Chronic Folliculitis- A Clinicoepidemiological Study

Abstract

BACKGROUND Chronic folliculitis is a chronic infection of the hair follicles predominantly seen on legs. The main features of the disease are follicular pustules, perifolliculitis, cutaneous oedema, crusting, scaling, atrophy, loss of hair and follicular scarring. In spite of treatment, the condition progresses till loss of all hair from the affected area. MATERIALS AND METHODS This is a cross-sectional descriptive study of seventy five patients with chronic folliculitis who attended the Outpatient Department of Dermatology and Venereology, Government Medical College, Kottayam, Kerala. After getting the informed written consent, they were enrolled in the study. Aim of the study is to find out the clinical and demographic profile, aetiology and treatment response. RESULTS Out of the 75 patients studied, 57 (76%) were males and 18 (24%) were females. Maximum age group affected were in the 21-40 years (60%). Out of 75 patients studied, 58.7% were manual labourers. Initial site of involvement was lower limb in 86.7% patients. Involvement of legs seen in all patients in the course of the disease. Oil application, working with wet soil, soap application and rubbing are the common precipitating factors noted in the study. Staphylococci was the commonest aetiological agent seen in 57 (76%) patients. CONCLUSION We conclude that chronic folliculitis is mainly a disease of males affecting mainly to the manual labourers, chronic folliculitis is a disease refractory to treatment.

Clinico-etiological profile and antibiotic sensitivity pattern of chronic folliculitis: a common but less focussed disease of tropics

“…Kunjukunju et al report that 48% had the disease for 1-5 years and few patients had it for >10 years. 19 We noted a shorter duration of disease in women. This could be due to women tending to notice skin conditions earlier due to cosmetic effect.…”

“…9,10,13,[16][17][18] Our patients complained of pustules (68%) and pruritis (18%); surprisingly, only men complained of pain, not women. Pustules (84%), papules (78.7%) and alopecia (64%) apart from scaling, crusting, excoriation and atrophy were the common lesions reported by Kunjukunju et al 19 Lower legs, thighs and forearm are the common affected sites. 16 We too noticed similar distribution with lower limbs being most affected (74.0%), followed by the beard area in men (9, 18%).…”

“…Contrary to the general belief, studies have proved that oil application aggravates the condition. 18,19 Coagulase positive staphylococci are the main causative agents for chronic folliculitis. 10,14,15,17,18,25 Presence of Staphylococci with plenty of pus cells (80%) on grams stain was the common observation.…”

“…5,16,19 Follicular disease is known by various names is a common dermatological condition caused by S. aureus and Streptococcus pyogenus. face and beard area are common among men, must be distinguished from pseudofolliculitis and acne.…”

Clinical profile and demography of patients with chronic folliculitis of leg

“…epidermidis (including mixed growth of Staph. epidermidis and Beta haemolytic streptococci), Beta haemolytic streptococci was seen as mixed isolate in 7% cases [24] . High incidence of coagulase positive Staphylococci in pyoderma was reported by several other workers [25] .…”