Folliculitis - Causes, Symptoms, Diagnosis and Treatment
Folliculitis - Infection of the middle and deep parts of the hair follicle, resulting in its purulent inflammation. Folliculitis may be bacterial, fungal, viral, parasitic etiology. It is manifested in the appearance of hair growth in places of single or multiple pustules, which runs through the middle of hair. Revealed the pustules form sores, their healing at a deep lesion of the hair follicle is accompanied by scarring. Diagnosis of folliculitis is carried out by dermoscopy, smear microscopy and research discharge pustules. Treatment is carried out with solutions of aniline dyes, antiseptics, local and systemic application etiotropic drugs: antibiotics, antifungals, acyclovir.
Folliculitis
gidradenity, sycosis, streptococcal impetigo and folliculitis streptokokkovym otnositsya to purulent skin diseases (pyoderma), the prevalence of which the population is 40%. In hot countries, the incidence of folliculitis above, since the very climate contributes to the development of infection. High incidence is also found among socially disadvantaged sections of the population living in unsanitary conditions.
In some cases, folliculitis begins with sycosis - superficial inflammation of the hair follicle, exciting only his mouth. The further spread of infection in the follicle depth leads to the transformation of sycosis in folliculitis.
syphilis, gonorrhea and others. bacteria. The cause of the disease may be fungal skin lesions (Candida species and of Pityrosporum, dermatophytes), viruses (molluscum contagiosum, simple and herpes zoster) and parasites (such as mites, causing demodicosis). According to the etiology of infection Clinical Dermatology distinguishes bacterial, fungal, viral, and parasitic syphilitic folliculitis.
The penetration into the hair follicle infection occurs through small skin lesions: scratches, excoriations, abrasions, soak. The probability of infection is increased in people suffering from itching dermatoses (eczema, pruritus, atopic dermatitis, allergic contact dermatitis, dermatitis Duhring) and therefore constantly combing his skin, as well as in those suffering from excessive sweating.
The weakening of the body's defenses and the skin barrier function facilitates the penetration of infection into the hair follicle and development of folliculitis. Therefore, the factors that contribute to infection, include diabetes and various immunodeficiency: HIV infection, conditions associated with prolonged disease or immunosuppressive therapy. Long term cutaneous glucocorticosteroids reduces local immunity and can also favor the development of folliculitis. Reduced skin protective properties occurs during prolonged exposure to the various chemicals it: kerosene, lubricants, industrial oils. With the appearance of professional associated folliculitis in mechanics, tractor, oil.
pigmentation or scar. More superficial folliculitis can be resolved without leaving a trace. The process of development and resolution of inflammation of the follicle takes up to 1 week.
In most cases of folliculitis is multiple in nature. Its elements are usually located on the hairy areas of the skin: on the face, scalp, armpits, groin, legs (mostly women, depilating hip and thigh). Eruptions are accompanied by pain and itching of varying severity. In the absence of proper treatment and hygienic measures folliculitis is complicated by the development of boils, carbuncles, hidradenitis sup-, abscesses, cellulitis.
Staphylococcal folliculitis usually localized in bristly hair growth areas, most often it is the skin around the chin and mouth. It occurs mainly in men who shave their beard and mustache. It may be complicated by the development of sycosis.
Pseudomonas folliculitis It is popularly known as "hot tub folliculitis", because in most cases occur after taking a hot bath with inadequate chlorination. Often it occurs in patients undergoing antibiotic therapy regarding acne. Klinicheski reflected in a sharp increase in acne occurs on the face and upper torso pierced hair pustules.
Syphilitic folliculitis (Eel syphiloderm) develops in secondary syphilis, accompanied nerubtsovoy alopecia in the beard and mustache growth area, as well as the scalp.
Gonorrheal folliculitis It is a complication of untreated gonorrhea and long flowing. Favourite localization - the skin of the perineum in women and foreskin in men.
Candida folliculitis observed mainly in the application of occlusive dressings, in bedridden patients and prolonged fever.
Dermatophyte folliculitis characterized by the beginning of inflammatory changes with the surface of the horny layer of the epidermis. The process then gradually captures the follicle and the hair shaft. It may occur in the background and trihofitii favus, leaving scarring.
Herpetic folliculitis characterized by the formation of vesicles in the mouths of hair follicles. There kozhe on the chin and nasolabial triangle, is more common in men.
Folliculitis caused by demodex, manifested by redness of the skin to form in the mouths of hair follicles characteristic pustule, which is celebrated around defurfuration.
Impetigo Bockhart - Another option folliculitis. It develops when skin maceration. The most common for hyperhidrosis or by hot compress therapy.
dermatoscopy, which helps the doctor determine the depth of the defeat of the follicle. Produced fence separated pustules microscopy and bacteriological sowing Research on fungi and pale treponemu. To exclude gonorrhea and syphilis performed PCR-diagnostics and the RPR test. If necessary, the patient is assigned immunogram, blood sugar and other tests.
During diagnostics folliculitis differentiate from sycosis, toadskin, perifollikulita Hoffmann, boils, acne uzlovatokistoznyh, streptokokkovogo impetigo, pink lichen Gibert, medical toxicoderma.
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Cases of severe recurrent course folliculitis require systemic therapy. When staphylococcal folliculitis inside prescribe cephalexin, dicloxacillin, erythromycin. Treatment of severe Pseudomonas folliculitis conducted with ciprofloxacin. When Candida folliculitis is used fluconazole and itraconazole, with dermatophyte - terbinafine. At the same time spend a concomitant therapy of diabetes or immunodeficiency states.