Clinical efficacy of artificially carbonated water bathing on superficial bacterial folliculitis in dogs.

BACKGROUND: Bathing with artificially carbonated water is reported to be a valuable therapeutic option for various human skin disorders. OBJECTIVE: To evaluate the clinical efficacy of artificially carbonated water bathing on superficial bacterial folliculitis (SBF) caused by Staphylococcus pseudintermedius (SP) in dogs. ANIMALS: Nineteen dogs with SBF from whom SP was isolated from skin lesions were enrolled. METHODS AND MATERIALS: Dogs with SBF were allocated randomly to either the artificially carbonated water bathing group or the control group bathed with tap water. The dogs were bathed with the designated water type on day (D)0, D7 and D14. Clinical scores and skin surface pH were evaluated on D0 and D21. Colony forming unit (cfu) assays were performed in vitro to investigate whether the artificially carbonated water affected growth of clinical SP isolates. RESULTS: The mean rate of improvement in the clinical scores was significantly higher in the carbonated water group than in the control group. Dogs bathed with carbonated water exhibited significant decreases in their skin surface pH after bathing; dogs bathed with tap water did not. No dogs experienced significant adverse events. The cfus of SP incubated in vitro with artificially carbonated water did not significantly differ from those incubated with tap water. CONCLUSION: Bathing with artificially carbonated water might be an effective and safe adjunctive therapy for canine SP-induced SBF.

Folliculitis decalvans-like pustular plaques on the limbs sparing the scalp.

Folliculitis decalvans is a neutrophilic cicatricial alopecia characterised by progressive pustular folliculitis. Folliculitis decalvans is seen as a condition usually limited exclusively to the scalp and rarely affects the limbs. We present a case of a 63-year-old man with a 3-year history of progressive pustular folliculitis with inflammatory patches and central scarring alopecia on both forearms and a circumscribed patch on his right lower leg. His presentation, clinical course and isolation of Staphylococcus aureus together with the histopathological findings all supported a folliculitis decalvans-like pustular folliculitis limited to the limbs. Biopsies revealed follicular pustules, gross interfollicular fibrosis with plasma cells and concentric perifollicular fibrosis with lymphocytes, all features seen with folliculitis decalvans. The positive response to antibiotics combined with topical corticosteroids mirrored the response seen with scalp folliculitis decalvans. In contrast to the previously reported cases, the patient had no evidence of folliculitis decalvans on the scalp.

Resolution of folliculitis decalvans with medical honey.

Folliculitis decalvans is a rare scarring alopecia that presents with indurated, tender pustules and papules on the vertex and occipital scalp. Although systemic antibiotics with activity against Staphylococcus species provide some symptomatic improvement, folliculitis decalvans remains a significant management challenge and often exhibits a relapsing-and-remitting course. In this report, we posit the potential utility of medical grade honey as a safe and cost-effective adjuvant therapy in the treatment of folliculitis decalvans. We describe a patient with painful, boggy scalp pustules who achieved clearance of his scalp lesions with the addition of Manuka honey. To our knowledge, this report is the first to demonstrate the clinical use of honey in the management of folliculitis decalvans and may lend support to the role of Staphylococcus in the pathogenesis of this disease.

Efficacy and Tolerability of a Twice-Daily, Three-Step Men's Skincare Regimen in Improving Overall Skin Quality and Reducing Shave-Related Irritation.

More men are beginning to take advantage of opportunities to improve the health and appearance of their skin; however, the effectiveness of men's skincare regimens has not been well studied. The authors investigated the efficacy and tolerance of a twice-daily, three-step men's skincare regimen in improving skin appearance and reducing shave-related issues. Twenty-nine men who used a wet-shaving method completed a specific, three-step, twice-daily facial regimen-a Shave Cleanser, a Post-Shave Treatment, and Day Protection-in place of their usual routine for 4 weeks. This skincare regimen produced significant improvements in tactile smoothness, clarity, radiance, and pore size at weeks 2 and 4 and in fine lines, razor burn, and photodamage at week 4 (P<.05). Significant improvements were seen in the appearance of nicks/cuts and folliculitis of the face and neck after weeks 2 and 4 (P<.05). Mean change in the moisture content of the stratum corneum was significant at week 4 (P<.05). The majority of men provided positive self-assessments and indicated an interest in continuing this regimen.

Primary cicatricial alopecia: Other lymphocytic primary cicatricial alopecias and neutrophilic and mixed primary cicatricial alopecias.

Primary cicatricial alopecias can be frustrating for both patients and physicians. Proper diagnosis guides more successful management of these challenging conditions. Part II will cover the remaining lymphocytic primary cicatricial alopecias, which include pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. It will also discuss the neutrophilic and mixed primary cicatricial alopecias, namely folliculitis decalvans, dissecting cellulitis, folliculitis keloidalis, folliculitis (acne) necrotica, and erosive pustular dermatosis.

Pseudofolliculitis cutis: a vexing disorder of hair growth.

Pseudofolliculitis cutis (PFC) is a troublesome and potentially disfiguring cutaneous disorder characterized by a chronic inflammatory response to ingrown hair. Despite a simple precipitating stimulus, ingrown hair, PFC has a relatively complex aetiology that can involve grooming practices, hair type, genetic predisposition and medication history. Curly hair and a single-nucleotide substitution in the gene encoding keratin 75 may act synergistically to increase the risk for developing this condition. PFC is most common in men of sub-Saharan African lineage, but can occur in men and women of many different ethnicities, particularly in body areas where hair is coarse, abundant and subject to traumatic removal. Treatment options for PFC can be divided into three main categories: modifying hair removal practices, managing symptoms with medication, and long-term hair removal with laser therapy. Laser hair removal is safe and effective in most skin types and has become increasingly popular among dermatologists in the treatment of PFC. However, it is imperative that the laser system and parameters are specifically matched to the patient's skin type.

Management of the Sequelae of Skin Grafting: Pruritis, Folliculitis, Pigmentation Changes, and More.

Scars commonly give rise to unpredictable, potentially irritating, cutaneous complications including pruritis, folliculitis, and pigment changes. These problems can be self-limiting and are prevalent in many burn cases, although their expression varies among individuals. A better understanding of the presentation, risk factors, and pathophysiology of these long-term sequelae allows for more comprehensive care of burn survivors.

Infectious folliculitis and dermatophytosis.

Bacterial, dermatophilosis, and superficial ringworm infections are common skin diseases noted in equine dermatology. The ability to recognize and accurately diagnose the skin condition is key to selecting an appropriate and successful treatment regimen. Addressing underlying etiology, environmental management, and infection control play a crucial role in preventing relapse of clinical signs.

The role of inflammation and immunity in the pathogenesis of androgenetic alopecia.

BACKGROUND: Female pattern hair loss affects many women; its pathogenetic basis has been held to be similar to men with common baldness. OBJECTIVE: The objective of this study was to determine the role of immunity and inflammation in androgenetic alopecia in women and modulate therapy according to inflammatory and immunoreactant profiles. MATERIALS AND METHODS: 52 women with androgenetic alopecia (AA) underwent scalp biopsies for routine light microscopic assessment and direct immunofluroescent studies. In 18 patients, serologic assessment for antibodies to androgen receptor, estrogen receptor and cytokeratin 15 was conducted. RESULTS: A lymphocytic folliculitis targeting the bulge epithelium was observed in many cases. Thirty-three of 52 female patients had significant deposits of IgM within the epidermal basement membrane zone typically accompanied by components of complement activation. The severity of changes light microscopically were more apparent in the positive immunoreactant group. Biopsies from men with androgenetic alopecia showed a similar pattern of inflammation and immunoreactant deposition. Serologic assessment for antibodies to androgen receptor, estrogen receptor or cytokeratin 15 were negative. Combined modality therapy with minocycline and topical steroids along with red light produced consistent good results in the positive immunoreactant group compared to the negative immunoreactant group. CONCLUSION: A lymphocytic microfolliculitis targeting the bulge epithelium along with deposits of epithelial basement membrane zone immunoreactants are frequent findings in androgenetic alopecia and could point toward an immunologically driven trigger. Cases showing a positive immunoreactant profile respond well to combined modality therapy compared to those with a negative result.

[Pseudofolliculitis and related disorders in skin of color]. / Pseudofolliculites et affections apparentées chez les sujets à peau noire.

The unique structure of the hair in Black people is responsible for a few specific follicular disorders. Pseudofolliculitis of the beard similar to pili incarnati as well as, the so-called keloidal acne and the follicular degeneration syndrome are frequent clinical entities in ethnic dermatology.

Recipient area folliculitis after follicular-unit transplantation: characterization of clinical features and analysis of associated factors.

BACKGROUND: Postoperative recipient-area folliculitis may be a cause of less or delayed growth of transplanted hair and an obvious cause of distress to the patient. No study has been done to elaborate on its clinical features and assess possible factors that may correlate with its occurrence. OBJECTIVE: To study the clinical features and possible factors that may be associated with the development of recipient-area folliculitis after follicular-unit transplantation (FUT). METHODS: Retrospective analysis of 27 patients who developed folliculitis after FUT and 28 patients without such complication. RESULTS: Lesion onset ranged from 2 days to 6 months after FUT (mean 1.44 months). Lesions were mostly pustules that resolved without sequela. Statistical analysis showed that, in terms of patient characteristics (e.g., hair features, scalp condition) and the number of grafts transplanted, there was no statistically significant difference in assessed parameters between those with and without folliculitis (p<.05). CONCLUSION: Main clinical features of postoperative folliculitis consist mostly of few to moderate self-limited pustules. In this study, regardless of management, lesions healed without scarring and without affecting graft growth. Neither patient characteristics nor number of grafts transplanted was associated with this complication.

Barber Knowledge and Recommendations for Pseudofolliculitis Barbae.

This survey study describes an opportunity for a partnership between barbers and dermatologists to identify, evaluate, and treat pseudofolliculitis barbae in the Black male population.

EGFR inhibitor-associated acneiform folliculitis: assessment and management.

Treatment with epidermal growth factor receptor (EGFR) inhibitors is associated with cutaneous adverse events, including acneiform folliculitis, dry skin, and nail disorders. Acneiform folliculitis is a class effect of EGFR inhibitors that is thought to be a direct result of EGFR blockade in the hair follicle. The folliculitis is typically mild to moderate in severity and reversible without scarring upon treatment completion. Dose modification or treatment discontinuation is rarely necessary, except in severe cases. Standard acne treatments (e.g. benzoyl peroxide, oral or topical antibacterials, retinoic acid) may provide some benefit, based on anecdotal reports. Clinicians should be aware of the possibility of superinfection with Staphylococcus aureus, in some cases involving meticillin-resistant strains, which may require treatment with oral antibacterials. Further study is needed to determine how the presence and severity of acneiform folliculitis are related to clinical outcomes, and which patients taking EGFR inhibitors are more likely to develop this disorder.