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Folliculitis: Part II

Folliculitis: Part II

Fungal folliculitis. This infection, which preferentially affects young women, appears as asymptomatic, slightly pruritic, follicular papules and pustules on upper back and chest, upper arms, and neck. The eruption may be acneiform and monomorphous. Treatment choices include antifungal body washes, sulfur-based antibiotic washes, oral antifungal antibiotics, and topical antifungal cream.

Eosinophilic pustular folliculitis. This type of folliculitis appears as erythematous, painful, intensely pruritic papulopustules. Patients have repeated episodes on the face, back, and upper extremities that usually last 7 to 10 days and recur every 3 to 4 weeks. Eosinophilic pustular folliculitis is classically considered idiopathic. However, variants have occurred in patients with systemic diseases, such as AIDS and chronic lymphocytic leukemia. The condition is about 5 times more common in men than in women. Medications associated with this type of folliculitis include minocycline, carbamazepine, allopurinol, indeloxazine hydrochloride, and possibly cyclophosphamide. Treatment generally consists of topical therapies, including corticosteroids, UVB phototherapy, psoralen-UVA, and indomethacin.

Steroid-induced folliculitis. This type of folliculitis is asymptomatic and appears as acneiform, usually monomorphous lesions. Outbreaks, which are abrupt, are attributable to high doses of corticosteroids. Discontinuation of the corticosteroids results in a slow resolution of the eruption.

On the following pages, you will find images of all 3 types.

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