Alternative Ways to Treat Folliculitis
Dermatologic nomenclature has always been a bugaboo for the new student. I heartily agree with many dermatologists that we should simplify the terminology, and that has been attempted in this text. Some of the changes are mine, but many have been suggested by others. However, after a diligent effort to simplify the names of skin diseases, one is left with the appalling fact that some of the complicated terms defy change. One of the main reasons for this is that all of our field, the skin, is visible to the naked eye. As a result, any minor alteration from normal has been scrutinized by countless physicians through the years and given countless names. The liver or heart counterpart of folliculitis ulerythematosa reticulata (ulerythema acneiform, atrophoderma reticulatum symmetricum faciei, atrophoderma vermiculatum) is yet to be discovered.
Fiberglass dermatitis is one of the most common work-related PICDs. It is well known that fiberglass can provoke intense itching. However, only glass fibers of a magnitude greater than 5 xm will cause mechanical irritation of the skin. Fiberglass dermatitis includes folliculitis and paronychia, burning of the eyes, sore throat and cough. However, the sensitivity between individuals varies. A study on 98 glass-wool workers was performed 43 . Three groups of individuals were determined group A with persistent troublesome itching from the fibers, group B without itching and group C who had 'hardened' to the itching. Neither anamnesis nor intense diagnostic tests revealed differences of the three groups that correlated with the subjectively increased sensitivity to the fibers in group A.
Folliculitis Folliculitis. ofMthe ScalpJSuper i.cial Form) Folliculitis . of . the. . Scalp . . (Deep. Form) Folliculitis of. the Beard Stye (.Hordeolum.) Impetigo Ecthyma Folliculitis Superficial folliculitis Folliculitis of the scalp Superficial acne miliaris necrotica Deep scarring folliculitis decalvans Folliculitis of the beard Stye Furuncle Carbuncle
Soreness, redness and ulceration of the skin at the contact points with the mask are common. These can be prevented by attention to the mask selection and fitting, and to the headgear. Once an ulcer has formed a barrier such as granuflex is usually required to assist healing and this can also be used prophylactically. A Staphylococcal folliculitis occasionally occurs and responds to fucidic acid cream.
Recurrent pruritic crops of sterile pustules. Has a characteristic histologic appearance and is seen most often in association with HIV-positive patients. Folliculitis, hot tub. A bacterial folliculitis with inflammatory nodules caused by Pseudomonas aeruginosa in people exposed to poorly chlorinated hot tubs, jacuzzis, whirlpools, and swimming pools. Folliculitis, perforating, of the nose. A folliculitis of the stiff hairs of the nasal mucocutaneous junction that penetrates deeply through to the external nasal skin. Unless the basic pathology is understood and corrected by plucking the involved stiff hair, the condition cannot be cured. The external papule can simulate a skin cancer.
History should be obtained including a review of risk factors for HIV-1 exposure, drug and alcohol history, sexual history, travel history, and medical history. A complete baseline physical examination should be performed. Focused follow- up examinations are then recommended with attention directed to findings that indicate disease progression such as general appearance and weight loss, dermatological conditions (seborrheic dermatitis, folliculitis, dermatophytosis, Kaposi's sarcoma, bacillary angiomatosis), oral lesions (candidiasis, hairy leukoplakia, aphthous ulcers, periodontal disease), localized lymphadenopathy, splenomegaly and signs or symptoms of neurological neuropsychiatric involvement (mood or affective disorders, psychomotor slowing, abnormal eye movements, hyperreflexia, change of gait).
Folliculitis decalvans is a chronic folliculitis of unclear cause. It is characterized by recurrent, progressive pustules that gradually extend and destroy the hair follicle. Bacterial cultures may reveal Staphylococcus aureus but usually reveal nonpathogenic organisms. Fungal cultures should be done to exclude a scarring type of tinea capitis. Favus of the scalp caused by Trichophyton schoenleinii may mimic this disease. Therapy with oral antibiotics is occasionally effective. Pseudopelade of Brocq (alopecia cicatrisata) is a scarring alopecia of unknown cause that presents with skin-colored areas of permanent hair loss without a clinically evident folliculitis. It may be a separate entity or the end stage of another skin disorder such as lichen planopilaris. There is no effective treatment.
Shaving, contrary to popular belief, does not increase the amount of hair that regrows. Chemical depilatories and bleaching agents are available over the counter and frequently prove effective but may be irritating to the skin of some persons. Waxing and plucking have the advantage of removing the unwanted hair for longer periods without retreatment than does shaving. Plucking, waxing, and electrolysis may cause a folliculitis. Electrolysis also can cause scarring when done incorrectly, and is expensive. Laser treatment may offer some help.