Folliculitis treatment

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. 

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. 

Unlabeled Uses Treatment of infected eczema, folliculitis, minor bacterial skin Infections. 

Transient acneiform eruptions have been noted early in lithium treatment. Some of them subside with temporary discontinuance of treatment and do not recur with its resumption. Folliculitis is less dramatic and probably occurs more frequently. Leukocytosis is always present during lithium treatment, probably reflecting a direct effect on leukopoiesis rather than mobilization from the marginal pool. This adverse effect has now become a therapeutic effect in patients with low leukocyte counts. 

The cutaneous adverse effects of lithium have been reviewed (401,402). Lithium can cause aggravation of psoriasis. Other dermatological problems related to lithium treatment include acne, folliculitis, and maculo-papular eruptions. The prevalence of dermatological difficulties is up to 45%, although many have reported a much lower rate, less than 4%. Men are more susceptible to than women. Most patients can be managed without withdrawing lithium, but aggravation of psoriasis may make it necessary. 

A 58-year-old man developed stomatitis and widespread edematous erythema with papules and pustules after taking a combination of carbamazepine and paracetamol for 2 days, a most unusual treatment for headache and fever (62). The stomatitis improved but the eruption persisted for 2 months and was diagnosed as eosinophilic pustular folliculitis, a disorder that is rarely drug-induced. Recovery was achieved with glucocorticoid therapy. 

Use Treatment of severe, recalcitrant cystic acne that is unresponsive to conventional acne therapies. Treatment of g-negative folliculitis, severe rosacea, correcting severe keratinization disorders Half-life 10-20 hours Onset UK Peaks Duration UK 5.3 hours... 

Adverse effects of tetracyclines include resistant bacteria, folliculitis, candidiasis, gastrointestinal upset, and phototoxic effects. Tetracyclines must not be combined with systemic retinoids because of the increased probability for development of intracranial hypertension. Tetracycline is used in the treatment of moderate to severe acne vulgaris. It is the least expensive of the tetracyclines and therefore often prescribed for initial therapy. A common initial approach includes tetracycline 1 g daily (500 mg twice daily), 1 hour before meals after 1 or 2 months, when marked improvement of inflammatory lesions is observed, the dose may be decreased to 500 mg every day, for another 1 or 2 months. Drawbacks to the use of tetracycline include also a drug-food interaction with dairy prodncts. 

Doxycycline is commonly used in the treatment of moderate to severe acne vulgaris. It is more effective and produces less resistance than tetracycline. The initial dosage is usually 100 or 200 mg daily, followed after improvement by 50 mg/day as a maintenance dose it may be taken with food even thongh it is more effective when taken 30 minutes before meals. Subantimicrobial-dose doxycycline (20 mg) has been investigated in a double-blind, placebo-controlled trial in the treatment of moderate facial acne. Positive ontcomes were achieved with no development of resistant organisms or change in normal skin flora. Adverse effects include resistant bacteria, folliculitis, candidiasis, gastrointestinal upset, and phototoxic effects such as photo-onycholysis. ... 

Deeper bacterial infections of the skin include folliculitis, erysipelas, cellulitis, and necrotizing fasciitis. Since streptococcal and staphylococcal species also are the most common causes of deep cutaneous infections, penicilUns (especially ji-lactarruise-resistant ji-lactams), and cephalosporins are the systemic antibiotics used most frequently in their treatment (see Chapter 44). A growing concern is the increased incidence of skin and soft tissue infections with hospital- and community-acquired methicillin-resistant S. aureus (MRSA) and drug-resistant pneumococci. Infection with community-acquired MRSA often is susceptible to trimethoprim—sulfamethoxazole. 

The infection is traditionally acquired from contact with cattle, mainly during winter months, when they are kept in the cattle sheds. The clinical picture is that of a highly inflammatory, pustular folliculitis. Hairs of the beard or moustache regions are surrounded by red, inflammatory papules or pustules, usually with exudation or crusting (Fig. 12). Many hairs within the affected areas are loose and easily removed with forceps without causing pain. It is noteworthy that, without treatment, lesions tend to settle spontaneously but may persist for months. 

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