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Folliculitis

by Carlo Raj, MD
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    00:01 In dermatology, we’ll take a look at those that that are infectious in nature, a lot of repetition here with microbiology as well as you can imagine.

    00:12 We’ll begin our topic by looking at folliculitis and I want to make sure that by the time we’re completed with our discussion that you’re quite clear as to what does it mean to have a folliculitis, and a furuncle, carbuncle, and abscess, so on and so forth.

    00:27 First, think of a follicular unit and that basically is going to house your hair, right? So think about the hair that’s coming out of your skin and it’s coming through a follicular unit.

    00:38 Infection of the hair follicles is what folliculitis is.

    00:42 Usually refers to bacterial folliculitis.

    00:44 Usually.

    00:45 So that’s where you want to go with this.

    00:47 And its continuum of furuncles, carbuncles, and abscesses.

    00:55 If you think of it as such from henceforth, you’ll be in good shape.

    01:00 So let’s say that you had an infection of the follicular unit and it wasn’t properly managed.

    01:05 And at some point in time, you can imagine that that infection is going to get more severe.

    01:10 And with the continuum, it’s the furuncle, carbuncle, and an abscess formation on the skin, which could then also include the follicular unit.

    01:19 Are we clear about the big picture of folliculitis? And if you take a look at the image that has been provided and that I’m showing you folliculitis where hair follicle unit has been infected.

    01:34 The demographics can occur at any age group.

    01:36 It can involve terminal and vellus hairs.

    01:40 Almost all cases are caused by Staph aureus.

    01:44 That’s where your focus should be on.

    01:46 Cases in the groin may be caused by what’s known as your Gram-negative type of bacteria.

    01:53 And degree of inflammation then dictates the presentation.

    01:57 A culture must be done so that you could then look for your particular organism.

    02:04 Management of folliculitis: oral antibiotics such a dicloxacillin or cephalexin.

    02:11 Consider culture for those that are non-responding.

    02:14 And 25% occurrence in all comers anyway.

    02:19 Incision and drainage for large fluctuant lesions.

    02:21 So imagine that now that folliculitis then goes on to become an abscess and drainage is necessary.

    02:27 Packing and marsupialization rarely required.

    02:32 So please do not choose this as being an answer choice.

    02:35 It will be a distraction when it comes to be folliculitis.

    02:39 Differential diagnoses: If it’s acne vulgaris, remember that this will be a condition that’s taking place in your pubertal age of population, adrenarche.

    02:50 Usually on the face and upper trunk only and the fact that have comedone as being a feature of acne, not of folliculitis.

    02:58 In the folliculitis, you’re focusing upon the hair unit.

    03:04 Another differential diagnosis, here it’s called prurigo nodule, which is more or less a neurodermatitic type of excoriation.

    03:12 Not necessarily follicularly based And the fact that it’s limited to those areas that are reachable, because here you’re thinking about this being a neurodermatitic type of condition.

    03:26 A differential diagnosis, also known as your prickly heat.

    03:31 And by that, we mean miliaria.

    03:33 And with malaria, occlusion of your eccrine sweat duct.

    03:39 Not referring to malaria, but this is miliaria.

    03:42 Extravasation of sweat into your dermis with inflammation.

    03:47 And often in body folds and areas in contact with the occlusion.


    About the Lecture

    The lecture Folliculitis by Carlo Raj, MD is from the course Infectious Skin Diseases.


    Included Quiz Questions

    1. Bacterial
    2. Viral
    3. Fungal
    4. Autoimmune
    5. No organism related
    1. Start on antibiotics covering S.aureus
    2. Antibiotics covering Pseudomonas
    3. Packing and marsupialization
    4. Incision and drainage
    5. Culture the pustules and wait for results
    1. Prurigo nodules
    2. Miliaria
    3. Acne
    4. Folliculitis
    5. Cellulitis

    Author of lecture Folliculitis

     Carlo Raj, MD

    Carlo Raj, MD


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