FOLLICULITIS.ppt

Medicine and surgery and pathology

1. FOLLICULITIS
Definition
This is a superficial infection and inflammation of
at the mouth of the hair follicle
Is secondary to infection by Staphylococcus aureus.
Other aetiologicalcauses include staphylococcus
group A, Escherichiacolior gram-negative organisms
in individuals with acne on antibiotic treatment or
people exposed to hot swimming pools contaminated
with Pseudomonas aeruginosa.
Lesions of folliculitis are usually seen on hairy parts
of the body.

2. FOLLICULITIS
Incidence
Is relatively common condition especially in young
adults occurring in ~1% of population.
The predisposing factors:
Applications of greasy substances topically over
hairy follicles e.g. oils or greases as seen in
mechanics., use of Vaseline, or elastoplasts in
dressings.
Underlying HIV disease, diabetes mellitus or
corticosteroid therapy.
Maceration and occlusion

3. FOLLICULITIS

4. FOLLICULITIS
Pathogenesis
Staphylococcigain entry into the follicles
through the follicular orifice
establish low-grade infection within the
epidermis surrounding the follicular canal
forming a pustule(small blister or pimple on
skin containing pus)
Patients who carry staphylococcus in their
nose and skin are more susceptible.

5. FOLLICULITIS
Clinical Presentation
mainly present as superficial pustules on the
skin usually observed as a lesion with a hair
centrally sticking out of it.
There is slight erythema at the base.
The pustules may rapture resulting in crusted
lesions.
If infection spreads to the inner part of the
follicle, then a furuncle may develop, and if
several adjacent follicles are involved then it
becomes a carbuncle.

6. FOLLICULITIS
Sites: -lesions are mainly found distributed on
the buttocks, thighs, lower limbs, beards
and occasionally the scalp.
The key to diagnosis is a lesion with hair
sticking out of it.
Involvement of the beards in males is called
Sycosis barbae.

7. FOLLICULITIS
Men have staphylococcus in the nose hence
when shaving and breathing out causes the
staphylococcus to spread to the new cuts
causing folliculitis. Sycosis barbae is more
difficult to eradicate due to nasal carriers, hence
need to be treated longer with antibiotics for
about 1 month or more.
Folliculitis may be asymptomatic, occasionally
patients may complain of mild discomfort
associated with the lesions.
It may be chronic or recurrent especially in HIV
infected individuals.

13. FOLLICULITIS
Differential diagnosis
Acne –see comedonesand lack of hair from
the papules of acne.
Keratosis pilaris –this presents as rough tiny
scaly papules on the back of arms or buttocks
or thighs.
Rarely fungal infections –but often
associated with scaly plaques and not easily
confused with folliculitis.

14. FOLLICULITIS
Diagnosis
Mainly clinical and through isolation of
staphylococcus from pustules by gram stain.
Treatment
Bath with soap and warm water, or antiseptic
solutions e.g. 0.5%-1% savlonlotion, potassium
permanganate solution, dettol, povodine-iodine
etc.

15. FOLLICULITIS
Apply topical antibiotics e.g. fusidic acid,
neomycin, or even 1% GV paint.
In severe widespread lesions -use systemic
antibiotic therapy e.g. erythromycin, cloxacillin,
Augmentin etc.
Heath education –remove the predisposing
cause, stop use of greasy preparations/oils on
the skin
Treat any underlying disorder e.g. DM,
HIV/AIDS

16. FOLLICULITIS
Course and complications
The condition has good response to therapy
and complications are rare and local e.g.
furuncle that may require incision and drainage.

17. TYPES OF FOLLICULITIS
1 BACTERIAL FOLLUCULITIS
Staphylococcal folliculitis
Gram negative folliculitis
2 FUNGAL FOLLUCULITIS
Dermatophytes folliculitis
Malassezia (pityrosporum)
folliculitis
Candida folliculitis
3 VIRAL FOLLICULITIS
Herpes folliculitis
DEMODEX FOLLICULITIS
Environmental
cause of
folliculitis
Mechanical
Occlusion
Chemical