Folliculitis is an infectious disease characterized by purulent inflammation that affects the hair follicles of the middle and deep sections. The disease has a different cause of occurrence: parasitic, viral, fungal and bacterial. Characteristic manifestations of folliculitis are multiple or single pustules appearing in places of hair growth, through which the hair passes. With a deep lesion of hair folliculitis, the opened pustules form ulcers, the healing of which is characterized by scarring. Diagnosis of folliculitis is carried out using smear microscopy, pustule examination and dermatoscopy. Therapy is carried out with the help of antiseptic drugs, local and systemic etiotropic agents: acyclovir, antimycotics, antibiotics.
The content of the article:
Causes of folliculitis
How can I get folliculitis
Symptoms of folliculitis
Diagnosis of folliculitis
Treatment of folliculitis
Prevention of folliculitis
Folliculitis
Folliculitis is a purulent disease of the skin, which, like sycosis, hydradenitis, streptococcal impetigo and streptoderma, refers to pyoderma, whose prevalence among people reaches slightly less than 50%. In countries with hot climates, the possibility of getting folliculitis is higher, since weather conditions themselves contribute to the multiplication of infection. Socially disadvantaged segments of the population who do not follow the rules of personal hygiene have a high risk of getting folliculitis.
In most cases, the disease develops first with ostiofolliculitis — a disease characterized by superficial inflammation of the hair follicle, affecting only its mouth. The subsequent continuation of infection already in the depth of the follicle leads to a change in ostiofolliculitis into folliculitis.
Causes of folliculitis
The causative agents of the disease that cause folliculitis are mostly bacteria, mainly staphylococci. There are cases of folliculitis due to infection with pseudomonads, which are the causative agents of gonorrhea and syphilis. Mycotic lesions of the skin (dermatophytes and pathogens of the genus Pityrosporum), viruses (herpes zoster and herpes simplex, contagious mollusc) and various parasites (for example, a tick — the causative agent of demodecosis) can cause the disease. Depending on the causes and conditions of infection, specialists distinguish such folliculitis: fungal, bacterial, viral, parasitic and syphilitic.
How can I get folliculitis
Infection with folliculitis occurs through the penetration of infection into the hair follicle, due to the presence of small lesions on the skin. It can be wetness, abrasions, scratches or excoriation. The risk group of infection includes people suffering from itchy dermatoses (pruritus, eczema, atopic, contact, allergic and herpetiform dermatitis), which causes skin scratching, which is the entrance gate for the pathogen, as well as persons suffering from increased sweating.
The weakened immunity of the human body and the protective function of the skin contributes to the infection of the hair follicle and the development of the disease. Therefore, diseases that take a long time and require immunosuppressive treatment are among the factors contributing to infection. Such diseases include immunodeficiency (human immunodeficiency virus) and diabetes mellitus. The development of the disease also provokes the external use of glucocorticosteroid drugs for a long time, since such drugs reduce the local barrier function. In addition, there are also professional folliculitis (occur in oil workers, tractor drivers and locksmiths). The appearance of the disease is associated with a decrease in the barrier functions of the skin due to its prolonged interaction with technical oils, lubricants, kerosene and other chemicals.
Symptoms of folliculitis
Folliculitis begins with the fact that redness appears in the follicle area and infiltration begins. After that, its formation occurs — a conical pustule permeated with fluffy hair, containing a purulent formation in the center. After it opens and gets rid of pus, a small ulcer appears, covered with a purulent-bloody crust. A scar or dark spot appears in place of the disappeared crust. More superficial types of the disease can pass without a trace. The process of development and course of inflammation of one follicle lasts up to 7 days.
Folliculitis most often has a multiple character. The elements of folliculitis, as a rule, have their favorite location, namely on the hairy areas of the skin: legs (especially in women, due to depilation), in the hips and shins, face, head, axillary pits, groin. The rash is accompanied by itching and soreness of varying degrees of explication. With the absence of correct therapy and hygienic measures, folliculitis worsens due to the development of carbuncles, furuncles, abscesses, hydradenitis and phlegmon.
Staphylococcal folliculitis
Staphylococcal folliculitis usually occurs on the skin around the mouth and chin, where bristly hair grows. It develops in men who shave their moustaches and beards. The disease becomes more complicated due to the development of sycosis.
Pseudomonas folliculitis
Pseudomonas folliculitis, popularly called “hot tub folliculitis”, due to its occurrence after taking a hot bath in insufficiently chlorinated water. Pseudomonas folliculitis is more common in patients undergoing antibiotic treatment for acne. It is expressed by an increase in acne rashes and the appearance of pustules.
Syphilitic folliculitis
Syphilitic folliculitis occurs with syphilis relapse, accompanied by non-pubic hair loss around the mouth and in the chin area, as well as on the head.
Gonorrheal folliculitis
Gonorrheal folliculitis is a complication of advanced and prolonged gonorrhea. It is more often manifested on the skin of the perineum in women and in men on the foreskin.
Candida folliculitis
Candidiasis folliculitis develops when sealed bandages are applied in bedridden patients and with prolonged elevated body temperature.
Herpetic folliculitis
Herpetic folliculitis is characterized by the appearance of vesicles in the follicle. It is more common in men on the nasolabial triangle and chin.
Parasitic folliculitis
Parasitic folliculitis caused by demodecosis is characterized by skin redness, the formation of pustules near the follicles, around which peeling occurs.
Bockhart ‘s Impetigo
Bokhart’s impetigo develops when the skin softens, due to the imposition of warming compresses with a disorder of the functioning of the sweat glands.
Diagnosis of folliculitis
When diagnosing folliculitis, it is recommended to investigate the condition of the hair follicle; determine the pathogen that caused inflammation and infection; exclude specific causes and conditions of the disease (gonorrhea, syphilis); identify associated diseases that may contribute to infectious processes.
During the consultation with a dermatologist, the rashes are examined and dermatoscopy is performed, which can help the specialist to find out the depth of the lesion of the follicle. The doctor takes a sample of the separated pustules to examine it under a microscope, perform back-sowing, check for the presence of mycosis and pale treponema. To exclude infectious diseases such as gonorrhea and syphilis, specialists diagnose polymerase chain reaction (PCR) and anticardiolipin test (RPR). If necessary, the patient is prescribed a blood glucose test, an immunogram and other studies.
In the process of diagnosis, it is also important to distinguish folliculitis from other diseases, such as pink lichen, perifolliculitis, furunculosis and others.
Treatment of folliculitis
The patient is prescribed therapy corresponding to the etiology of his disease. Ointments and antibiotics are prescribed for bacterial folliculitis, antimycotic drugs for fungal, and herpetic folliculitis is treated with acyclovir.
Local therapy in the form of treatment of lesions with the help of zelenka and other similar drugs is quite enough for the initial stage of the disease. In order to prevent infection of healthy areas of the skin, it is necessary to treat them with boric or salicylic alcohol. In parallel, UFO therapy is prescribed.
In case of relapse, systemic treatment is prescribed. Dicloxacillin, cephalexin and erythromycin are used orally for staphylococcal folliculitis. A severe form of pseudomonas folliculitis is treated with ciprofloxacin. In the candidiasis form of folliculitis, itraconazole and fluconazole are prescribed, in the dermatophytic form — terbinafine. At the same time, therapy of immunodeficiency conditions or concomitant diabetes mellitus is carried out.
Prevention of folliculitis
Prevention of folliculitis consists in the need to eliminate factors that can provoke the disease. Also, for prevention purposes, you should use soap with antiseptic effect and regularly treat the skin with benzoyl peroxide, which has excellent disinfecting and keratolytic properties.
