Follikulit — the infectious defeat of average and deep departments of a hair follicle leading to its purulent inflammation. Follikulit can have a bacterial, fungal, virus, parasitic etiology. It is shown by emergence in places of growth of hair single or multiple on which center there passes the hair. The opened pustula form sores, their healing at deep defeat of a hair follicle is followed by scarring. Diagnostics of a follikulit is carried out by Dermoscopy, microscopy of dabs and the research separated . Treatment is performed by solutions of aniline dyes, antiseptics, local and system use of etiotropny medicines: antibiotics, antimycotics, acyclovir.
Along with gidradenity, sikozy, a streptodermiya and streptococcal impetigo follikulit treats purulent diseases of skin (piodermiya) which prevalence among the population reaches 40%. In tropical countries incidence follikulity above as the climate promotes development of an infection. The high incidence is noted also among socially unsuccessful segments of the population living in insanitary conditions.
In some cases follikulit begins with an ostiofollikulit — a superficial inflammation of a hair follicle, the mouth only capturing him. Further spread of an infection to depth of a follicle leads to transformation of an ostiofollikulit in follikulit.
Causes of a follikulit
Infectious agents, defiant follikulit, in most cases are a bacterium, mainly staphylococcus. Meets the follikulita caused by pseudo-monads, the causative agent of syphilis, gonorrhea, etc. bacteria. Fungal damages of skin (mushrooms of the sort Candida and Pityrosporum, dermatophytes), viruses (a contagious mollusk, the simple and surrounding herpes) and parasites can be a cause of illness (for example, the tick causing ). According to an etiology of infectious process the clinical dermatology allocates bacterial, fungal, virus, syphilitic and parasitic follikulita.
Penetration of an infection in a hair follicle happens through small injuries of skin: scratches, ekskoriation, grazes, moknutiya. The probability of infection is increased at the people suffering from the itching dermatosis (eczema, a pochesukha, atopic dermatitis, allergic contact dermatitis, dermatitis of Dyuringa) and in this regard constantly combing the skin, and also at the persons suffering from the increased perspiration.
Weakening of protective forces of an organism and barrier function of skin facilitates penetration of an infection in a hair follicle and development of a follikulit. Therefore carry diabetes and various immunodeficiencies to the factors promoting infection: The HIV infection, states connected with a long disease or immunosupressorny therapy. Prolonged skin use of glucocorticosteroids leads to decrease in local immunity and also can favor to development of a follikulit. Decrease in protective properties of skin happens also at long impact on it of various chemicals: kerosene, lubricants, technical oils. With these emergence of a professional follikulit at mechanics, tractor operators, oil industry workers is connected.
Symptoms of a follikulit
Follikulit begins with reddening and infiltration in the field of a hair follicle. Then the conic pustula penetrated by a pushkovy hair with purulent contents in the center is formed. After its opening and release from pus the small sore covered with a bloody and purulent crust is formed. At defeat of all follicle after a crust otkhozhdeniye on skin there is a hyperpegmentation or a hem. More superficial follikulita can be resolved, without leaving behind any traces. Development and permissions of an inflammation of one follicle takes up to 1 week.
Most often follikulit has multiple character. Its elements usually settle down on hairy sites of skin: on a face, the head, in axillary hollows, in a groin, standing (generally at women, depiliruyushchy shins and hips). Rashes are followed by morbidity and an itch of various degree of expressiveness. In the absence of correct treatment and hygienic actions follikulit is complicated by development of a furuncle, anthrax, a gidradenit, abscess, phlegmon.
Staphylococcal follikulit usually is localized in areas of growth of shchetinisty hair, most often it is a chin and skin around a mouth. Occurs generally at men who shave a beard and moustaches. Can be complicated by development of a sikoz.
Psevdomonadny follikulit carries the name "follikulit a hot bathtub" as in most cases arises after acceptance of a hot bathtub at an insufficient hlorirovannost of water in the people. Often develops at the patients undergoing antibiotic treatment concerning an acne disease. It is clinically expressed in sharp strengthening of acne rash, emergence on the face and the top part of a trunk penetrated by a hair .
Gonorrheal follikulit is a complication at uncured and is long the proceeding gonorrhea. Favourite localization — crotch skin at women and extreme flesh at men.
Kandidozny follikulit is observed generally when imposing okklyuzionny bandages, at bed patients and at long fever.
Dermatofitny follikulit is characterized by the beginning of inflammatory changes from a superficial horn layer of epidermis. Then process gradually takes a follicle and a hair core. Can arise against the background of a trichophytia and a favus, leaving behind cicatricial changes.
Herpetic follikulit differs in formation of vesicles in mouths of hair follicles. It is observed on skin of a chin and a nasolabial triangle, is more often at men.
Follikulit, caused demodekozy, it is shown by reddening of skin with education in mouths of hair follicles characteristic around which the otrubevidny peeling is noted.
Bokhart's impetigo — one more option of a follikulit. It develops at maceration of skin. Most often meets at a gipergidroza or owing to therapy by the warming compresses.
Diagnostics of a follikulit
On follikulit diagnostic actions at suspicion are directed to a research of a condition of a hair follicle; definition of the activator which caused an inflammation; exception of a specific etiology of a disease (syphilis, gonorrhea); detection of the associated diseases favoring to development of infectious process.
On consultation of the dermatologist inspection of rashes and Dermoscopy which helps the doctor to determine depth of defeat of a follicle is performed. The fence of the separated for microscopy and bacteriological crops, a research on mushrooms and a pale treponema is made. For an exception of gonorrhea and syphilis PTsR-diagnostics and the RPR test is carried out. If necessary to the patient the immunogramma, blood test is appointed to sugar and other inspections.
During diagnostics follikulit differentiate from an ostiofollikulit, a frinoderma, Hoffman's perifollikulit, a furunkulez, uzlovatokistozny eels, streptococcal impetigo, pink depriving of Zhiber, a medicamentous toksikodermiya.
Treatment of a follikulit
Therapy of a follikulit has to correspond to its etiology. At bacterial genesis of a follikulit appoint ointments with antibiotics, at fungal — antifungal medicines, carry out treatment of a herpetic follikulit by an acyclovir.
At the beginning of a disease of rather local therapy and processing of the centers of defeat of solutions of aniline dyes (, brilliant green, methylene blue). On healthy sites of skin make their processing for the prevention of spread of an infection salicylic or boric alcohol. Ural federal district is in addition applied.
Cases of a heavy recidivous current of a follikulit demand system therapy. At a staphylococcal follikulit inside appoint cefalexin, , erythromycin. Treatment of severe forms of a psevdomonadny follikulit is carried out by ciprofloxacin. At a kandidozny follikulit apply and , at dermatofitny — . At the same time carry out therapy of the accompanying diabetes or immunodeficiency.