Folliculitis
Folliculitis is an inflammation of the hair follicle that often results from trauma or infection. Folliculitis can occur anywhere on the body where there are hair follicles. They are often red or white papules or pustules that can burst and drain. Most ca
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Folliculitis Amanda Selk and Sara Wood
27.1 Introduction Folliculitis can be defined by inflammation of the superficial area of the hair follicle and pilosebaceous unit within the epidermis [1]. While any region with hair may be affected, areas with friction and perspiration, such as the inguinal and vulvar area, may be particularly bothersome to women [1–3]. Both noninfectious and infectious causes can produce the signs and symptoms of folliculitis as purulence alone does not necessarily denote an infectious etiology. The physical exam generally reveals a classic erythematous pustule associated with a hair follicle often in clusters although progressive and deeper inflammatory nodules or furuncles may be visualized as well [1, 4]. Integral to the identification of the inciting etiology, a thorough history should be conducted and include investigation of risk factors, such as prior skin infections, immunosuppression, and environmental work and home exposures. Lesions that do not or incompletely resolve may be managed in consultation with dermatologic experts who may utilize more advanced diagnostic and treatment modalities.
Folliculitis often occurs when the hair follicle has been damaged. A common cause of trauma to the hair follicle is hair removal practices such as shaving, waxing, etc. [1]. Clothing that is constricting and rubs the skin can also lead to irritation and subsequent inflammation. If the hair follicles are blocked by sweat, they are also more likely to become irritated and inflamed. Some risk factors for developing folliculitis include: • The use of hot tubs, whirlpools, and swimming pools that are inadequately chlorinated. • Using oily products on the skin that can block follicles. • Any cut or microabrasion to the skin. • When “hot tub folliculitis” appears, it is often caused by a Pseudomonas aeruginosa infection [4]. It will appear within a few days after bathing in a hot tub, swimming pool, or whirlpool and often occurs in the distribution of a bathing suit or other areas that were submersed in contaminated water. It usually resolves within 10 days with good hygiene and supportive care. Oral antibiotics are rarely required.
A. Selk (*) Women’s College Hospital, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
27.2 Diagnosis
S. Wood OBGYN Residency Program, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Mercy Hospital St. Louis, St. Louis, MO, USA
Folliculitis is an inflammation of the hair follicle. It can occur anywhere on the body but is common in the groin as well as the buttock. It commonly
© Springer International Publishing AG, part of Springer Nature 2019 J. Bornstein (ed.), Vulvar Disease, https://doi.org/10.1007/978-3-319-61621-6_27
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presents as red or white bumps or pimple-like areas (papules or pustules) in hair-bearing skin (Fig. 27.1). On close examination, a hair can often be seen at the center of the lesion. Patients usually complain of itch or pain in the affected
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