in that they show a moderately intense infiltrate of inflammatory cells in the follicular ostium and upper regions of the follicle. In most cases, the inflammation initially consists of neutrophils and then becomes more mixed with the addition of lymphocytes and macrophages. If the folliculitis is from an infectious cause, then various organisms can be identified within the follicle.

• #2 Folliculitis

  https://dermnetnz.org/topics/folliculitis

  Folliculitis means an inflamed hair follicle due to any cause. The result is a tender red spot, often with a surface pustule. […] Swabs should be taken from the pustules for cytology and culture in the laboratory to determine if folliculitis is due to an infection. […] Eosinophilic folliculitis is a specific type of folliculitis that may arise in some immune-suppressed individuals such as those infected by human immunodeficiency virus (HIV) or those who have cancer. […] Treatment depends on the underlying condition and its severity. A skin biopsy is often necessary to establish the diagnosis.

• #2 Folliculitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21873

  Folliculitis is a common, generally benign, skin condition in which the hair follicle becomes infected/inflamed and forms a pustule or erythematous papule of overlying hair-covered skin. […] The diagnosis of folliculitis is clinical. In general, no diagnostic testing or radiographic evaluation is necessary to diagnose this condition in lieu of a thorough history and physical exam. […] In the vast majority of cases of folliculitis, histopathology is not needed for diagnosis as this condition is a clinical diagnosis. However, in the case of eosinophilic folliculitis skin biopsy should be done for confirmation of the diagnosis. […] A complete history, as well as a focused physical exam, is usually enough to elucidate the diagnosis. […] Essential elements of history should include recent increase of scratching due to pruritus, history of increased sweating, use of topical corticosteroids, recent and/or long term use of oral antibiotics, any hot tub and/or swimming pool exposure, history of HIV with CD4 count less than 250 or immunosuppression. […] The diagnosis of folliculitis is clinical. […] A standard KOH preparation can be used to visualize hyphae and spores associated with folliculitis caused by Malassezia. […] A skin biopsy is usually required to confirm the diagnosis of eosinophilic folliculitis.

• #2 Folliculitis – wikidoc

  https://www.wikidoc.org/index.php/Folliculitis

  Folliculitis is a clinical diagnosis so the laboratory tests are generally done in cases of treatment resistance. CBC suggestive of leukocytosis and eosinophilia, with elevated immunoglobulin E levels in patients with eosinophilic folliculitis. […] Folliculitis may also be diagnosed using skin biopsy and histology. Findings on biopsy and histology varies depending upon the causative agent and type of folliculitis. Eosinophilic folliculitis shows perifollicular infiltrates of lymphocytes and eosinophils associated with follicular eosinophilic spongiosis. Bacterial and fungal folliculitis neutrophils infiltrating the walls and lumen of the hair follicles, with variable admix of lymphocytes and macrophages depending on chronicity of the folliculitis. Histological picture of viral folliculitis suggestive of lymphocyte infiltrate in the walls and lumen of the hair follicles. Demodex folliculitis shows perifollicular lymphohistiocytic inflammation is often seen along with mite Demodex folliculorum within the hair follicle.

• #2 Pathology Outlines – Folliculitis

  https://www.pathologyoutlines.com/topic/skinnontumorfolliculitis.html

  Differential diagnosis: Acne vulgaris […] Acneiform eruptions […] Arthropod bites […] Cutaneous candidacies […] Coccidiomycosis […] Dermatologic manifestations of renal disease […] Erythema toxic neonatorum […] Fox-Fordyce disease […] Graham-Little-Piccardi-Lasseur syndrome […] Id-reaction (autoeczematization) […] Impetigo […] Irritant contact dermatitis […] Milia […] Perioral dermatitis […] Papular urticaria […] Pruritic papular eruption of HIV disease (Indian J Sex Transm Dis AIDS 2018;39:44) […] Rosacea […] Seabathers eruption […] Subcorneal pustular dermatosis.

• #2 Folliculitis: diagnosis and management of subtypes | Medicine Today

  https://medicinetoday.com.au/mt/2021/october/feature-article/folliculitis-diagnosis-and-management-subtypes

  Treatment is mainly aimed at eradicating S. aureus. Antiseptic shampoos and topical clindamycin are sufficient to treat mild cases. […] There is some evidence, however, that maximal treatment effect is obtained through rifampicin and clindamycin, tetracyclines and intralesional corticosteroids, although individual clinician treatment choices vary widely. […] Management is mainly via oral tetracyclines and usually achieves a good result.

• #2 Folliculitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/folliculitis/symptoms-causes/syc-20361634

  Folliculitis is often caused when hair follicles are infected with bacteria, commonly Staphylococcus aureus (staph). […] Make an appointment with your health care provider if your condition is widespread or the symptoms don’t go away after a week or two of self-care measures. You may need a prescription-strength antibiotic or antifungal medication to help control the condition. […] Seek immediate medical care if you experience signs of a spreading infection. These include a sudden increase in redness or pain, fever, chills, and a feeling of being unwell (malaise).

• #2 Folliculitis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1070456-overview

  Folliculitis is a relatively common condition that arises due to an accumulation of inflammatory cells within the superficial or deep aspect of the hair follicle and has either an infectious or non-infectious etiology. […] When folliculitis is suspected, clinical history along with morphology and distribution of the lesions play an essential role in narrowing the differential diagnosis, but occasionally a gram stain, KOH or biopsy may be required to determine exact etiology. […] The type of inflammatory cells varies depending on the etiology of the folliculitis and/or the stage at which the biopsy specimen was obtained. […] Histologically, in superficial folliculitis the inflammatory cells are restricted to follicular ostia and infundibulum, whereas the inflammation extends throughout the length of follicle and into surrounding dermis in cases of deep folliculitis. […] Management depends on extent of involvement, duration and underlying etiology.

• #2 Infectious folliculitis – UpToDate

  https://www.uptodate.com/contents/infectious-folliculitis/print

  Folliculitis refers to inflammation of the superficial or deep portion of the hair follicle. The classic clinical findings of superficial folliculitis are folliculocentric, inflamed papules and/or pustules on hair-bearing skin. Nodules are a feature of deep, follicular inflammation. […] A correct diagnosis of infectious folliculitis is essential for appropriate management. The patient history and physical examination, particularly the assessment of the distribution of folliculitis, help to narrow the differential diagnosis. Detection of the causative organism confirms the diagnosis and may help direct therapy. […] The etiologies, clinical manifestations, diagnosis, and management of infectious folliculitis will be reviewed here.

• #2 Folliculitis, Gram-Negative – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/folliculitis-gram-negative/

  Gram-negative folliculitis can be divided into two main categories. Type 1 lesions are seen in 80% of the cases and appear as superficial pustules without the presence of comedonal lesions. Type 2 is characterized by deep nodular or cystic lesions. In approximately 20% of patients, the most common organism isolated is Proteus species. […] While the diagnosis of gram-negative folliculitis can usually be made on history and clinical exam, an aerobic bacterial culture should be obtained to confirm the diagnosis. A fresh pustule makes the best sample. […] It is important to think about this clinical entity when patients have a sudden flare or worsening of their acne, or when they are not responding to therapy, especially if they have been treated with long-term systemic antibiotics. […] Gram-negative folliculitis is seen in 4% of patients who are on systemic antibiotics for a prolonged period.

• #2 Folliculitis Workup: Laboratory Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1070456-workup

  When folliculitis is suspected, clinical history along with morphology and distribution of the lesions play an essential role in narrowing the differential diagnosis, but occasionally gram stain, cultures, potassium chloride (KOH) preparation or 3-4mm punch biopsy may be required to determine exact etiology in atypical cases or in patients resistant to standard treatments. […] Gram stain and bacterial culture are best performed by unroofing an entire pustule with a No. 15 blade and depositing material onto a glass slide and a sterile cotton swab. In typical cases, Gram stain shows gram-positive cocci, and culture grows S aureus. Pseudomonas species can be cultured from the pustules of hot tub folliculitis. […] Nasal culture of family members to look for S aureus colonization may be needed in chronic cases.

• #2 Folliculitis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/folliculitis-pro

  Folliculitis is inflammation of the hair follicles. […] Investigations: None is usually needed. […] If there is atypical response to therapy or episodes are recurrent, consider punch biopsy, Gram-staining of skin swabs/scrapings, scrapings for fungal culture or potassium hydroxide test. […] If HSV folliculitis is suspected then it may be worth sending vesicopustular fluid for viral culture to confirm the diagnosis. […] Skin biopsy shows different types of infiltrate in the walls and lumen of the hair follicle, dependent on cause. […] Cytology is being used by dermatologists increasingly frequently in the differential diagnosis of folliculitis.

• #2 Folliculitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/282

  Causes of folliculitis include bacterial, fungal, viral, and parasitic microorganisms. […] Most commonly superficial and resulting from infection by Staphylococcus aureus; use of antibacterial soaps may suffice as treatment for uncomplicated folliculitis, which is self-limited. […] Deeper infection and inflammation of hair follicles from Staphylococcus aureus generally require systemic antibiotic therapy based on culture sensitivities. […] Folliculitis can occur in patients with acne undergoing long-term oral antibiotic therapy and may mimic an acne flare. […] Treatment is tailored to the underlying cause; hygienic measures, MRSA eradication, and symptomatic therapies are other important treatment modalities to consider. […] Folliculitis manifests clinically as erythematous papules or pustules around hair follicles.

• #2 Folliculitis, Gram-Negative – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/folliculitis-gram-negative/

  Typically, gram-positive organisms, such as coagulase-negative Staphylococcus species and aerobic diptheroids, populate the nasal passages, while gram-negative bacteria make up less than 1% of normal flora. […] Gram-negative folliculitis is confined to the skin and does not have systemic implications or complications in immunocompetent patients. […] The treatment of choice for gram-negative folliculitis is isotretinoin 0.5-1.0mg/kg for 20 weeks. […] Patients should be advised that topical therapy is generally considered ineffective. Systemic antibiotics can suppress the eruption, but once they are discontinued, relapses are frequent. […] Gram-negative folliculitis can be a difficult diagnosis to make, and is probably under-reported because routine cultures are rarely performed. Consider this diagnosis if a patient has been on tetracycline antibiotics for 3-6 months with no clinical improvement or if there is a sudden flare of pustular acne or nodulocystic acne during treatment.

• #3 Folliculitis – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/bacterial-skin-infections/folliculitis

  Folliculitis is an infection of hair follicles. Diagnosis is clinical. Treatment for most cases of bacterial folliculitis is with topical mupirocin or clindamycin. […] The primary skin finding in folliculitis is a pustule and perifollicular inflammation. […] Microbiologic testing is not routinely indicated. […] If these measures do not result in a cure, or folliculitis recurs, pustules are Gram stained and cultured to rule out gram-negative or methicillin-resistant S. aureus (MRSA) etiology, and nares are cultured to rule out nasal staphylococcal carriage. […] Potassium hydroxide wet mount should be done on a plucked hair to rule out fungal folliculitis.

• #3 Folliculitis: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/folliculitis-pro

  Folliculitis is inflammation of the hair follicles. […] Investigations: None is usually needed. […] If there is atypical response to therapy or episodes are recurrent, consider punch biopsy, Gram-staining of skin swabs/scrapings, scrapings for fungal culture or potassium hydroxide test. […] If HSV folliculitis is suspected then it may be worth sending vesicopustular fluid for viral culture to confirm the diagnosis. […] Skin biopsy shows different types of infiltrate in the walls and lumen of the hair follicle, dependent on cause. […] Cytology is being used by dermatologists increasingly frequently in the differential diagnosis of folliculitis.

• #3 Infectious folliculitis – UpToDate

  https://www.uptodate.com/contents/infectious-folliculitis

  Infectious folliculitis […] A correct diagnosis of infectious folliculitis is essential for appropriate management. The patient history and physical examination, particularly the assessment of the distribution of folliculitis, help to narrow the differential diagnosis. Detection of the causative organism confirms the diagnosis and may help direct therapy. […] The etiologies, clinical manifestations, diagnosis, and management of infectious folliculitis will be reviewed here.

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