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Pityrosporum Folliculitis - Symptoms and Treatment

Pityrosporum folliculitis is a condition where the yeast, pityrosporum, gets down into the hair follicles and multiplies, setting up an itchy, acne-like eruption. Most infections are superficial, and although they may itch, they're seldom painful. It is especially common in the cape distribution (upper chest, upper back) and the pimples are pinhead sized and uniform. Pityrosporum folliculitis sometimes turns out to be the reason a case of acne isn't getting better after being on antibiotics for months. The yeast overgrowth may be encouraged by external factors and/or by reduced resistance on the part of the host. Malassezia folliculitis is due to proliferation of a yeast, called malassezia , within the hair follicles. Malassezia can be found on the skin of most adults; it only causes folliculitis when conditions are right. It presents as an itchy, acne-like eruption and most often affects the trunk. Malassezia can also cause pityriasis versicolor and seborrhoeic dermatitis. Folliculitis usually appears as small, white-headed pimples around one or more hair follicles the tiny pockets from which each hair grows. Superficial folliculitis often clears by itself in a few days, but deep or recurring folliculitis may need medical treatment. With common names like hot tub folliculitis and barber's itch, folliculitis may sound more like a bad joke than a skin disorder. Pityrosporum folliculitis is a clinically distinct condition most often seen in young adult males. In recent years, oral antifungal therapy has gained growing acceptance for the treatment of pityriasis versicolor, but there is paucity of controlled trials of oral antifungals in pityrosporum folliculitis.

Pityrosporum yeast can hydrolyze triglycerides into free fatty acids, and it has been postulated that an overgrowth of the yeast in a follicle produces folliculitis by a combination of fatty acid production and blockage of follicular ostium by scale. A chronic, superficial, fungal infection, tinea versicolor may produce a multicolored rash, commonly on the upper trunk. They are localized most frequently to the upper portion of the back, shoulders and chest. The lesions consist mostly of small dome shaped follicular papules and scarce intermingling small pustules with minute inflammatory reactions. The actual type of inflammatory cells can vary and may be dependent on the etiology of the folliculitis and/or the stage at which the biopsy specimen was obtained. Folliculitis is defined histologically as the presence of inflammatory cells within the wall and lumen of the hair follicle, creating a follicular based pustule. The inflammation can be either limited to the superficial aspect of the follicle with primary involvement of the infundibulum or the inflammation can affect both the superficial and deep aspects. In lay man language, Folliculitis is the condition which results in hair loss. Perifollicuties while the Folliculitis means the inflammation of the hair follicle itself, the peri-folliculitis is usually seen attacking the surrounding area of the hair. Actually Folliculitis is a disease that causes acute inflammation of the walls of the lumen of the hair follicle causing it to die and fall.

Causes of Pityrosporum Folliculitis

Common Causes of Pityrosporum Folliculitis :

  • An increase in sebum production, such as that in pregnancy, and high levels of androgens may initiate the development of pityrosporum folliculitis.
  • Application of greasy sunscreens and oily emollients such as coconut oil.
  • Antibiotics can alter normal skin flora, allowing the yeast to proliferate.
  • Pityrosporum folliculitis has more tendency to occur in environments of high heat and humidity.

Symptoms of Pityrosporum Folliculitis

Some Common Symptoms of Pityrosporum Folliculitis :

  • Including large.
  • Painful.
  • Pus-filled pimples.
  • Always formed around a hair follicle.

Treatment of Pityrosporum Folliculitis

Some Common Treatment of Pityrosporum Folliculitis :

  • For recurrent uncomplicated superficial folliculitis, use of antibacterial soaps and good hand washing technique may be all that is needed.
  • Treatment must deal with both the yeast overgrowth and predisposing factors, otherwise the condition will recur. Malassezia folliculitis has a tendency to recur.
  • For recurrent and recalcitrant folliculitis, mupirocin ointment in the nasal vestibule twice a day for 5 days may eliminate the S aureus carrier state.
  • For refractory or deep lesions that have a suspected infectious etiology, empiric treatment with topical and/or oral antibiotics that cover gram-positive organisms may be of benefit.
  • Methicillin-resistant organisms are becoming more common, and treatment may require clindamycin, trimethoprim-sulfamethoxazole, minocycline, or linezolid.








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