Summary
Definition
History and exam
Key diagnostic factors
- recent history of immersion in spa water
- man with dark skin and curly hair
- recent ingestion of drugs known to be associated with folliculitis
Other diagnostic factors
- recent history of shaving
- umbilicated, flesh-colored papules
- papules on one side of the face in the submaxillary area
- small, uniform papules and pustules
- background erythema
- alopecia/scalp scaling
- erythematous plaques with hemorrhagic crusts in a dermatomal distribution
Risk factors
- trauma, including shaving and extraction
- topical corticosteroid preparations
- diabetes mellitus
- immunosuppression
- occlusion
- perspiration
- systemic antibiotics
- immersion in under-chlorinated water
- drugs
Diagnostic investigations
Investigations to consider
- Gram stain
- potassium hydroxide (KOH) preparation
- Tzanck smear
- direct fluorescent antibody (DFA) assay
- tissue culture
- skin biopsy
Treatment algorithm
Contributors
Authors
Clinical Research Fellow
Dermatology Department
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
Disclosures
JH declares that he has no competing interests.
Clinical Research Fellow
Dermatology Department
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
Disclosures
NEC declares that she has no competing interests.
Associate Dean, Clinical Research
Associate Professor of Dermatology
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
Disclosures
AWA has served as consultant for Abbvie, Amgen, Janssen, Merck, Eli Lilly, Novartis, and Pfizer; has served as an investigator for Abbvie, Janssen, and Eli Lilly; and is a member of Speaker’s Bureau for Abbvie.
Joshua Hekmatjah, Dr Nazanin Ehsani-Chimeh, and Dr April W. Armstrong would like to gratefully acknowledge Professor Howard Baden, a previous contributor to this topic.
Disclosures
HB declares that he has no competing interests.
Peer reviewers
Professor of Dermatology
Dean Emeritus
School of Medicine and Dentistry
University of North Carolina
Chapel Hill
NC
Disclosures
LG is editor-in-chief and co-founder of Logicalimages, Inc, which has print and electronic products for education and point-of-care; he has stock and stock options in that corporation. He is on the clinical and scientific advisory boards of Anacor Inc, which is developing anti-inflammatory and anti-infective products that are in early clinical trials; he receives payments and stock options for those services.
Head of Department
Department of Dermatology
St George Hospital
Conjoint Professor
University of New South Wales
Sydney
Australia
Disclosures
DFM declares that she has no competing interests.
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