Scalp Folliculitis Research Articles

Comorbidities and Treatment Options for Acne Keloidalis Nuchae

Acne keloidalis nuchae (AKN) is a condition that involves chronic inflammation of the hair follicles on the occipital scalp and posterior neck that often progresses to keloid-like plaques. AKN has most commonly been reported to affect postpubertal males of African descent. The cause of AKN has not been definitively described; however, it is likely an inflammatory response to trauma or infection of the scalp. AKN is associated with chronic scalp folliculitis, hidradenitis suppurativa, folliculitis decalvans, acne mechanica, keratosis follicularis spinulosa decalvans, cutis verticis gyrata, metabolic syndrome, acanthosis nigricans, and hypothyroidism. Treatment for AKN begins with topicals, antibiotics, and intralesional steroid injections. Refractory cases are treated with laser and surgery. Isotretinoin, cryotherapy, phototherapy, electrosection, and radiotherapy have also been effective in treating AKN but are less commonly used. In this review, we describe the existing understanding of AKN with a focus on comorbid conditions and available treatment options.

Inaugural Scalp Metastasis of Pulmonary Squamous Cell Carcinoma: A Rare Case Report and Literature Review

Distant cutaneous metastasis of primary lung squamous cell carcinoma is an exceedingly rare event, with scalp metastasis as the initial clinical presentation even rarer. Scalp skin metastases are prone to be misdiagnosed as other scalp disorders, yet their appearance signifies the deterioration and poor prognosis of lung cancer. This case report documents a female patient presenting initially with scalp folliculitis in dermatology, who was subsequently diagnosed with malignant lung tumor through radiological imaging and referred to Department of Thoracic Surgery. Pathological examination of the excised lesion from the scalp revealed distant metastasis of lung cancer. A review of similar cases reported in literature was conducted. This article aims to enhance understanding and awareness of skin metastasis in lung cancer, to emphasize the importance of this condition, and to improve early recognition and precise diagnosis. It is crucial to prevent clinical misdiagnosis and ensure appropriate treatment, finally leading to improve the prognosis of the patients. .

Bullous reaction to cupping therapy

A 54-year-old African American male presented with pruritic, circular, purpuric lesions, following a cupping service 4 days prior. The patient had a history of eczematoid dermatitis, scalp folliculitis and xerosis cutis. Upon examination, 13 lesions were identified with a diameter of 6 cm each. These lesions contained both bullae and vesicles concentrated along the perimeter of the lesions. All lesions showed varying degrees of ecchymosis. The diagnosis of iatrogenic-induced bullae was made and topical zinc-oxide astringent ointment was prescribed for BID use. Follow up examination revealed significant healing with all bullae flattened. The patient reported no pain but had minor complaints of residual pruritic hyperpigmentation. He was prescribed Triamcinolone Acetonide 0.005% ointment BID for these areas with good recovery.

28518 Differential diagnosis of scalp folliculitis and acne vulgaris affecting the scalp using polarized light dermatoscopy

Introduction: Acne vulgaris may rarely affect the scalp. Differential diagnosis between scalp folliculitis and acne vulgaris affecting the scalp is important because of the different management strategies of the two conditions. Polarized light dermatoscopic examination, in addition to clinical examination and patient history may be used to identify subtle changes, such as the presence of comedos typical for acne and which are not a feature of scalp folliculitis.

Chronic nonscarring scalp folliculitis: Retrospective case series study of 34 cases

Chronic nonscarring scalp folliculitis: Retrospective case series study of 34 cases

Acne keloidalis nuchae: risk factors and associated disorders - a retrospective study.

Acne keloidalis nuchae (AKN) is a chronic scarring folliculitis which usually occurs in young adult males of African descent. Studies have suggested that AKN may be associated with other dermatologic conditions and even general medical disorders. The aim of this study was to identify cutaneous and extracutaneous associated disorders and to examine risk factors in our population for developing AKN. The study was a retrospective, descriptive, and analytical study conducted at the Dermatology Outpatient department of the University Hospital of the West Indies. Data were obtained from the medical records of patients diagnosed over a 15-year period (2000-2014). There were 1031 new patients during the study period. Of these, 43 (4.2%) had AKN. The male to female ratio for AKN was approximately 7:1. Pseudofolliculitis barbae was associated with keloidal plaques on the scalp (OR = 6.22, P = 0.036). Also, when the duration of AKN was divided into two groups (0-5 years and greater than 5 years), there was an association between keloidal plaques and duration of greater than 5 years (OR = 7.5, P = 0.032). However, when the odds ratio was adjusted, only the duration of AKN remained significantly associated with keloidal plaques (OR = 7.08, P = 0.047). Chronic scalp folliculitis (P = 0.001) and the presence of any component disease of the metabolic syndrome (OR = 14, P = 0.008) and specifically hypertension (OR = 6.75, P = 0.036) were significantly associated with the extension of the lesions beyond the nape and occipital scalp. Pseudofolliculitis barbae, chronic scalp folliculitis, and aspects of the metabolic syndrome may be associated with acne keloidalis nuchae.

광역동요법을 병행한 두피 모낭염 한방치험 1례

Objectives : The purpose of this study is to report the effect of combination therapy of photodynamic therapy (PDT) with Korean medical treatments on scalp folliculitis, which has been difficult to treat by using antibiotic.Methods : A 32-year-old male patient with scalp folliculitis, received treatment with acupuncture, herbal medicine and PDT and so on. We used Visual Anologue Scale(VAS) to evaluate recovery from erythema, pruritus and pain. Also, the photos of patient were taken before and after treatments.Results : Visible symptoms to the naked eye and VAS scale effectively decreased after Korean medicine treatments for two months.Conclusions : It is expected that Korean medical treatments and PDT were thouht to be effective for scalp folliculitis.

Potential influence of bacterial biofilm formation on scalp folliculitis therapy

Potential influence of bacterial biofilm formation on scalp folliculitis therapy

Suppressive therapy using azithromycin in 2 rare cases of recurrent staphylococcal infections

Recurrent staphylococcal skin and soft tissue infections may recur despite decontamination and multiple courses of antibiotic therapy and may dramatically impair the patient's quality of life. We report successful use of long-term azithromycin prophylaxis in a recurrent laryngitis and a scalp folliculitis due to methicillin-susceptible Staphylococcus aureus.

Chronic Scalp Folliculitis versus Acne Vulgaris (Observational Case Series Study)

Background: Acne vulgaris is a chronic inflammatory disease of pilosebeceous units, of adolescents, and more likely to be associated with chronic scalp folliculitis Objective: To assess the association between chronic scalp folliculitis with acne vulgaris and vise versa in Iraqi patients Patients and methods: This observational case series study was done in Department of Dermatology- Baghdad Teaching Hospital from March 2009-July 2010. Two groups of patients were included: the first group (39) patients with chronic scalp folliculitis. Full history and examination were done for each patient. Also, careful history was taken from each patient recording the association with acne vulgaris. The second group consisted of 282 patients with acne vulgaris. Detailed history and examination of all patients were performed concerning the association with chronic scalp folliculitis. Results: In the first group, the age of patients ranged from 16-33 years with a mean ± SD of 24.1 ± 5.4 years. Acne vulgaris was found in 28 (71.7%) patients. In the second group, the age of patients ranged from 13-32 with a mean ± SD of 21.5 ± 4.8 years. Chronic folliculitis of the scalp was found in 24 (8.5%) patients. Conclusions: Chronic folliculitis of the scalp and acne vulgaris was closely associated and might share the same etiopathogeneic factors.

Folliculitis et perifolliculitis capitis abscedens et suffodiens controlled with a combination therapy: Systemic antibiosis (Metronidazole Plus Clindamycin), dermatosurgical approach, and high-dose isotretinoin

Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as ‘acne necrotica miliaris’ or ‘Proprionibacterium’ folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating painful fistule-forming conglomerates of abscesses in the region of the occipital scalp. The cause of scalp folliculitis is not well understood. It is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include: bacteria (especially Propionibacterium acnes, but in severe cases, also Staphylococcus aureus), Yeasts (Malassezia species) and mites (Demodex folliculorum). The initial histopathologic finding is an exclusively neutrophilic infiltration followed by a granulomatous infiltrate. The treatment of the disease is usually difficult and often disappointing. Successful treatment with isotretinoin 1 mg/kg body mass could be achieved only after regular systematic administration in the course of 3–4 months. Here we describe a patient with eruptive purulent form of the disease, which has been controlled with combination therapy: systemic antibiosis with metronidazole and clindamycin, dermatosurgical removal of single nodular formations, and isotretinoin 1 mg/kg body mass for 3–5 months.

Inflammatory Tinea Capitis: Non-healing Plaque on the Occiput of a 4-year-old Child

Inflammatory tinea capitis is an uncommon condition in Singapore. In this case report we present a patient whom we managed for this condition. A 4-year-old girl presented to us with multiple pustules over the occipital scalp for 6 weeks, associated with painful cervical lymphadenopathy. Her condition did not respond to topical and oral antibiotics. The patient was diagnosed with kerion (inflammatory tinea capitis) and fungal culture of plucked hairs from the kerion grew Microsporum species of dermatophyte. She was treated with a course of oral griseofulvin and topical selenium sulfide shampoo. She was advised to bring her pet cats to the veterinarian for screening, as well as not to share combs with her other siblings. Her condition improved with the antifungal therapy, and there was no residual alopecia. Physicians should consider tinea capitis when they encounter a patient with scalp folliculitis or scarring alopecia in the appropriate clinical context.

Photodynamic therapy with methyl aminolevulinate for resistant scalp folliculitis secondary to Demodex infestation

Photodynamic therapy with methyl aminolevulinate for resistant scalp folliculitis secondary to <i>Demodex</i> infestation

Cutaneous Adverse Events in Renal Transplant Recipients Receiving Sirolimus-Based Therapy1

Sirolimus is an immunosuppressive drug recently developed for organ transplantation. Its mechanism of action, independent of calcineurin, is different from that of cyclosporine and tacrolimus, two calcineurin inhibitors (CIs). Because the toxicity of CIs is partly the result of calcineurin blockade, sirolimus exhibits a different toxicity profile. In this study, we evaluated the profile, frequency, and severity of cutaneous adverse events in renal transplant recipients receiving sirolimus-based therapy. A systematic and in-depth evaluation of skin, mucous membranes, nails, and hair was performed in 80 renal transplant recipients receiving sirolimus-based therapy. The mean duration of the graft was 6 years and of sirolimus treatment was 18 months. Mycophenolate mofetil and steroids were combined with sirolimus for 74 patients. Sirolimus was used as first immunosuppressive therapy for 36 patients, and 44 patients were switched from CIs to sirolimus. Seventy-nine patients (99%) experienced cutaneous adverse events. Twenty patients (25%) demonstrated serious adverse events, and six patients (7%) stopped sirolimus during the 3 months after the study because of cutaneous events. The most frequent of these were pilosebaceous apparatus involvement, including acne-like eruptions (46%), scalp folliculitis (26%), and hidradenitis suppurativa (12%); edematous complaints, including chronic edemas (55%) and angioedema (15%); mucous membrane disorders, including aphthous ulceration (60%), epistaxis (60%), chronic gingivitis (20%), and chronic fissure of the lips (11%); and last, nail disorders including chronic onychopathy (74%) and periungual infections (16%). Skin disorders are frequent in renal transplant recipients receiving sirolimus as a long-term therapy. Despite the usually mild nature of skin events, they are often the reason for stopping sirolimus.

Outcome of Scalp Donor Sites in 450 Consecutive Pediatric Burn Patients

The scalp is a useful and reliable donor site in pediatric burn patients that can be multiply harvested with minimal morbidity. Healing complications, however, may include alopecia and chronic folliculitis. To investigate scalp donor-site morbidity, a consecutive series of 2478 pediatric burn patients treated over a 10-year period were reviewed. A total of 450 of these patients had scalp donor sites for wound closure. Percent of total body surface area burned was 46+/-23 percent (mean+/-standard deviation), and the mean number of sequential scalp donor-site harvests was 2.2+/-2 (range, 1 to 10) with mean intervals between harvesting of 6+/-0.6 days. Ten patients (2.2 percent) had related complications. Eight patients developed scalp folliculitis, with Staphylococcus sp as the predominant organism (80 percent). Two patients were managed successfully with wound care alone; the other six patients required surgical debridement and split-thickness skin grafting to achieve wound healing. These eight patients developed varying degrees of alopecia. Two patients developed alopecia without previous folliculitis. Six patients required reconstructive surgery, which consisted of primary closure (3), staged excision (1), and tissue expansion (2). A number of variables were examined to determine any differences in the group that had complications compared with the group of patients that did not. No differences in age, sex, race, burn type, burn size, septic episodes, time to wound closure, or number of times the scalp was harvested were detected. Healed second-degree burns to the scalp that were subsequently taken as donor sites seemed to be a risk factor (p < 0.05) for folliculitis and alopecia. Our study confirms that scalp donor sites are reliable with low morbidity. Complications include alopecia and chronic folliculitis that can be avoided by meticulous technique and avoidance of previously burned areas.

Outcome of scalp donor sites in 450 consecutive pediatric burn patients.

The scalp is a useful and reliable donor site in pediatric burn patients that can be multiply harvested with minimal morbidity. Healing complications, however, may include alopecia and chronic folliculitis. To investigate scalp donor-site morbidity, a consecutive series of 2478 pediatric burn patients treated over a 10-year period were reviewed. A total of 450 of these patients had scalp donor sites for wound closure. Percent of total body surface area burned was 46+/-23 percent (mean+/-standard deviation), and the mean number of sequential scalp donor-site harvests was 2.2+/-2 (range, 1 to 10) with mean intervals between harvesting of 6+/-0.6 days. Ten patients (2.2 percent) had related complications. Eight patients developed scalp folliculitis, with Staphylococcus sp as the predominant organism (80 percent). Two patients were managed successfully with wound care alone; the other six patients required surgical debridement and split-thickness skin grafting to achieve wound healing. These eight patients developed varying degrees of alopecia. Two patients developed alopecia without previous folliculitis. Six patients required reconstructive surgery, which consisted of primary closure (3), staged excision (1), and tissue expansion (2). A number of variables were examined to determine any differences in the group that had complications compared with the group of patients that did not. No differences in age, sex, race, burn type, burn size, septic episodes, time to wound closure, or number of times the scalp was harvested were detected. Healed second-degree burns to the scalp that were subsequently taken as donor sites seemed to be a risk factor (p < 0.05) for folliculitis and alopecia. Our study confirms that scalp donor sites are reliable with low morbidity. Complications include alopecia and chronic folliculitis that can be avoided by meticulous technique and avoidance of previously burned areas.

Outcome of Scalp Donor Sites in 450 Consecutive Pediatric Burn Patients

The scalp is a useful and reliable donor site in pediatric burn patients that can be multiply harvested with minimal morbidity. Healing complications, however, may include alopecia and chronic folliculitis. To investigate scalp donor-site morbidity, a consecutive series of 2478 pediatric burn patients treated over a 10-year period were reviewed. A total of 450 of these patients had scalp donor sites for wound closure. Percent of total body surface area burned was 46 ± 23 percent (mean ± standard deviation), and the mean number of sequential scalp donor-site harvests was 2.2 ± 2 (range, 1 to 10) with mean intervals between harvesting of 6 ± 0.6 days. Ten patients (2.2 percent) had related complications. Eight patients developed scalp folliculitis, with Staphylococcus sp as the predominant organism (80 percent). Two patients were managed successfully with wound care alone; the other six patients required surgical debridement and split-thickness skin grafting to achieve wound healing. These eight patients developed varying degrees of alopecia. Two patients developed alopecia without previous folliculitis. Six patients required reconstructive surgery, which consisted of primary closure (3), staged excision (1), and tissue expansion (2). A number of variables were examined to determine any differences in the group that had complications compared with the group of patients that did not. No differences in age, sex, race, burn type, burn size, septic episodes, time to wound closure, or number of times the scalp was harvested were detected. Healed second-degree burns to the scalp that were subsequently taken as donor sites seemed to be a risk factor (p < 0.05) for folliculitis and alopecia. Out study confirms that scalp donor sites are reliable with low morbidity. Complications include alopecia and chronic folliculitis that can be avoided by meticulous technique and avoidance of previously burned areas.

Keratosis Pilaris and Scarring Alopecia

REPORT OF A CASE A 28-year-old white man was referred for evaluation of scarring alopecia of his scalp and possible folliculitis of his limbs and trunk. These problems had been present for more than 10 years. He received no benefit from prior use of various topical therapies. Seven years before presentation, he had been treated for a few weeks with oral vitamin A (50 000 U twice daily). Family history was significant for keratosis pilaris in his mother, sister, and several nieces and nephews. All family members have straight hair. The findings from the physical examination of his scalp revealed an 8-cm area of scarring alopecia with follicular scaling papules and pustules; the remainder of his scalp hair was excessively curly (Fig 1). On his trunk, arms, and legs were 1- to 2-mm erythematous follicular keratotic papules. Palms and soles showed mild diffuse keratotic thickening. Facial findings were significant for

Development of folliculitis and pyoderma gangrenosum in association with abdominal pain in a patient following treatment with isotretinoin

A 19-year-old man with severe acne developed extensive scalp folliculitis and later superficial pyoderma gangrenosum following treatment with isotretinoin. A cyclical neutropenia was noted and bone marrow findings suggested myelodysplasia. We believe that isotretinoin was implicated in the development of overt symptoms in this patient whose haematological condition was previously asymptomatic.

Repeated Skin Infections as a Manifestation of Lupus Erythematosus

<h3>To the Editor.—Report of a Case.—</h3> A 50-year-old woman was first seen by us in July 1977 with an eight-year history of pyodermas and urticarial-type eruptions with slight fever. On physical examination, she displayed a scalp folliculitis and a furuncle on one finger. Coagulase-positive staphylococci were cultivated from the lesions. Fasting and postprandial blood glucose levels, as well as erythrocyte and leukocyte levels, were normal. The patient's antistaphylolysin titer was elevated (2 IU/mL; normal, ≥ 1 IU/mL). Quantitative IgA and IgE levels were 650 mg/dL (normal, 120 to 140 mg/dL) and 800 μg/mL (normal, 50 to 100 μg/mL), respectively. Complement C3 and C4 levels were normal. The E rosette count of 30% (normal, 50% to 70%) and the stimulating indexes for phytohemagglutinin (17 cpm; normal, &gt; 80 cpm) and concanavalin A (6 cpm; normal, &gt; 20 cpm) indicated defective cell-mediated immunity. There was a slight decrease in neutrophil chemotaxis and