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Essentials of Diagnosis
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General Considerations
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Frequently caused by staphylococcal infections
May be more common in diabetic persons
Gram-negative folliculitis
Klebsiella
Enterobacter
Escherichia coli
Proteus
"Hot tub folliculitis"
Nonbacterial folliculitis
May be caused by friction and oils
Occlusion, perspiration, and rubbing, such as that resulting from tight jeans and other heavy fabrics on the upper legs, may worsen
Eosinophilic folliculitis
Pseudofolliculitis
Caused by ingrowing hairs in the beard area
It may be treated by growing a beard, by using chemical depilatories, or by shaving with a foil-guard razor
Laser hair removal, medically indicated, is dramatically beneficial in patients with pseudofolliculitis, requires limited maintenance, and can be done on patients of any skin color
Demodex folliculitis
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The symptoms range from slight burning and tenderness to intense itching
The lesions consist of pustules of hair follicles
Sycosis
Gram-negative folliculitis
"Hot tub folliculitis"
Characterized by pruritic or tender follicular or pustular lesions occurring within 1–4 days after bathing in a hot tub, whirlpool, or swimming pool
Systemic flu-like symptoms may be present
Rarely, systemic infections may result
Nonbacterial folliculitis
May be caused by friction and oils
Occlusion, perspiration, and chronic rubbing (eg, from tight jeans or other heavy fabrics on the buttocks and thigh) can worsen this type of folliculitis
Corticosteroid therapy-related folliculitis may be seen during topical or systemic corticosteroid therapy—so-called steroid acne
Eosinophilic folliculitis
Consisting of urticarial papules with prominent eosinophilic infiltration
Common in immunocompromised patients, especially those with AIDS
Pseudofolliculitis
Caused by ingrowing hairs in the beard area
In this entity, the papules and pustules are located at the side of and not in follicles
Demodex folliculitis
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Differential Diagnosis
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