Folliculitis

Isotretinoin COOH Topical 0.05% cream Oral 0.251.0 mg/kg/ d Cystic acne, recalcitrant nodular acne Rosacea gram-negative folliculitis pyoderma faciale hidradenitis suppurativa cancer prevention... 

Folliculitis caused by colonization with S. aureus or S. epidermidis on the face can be sometimes misdiagnosed as acne. The prominent lesions are superficial follicular pustules that are often distributed on the lateral cheeks, the chin and the temporal sites of the forehead. The rare folliculitis due to Candida may also present as multiple pustular eruptions. 

Cytotoxic and hemolytic activity has been obtained from the sponge Pachy-matisma johnstonii 63). Debromoaplysiatoxin, which causes contact dermatitis and a pustular folliculitis in humans and severe inflammation in rabbits, is one of the most potent skin irritants known 64). 

Skin contact with metalworking fluids may cause skin irritation or a contact irritant dermatitis. Contact with neat oils may cause folliculitis (oil acne). Contact with some aqueous-mix fluids may, depending upon the additives, e.g. biocides, cause an allergic contact dermatitis. Formerly the use of unrefined mineral oils posed a risk of skin cancer. 

Coal tar is keratolytic and may have anti-proliferative and anti-inflammatory effects.2 Coal tar products include crude coal tar and tar distillates (liquor carbonis detergens) available as ointments, creams, and shampoos in various strengths. Preparations containing coal tar may precipitate folliculitis,10 will stain clothing, and have an unpleasant odor. They are also photosensitizing and can be combined with UVB phototherapy (Goekermann s regimen) to increase treatment response.19,20... 

Folliculitis, furuncles, and carbuncles refer to the inflammation of one or more hair follicles, often attributed to infection with S. aureus. Treatment depends on severity and may involve local heat, incision and drainage, and/or oral or topical antibiotic therapy. 

Folliculitis presents as small, pruritic, erythematous papules. Location of the lesions and a good patient history are often all that are required in the diagnosis of folliculitis. While the papules may be cultured and Gram stains or potassium hydroxide stains done to help determine causative agent, it is not generally required because folliculitis often resolves spontaneously within a few days. 

Also known as boils, furuncles might be described as a deep form of folliculitis. 

The goals of therapy for folliculitis, furuncles, and carbuncles are resolution of infection with no or minimal scaring. 

A topical antibiotic or antifungal may be used to control the spread of infection but generally is unnecessary. For staphylococcal or streptococcal folliculitis, antibiotic ointments such as mupirocin might be administered three times daily. Antifungal shampoo can be used for dermatophytes. 

Luelmo-Aguilar J, Santandreu MS. Folliculitis Recognition and management. Am I Clin Dermatol 2004 5(5) 301-310. 

Ointments are the most effective formulations for psoriasis because they have an occlusive oily phase that conveys a hydrating effect and enhances penetration of the corticosteroid into the dermis. They are not suited for use in the axilla, groin, or other intertriginous areas where maceration and folliculitis may develop secondary to the occlusive effect. 

Folliculitis and small furuncles can be treated with moist heat large furuncles and carbuncles require incision and drainage. Antimicrobial therapy is unnecessary unless extensive lesions or fever are present. 

Other late-appearing lithium side effects include benign reversible leukocytosis, acne, alopecia, exacerbation of psoriasis, pruritic dermatitis, mac-ulopapular rash, folliculitis, and weight gain. 

Q83 Patients using Elidel cream should be advised to avoid alcoholic drink during treatment. Elidel may cause folliculitis and impetigo as side-effects. 

Elidel cream consists of pimecrolimus, which is a calcineurin inhibitor that is used for eczema or psoriasis. Patients should be advised to avoid alcoholic drink during the treatment period as consumption of alcohol may lead to facial flushing and skin irritation. Side-effects associated with the topical administration of pimecrolimus include a burning sensation, pruritus, erythema and skin infections, including folliculitis and, less commonly, impetigo. 

Vehicles - Ointments are more occlusive and are preferred for dry scaly lesions. Use creams on oozing lesions or in intertriginous areas where the occlusive effects of ointments may cause maceration and folliculitis. 

McCatm, S. et al. (2001). Control of gonadotrophin secretion by follicule stimulating hormone-releasing factor, luteinizing hormone-releasing hormone and leptin. Arch. Med. Res. 32(6), 476-485. 

Dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral... 

Skin atrophy, hyperpigmentation, folliculitis Serious Reactions... 

Itching, redness, dryness, irritation, burning at site of application, arthralgia, folliculitis, maceration, muscle atrophy, secondary infection... 

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