小结
定义
病史和体格检查
关键诊断因素
- 近期热水浴史
- 新使用的药物已知与毛囊炎相关
其他诊断因素
- 近期剃须/剃毛史
- 脐形、肉色丘疹
- 面部一侧的颌下区出现丘疹
- 小型、形态一致的丘疹和脓疱
- 红斑基底
- 脱发/头皮脱屑
- 沿皮节分布的红色斑块伴出血痂皮
危险因素
- 创伤,包括剃除和拔除毛发
- 外用皮质类固醇制剂
- 糖尿病
- 免疫抑制
- 阻塞和出汗
- 全身性应用抗生素
- 浸泡在氯化不足的水中
- 药物
诊断性检查
需考虑的检查
- 针对细菌的皮肤拭子
- 针对病毒的皮肤拭子
- 刮皮屑查真菌
- 组织培养
- 皮肤活组织检查
治疗流程
无并发症的浅表性毛囊炎,病原体未知
甲氧西林敏感金黄色葡萄球菌 (MSSA) 导致的复发性/深层毛囊炎
耐甲氧西林金黄色葡萄球菌 (methicillin-resistant Staphylococcus aureus, MRSA) 导致的复发性/深层性毛囊炎
革兰阴性菌毛囊炎
铜绿假单胞菌感染导致的浴池毛囊炎
皮肤真菌性毛囊炎
糠秕马拉色菌(糠疹癣菌毛囊炎)
念珠菌毛囊炎
单纯疱疹病毒 (HSV) 毛囊炎
毛囊蠕形螨毛囊炎
药源性毛囊炎
嗜酸性脓疱性毛囊炎(Ofuji 病)
HIV 相关的嗜酸性毛囊炎
婴幼儿嗜酸性脓疱性毛囊炎
撰稿人
作者
Joshua Hekmatjah, BS
Clinical Research Fellow
Dermatology Department
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
利益声明
JH declares that he has no competing interests.
Nazanin Ehsani-Chimeh, MD
Clinical Research Fellow
Dermatology Department
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
利益声明
NEC declares that she has no competing interests.
April W. Armstrong, MD, MPH
Associate Dean, Clinical Research
Associate Professor of Dermatology
Keck School of Medicine of USC
University of Southern California
Los Angeles
CA
利益声明
AWA has served as an investigator for Abbvie, Bristol-Myers-Squibb, Dermavent, Janssen, Eli Lilly, Modernizing Medicine, Novartis, OrthoDermalogics, Pfizer, Regeneron Pharmaceuticals, Sanofi Genzyme, and Sun Pharma; has been a speaker for Abbvie, Regeneron, and Sanofi Genzyme; and is a member of the data safety monitoring board for Boehringer Ingelheim/Paraxel. Her institution has received funding from Bristol-Myers-Squibb, Dermavent, Dermira, Eli Lilly, Galderma, Janssen-Ortho, Kyowa Hakko Kirin, Leo Pharma, Pfizer, and UCB Pharma.
鸣谢
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.
利益声明
HB declares that he has no competing interests.
同行评议者
Lowell Goldsmith, MD
Professor of Dermatology
Dean Emeritus
School of Medicine and Dentistry
University of North Carolina
Chapel Hill
NC
利益声明
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.
Dedee F. Murrell, MA, BMBCh, FAAD, MD
Head of Department
Department of Dermatology
St George Hospital
Conjoint Professor
University of New South Wales
Sydney
Australia
利益声明
DFM declares that she has no competing interests.
鉴别诊断
- 须部假性毛囊炎
- 寻常痤疮
- 玫瑰痤疮(玫瑰痤疮)
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