FOLLICULITIS.ppt
- 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 aetiological causes include staphylococcus group A, Escherichia coli or 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 Staphylococci gain 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 comedones and 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% savlon lotion, 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