Folliculitis

Folliculitis is caused by infection or irritation of individual hair follicles. Patients with folliculitis present with pustules at the bases of hairs, particularly on the scalp, back, legs, and arms (Fig. 33-38). Folliculitis occurs more often in obese, immunocompromised, or diabetic patients. S. aureus is the most common pathogen. A form of folliculitis

Figure 33-37 Cellulitis on foot of child after a break in the skin. (© Richard P. Usatine.)

caused by Pseudomonas, "hot tub folliculitis," occurs when patients use poorly maintained hot tubs. The condition may be self-limited, requiring only the use of antibacterial soap, or may persist and require topical or systemic antibiotic therapy. If a pseudomonal infection is suspected and lesions persist for more than 5 days without treatment, an oral fluoroquinolone (e.g., ciprofloxacin) should be considered.

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