Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/diagnosis , Exanthema , Folliculitis/diagnosis , Pregnancy Trimesters , Pruritus/diagnosis , Pregnant WomenABSTRACT
BACKGROUND: Folliculitis due to Malassezia spp. (MF), caused mainly by Malassezia furfur, is clinically characterized by an acneiform eruption expressing follicular papules and pustules, predominantly on the trunk. Diagnosis of MF requires confirmation of the presence of yeasts in the hair follicle. The treatment of choice is topical or oral with azoles. We report two cases of folliculitis due to Malassezia spp. of atypical distribution in immunosuppressed patients. CASE REPORTS: Case 1. We describe a 14-year-old male patient diagnosed with chondroid osteosarcoma who required surgical treatment and chemotherapy. He was hospitalized for fever and neutropenia, presenting a rash of papulopustular lesions on the upper and lower extremities and neck. Direct examination and biopsy were performed to conclude the diagnosis of disseminated atypical Malassezia spp. folliculitis. Case 2. We describe a 16-year-old male patient diagnosed with synovial sarcoma, treated with surgical resection and chemotherapy. During hospitalization due to fever and neutropenia, he presented with disseminated dermatosis of the head, trunk, and upper extremities, showing multiple follicular papules and pustules with erythematous base; on the trunk, there were few lesions. In the supraciliary region, he showed erythema and furfuraceous desquamation. Direct examination of a follicle showed thick-walled round yeasts compatible with MF. CONCLUSIONS: MF is a frequent entity but of low diagnostic suspicion. Immunosuppressed patients may manifest atypical clinical characteristics in non-seborrheic areas, implying diagnostic difficulty. Biopsy and direct examination are essential to corroborate the etiology in patients with immunosuppression or with a non-classical presentation.
INTRODUCCIÓN: La foliculitis por Malassezia spp., causada principalmente por Malassezia furfur, se caracteriza clínicamente por una erupción acneiforme, con pápulas y pústulas foliculares de predominio en el tronco. El diagnóstico requiere confirmar la presencia de las levaduras en el folículo piloso. El tratamiento de elección es tópico u oral con azoles. Se reportan dos casos de foliculitis por Malassezia spp. de distribución atípica en pacientes inmunosuprimidos. CASOS CLÍNICOS: Caso 1. Paciente de sexo masculino de 14 años con diagnóstico de osteosarcoma condroide que ameritó tratamiento quirúrgico y quimioterapia. Fue hospitalizado por fiebre y neutropenia, presentando una erupción con lesiones papulopustulosas en las extremidades superiores e inferiores y en el cuello. Se realizaron examen directo y biopsia para concluir el diagnóstico de foliculitis por Malassezia spp. atípica diseminada. Caso 2. Paciente de sexo masculino de 16 años con diagnóstico de sarcoma sinovial, tratado con resección quirúrgica y quimioterapia, hospitalizado por fiebre y neutropenia. Presentó dermatosis diseminada en la cabeza, el tronco y las extremidades superiores, con múltiples pápulas y pústulas foliculares con base eritematosa; en el tronco había escasas lesiones. En la región supraciliar mostró eritema y escama furfurácea. Se realizó examen directo de un folículo, que reportó levaduras redondas de pared gruesa, compatibles con foliculitis por Malassezia spp. CONCLUSIONES: La foliculitis por Malassezia spp. es una afección frecuente, pero de poca sospecha diagnóstica. En pacientes inmunosuprimidos puede manifestarse con una clínica atípica en áreas no seborreicas, lo que implica la dificultad del diagnóstico. La biopsia y el examen directo son fundamentales para corroborar la etiología en pacientes con inmunosupresión o con expresión no clásica.
Subject(s)
Dermatomycoses , Folliculitis , Malassezia , Neutropenia , Adolescent , Biopsy , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Folliculitis/diagnosis , Folliculitis/drug therapy , Folliculitis/pathology , Humans , MaleABSTRACT
Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.
Subject(s)
Exanthema , Folliculitis , Child , Folliculitis/diagnosis , Humans , Mexico/epidemiology , Recurrence , TorsoABSTRACT
La foliculitis pseudolinfomatosa, descripta por McNutt en 1986, es una afección de etiología desconocida y poco frecuente, que simula un linfoma cutáneo tanto por su clínica como por su histología. Se presenta como una lesión nodular solitaria, eritematosa, de 0,5 hasta 3cm, de crecimiento rápido, sobre todo en la cara, en personas de 40 a 60 años, con una histopatología caracterizada por un infiltrado linfocitario B yT perifocular, y células dendríticas positivas en la inmunohistoquímica para S100yCD1a. Su curso es benigno, muchas veces autolimitado. Se expone el caso de una paciente con una particular forma clínica de pseudolinforma.
Pseudolymphomatous folliculitis, described by McNutt in 1986, is a non-frequent entity of unknown etiology that simulates a cutaneous lymphoma, both clinically and histologically. It shows as a solitary erythematous nodular lesion of 0.5 to 3 cm, with a rapid growth, mainly on the face, in people aged 40 to 60 years, and histopathology characterized by a perifollicular B and T lymphocytic infiltrate, and positive dendritic cells for immunohistochemistry S100 and CD1a. Its course is benign, often self-limited. The case of a patient with a particular clinical form of pseudolymphoma is presented.
Subject(s)
Humans , Female , Middle Aged , Skin Neoplasms , Pseudolymphoma/diagnosis , Folliculitis/diagnosis , Triamcinolone Acetonide/administration & dosage , Nose/injuries , Nose/pathology , Nasal Surgical ProceduresSubject(s)
Folliculitis , Lichen Planus , Alopecia , Child , Folliculitis/diagnosis , Humans , Lichen Planus/diagnosisABSTRACT
Pseudolymphomatous folliculitis (PLF) is a rare disease of cutaneous lymphoid hyperplasia, with a low index of clinical suspicion. We present the clinical case of a 19-year-old male patient, with a solitary violet erythematous nodule of 6 months of evolution, located in the right infraorbital region, without presenting another symptomatology. Histopathological examination showed a lymphocytic infiltrate that surrounds the hair follicles, sebaceous and sweat glands that focally destroy their basement membrane. PLF was diagnosed based on histological and immunohistochemical studies. In the multiple studies and case reports, the variability of the initial clinical diagnosis never corresponds to PLF, becoming a pathology with a low suspect index.
Subject(s)
Folliculitis , Pseudolymphoma , Skin Diseases , Adult , Diagnosis, Differential , Folliculitis/diagnosis , Hair Follicle , Humans , Male , Pseudolymphoma/diagnosis , Young AdultSubject(s)
Folliculitis , Lymecycline , Alopecia , Cellulitis/diagnosis , Cellulitis/drug therapy , Folliculitis/diagnosis , Folliculitis/drug therapy , HumansABSTRACT
El acné es la enfermedad dermatológica más común de la adolescencia. Aunque casi todos los casos remiten alrededor de la tercera década de la vida, cuando este problema conlleva una carga emocional para el paciente se requiere indicar tratamiento. En esta actualización, los autores revisan los distintos grados de compromiso de esta patología, el tratami-ento y los niveles de evidencia que tiene cada uno de ellos, con el objetivo de facilitar a los médicos de atención primaria el manejo de los pacientes que presentan esta enfermedad. (AU)
Acne is the most common dermatological condition in adolescents. Even though almost all cases will resolve around the third decade of life, treatment is indicated when this health problem carries an emotional burden for the patient. In this update, the authors review the grades of involvement of the disease and the available treatments according to levels of evidence, with the aim of helping primary care physicians to manage the patients presenting this illness. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Acne Vulgaris/therapy , Acne Conglobata/therapy , Anxiety , Self Concept , Skin Diseases/etiology , Testosterone/adverse effects , Cicatrix/prevention & control , Skin Diseases, Papulosquamous/therapy , Dermatitis, Seborrheic/diagnosis , Acne Vulgaris/diagnosis , Acne Vulgaris/pathology , Acne Vulgaris/psychology , Acne Vulgaris/drug therapy , Rosacea/diagnosis , Acne Conglobata/diagnosis , Folliculitis/diagnosisABSTRACT
Amicrobial pustulosis of the folds is a chronic relapsing neutrophilic dermatosis characterized by sterile pustules compromising skin folds, scalp, face and periorificial regions. It predominantly affects women. Demodicosis is an inflammatory disease associated with cutaneous overpopulation of the mite Demodex spp., the pathogenesis of which is not completely established, but is frequently related to local immunodeficiency. A case of a young woman with amicrobial pustulosis of the folds, and isolated worsening of facial lesions, is reported; investigation revealed overlapping demodicosis. There was complete regression of lesions with acaricide and cyclin treatment. This case warns of a poorly diagnosed but disfiguring and stigmatizing disease, often associated with underlying dermatoses or inadvertent treatments on the face.
Subject(s)
Folliculitis/parasitology , Granuloma/parasitology , Mite Infestations/complications , Mites/classification , Adult , Animals , Doxycycline/therapeutic use , Female , Folliculitis/diagnosis , Folliculitis/drug therapy , Granuloma/diagnosis , Granuloma/drug therapy , Humans , Ivermectin/therapeutic use , Mite Infestations/diagnosis , Mite Infestations/drug therapyABSTRACT
Abstract: Amicrobial pustulosis of the folds is a chronic relapsing neutrophilic dermatosis characterized by sterile pustules compromising skin folds, scalp, face and periorificial regions. It predominantly affects women. Demodicosis is an inflammatory disease associated with cutaneous overpopulation of the mite Demodex spp., the pathogenesis of which is not completely established, but is frequently related to local immunodeficiency. A case of a young woman with amicrobial pustulosis of the folds, and isolated worsening of facial lesions, is reported; investigation revealed overlapping demodicosis. There was complete regression of lesions with acaricide and cyclin treatment. This case warns of a poorly diagnosed but disfiguring and stigmatizing disease, often associated with underlying dermatoses or inadvertent treatments on the face.
Subject(s)
Humans , Animals , Female , Adult , Folliculitis/parasitology , Granuloma/parasitology , Mite Infestations/complications , Mites/classification , Ivermectin/therapeutic use , Doxycycline/therapeutic use , Folliculitis/diagnosis , Folliculitis/drug therapy , Granuloma/diagnosis , Granuloma/drug therapy , Mite Infestations/diagnosis , Mite Infestations/drug therapySubject(s)
Folliculitis/diagnosis , Folliculitis/virology , Herpes Simplex/diagnosis , Herpesvirus 3, Human/isolation & purification , Valacyclovir/therapeutic use , Wrestling/injuries , Adolescent , Diagnosis, Differential , Folliculitis/etiology , Forehead/pathology , Forehead/physiopathology , Humans , Male , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
Aeromonas species are rarely an identified cause of folliculitis. Here, we describe the case of a patient who had purulent folliculitis of the breast caused by an Aeromonas species and review 4 other cases presented in the literature, highlighting the commonalities observed. Aeromonas infection should be considered in patients who present with purulent folliculitis, particularly those with exposure to nonchlorinated pools or baths.
Subject(s)
Aeromonas , Breast Diseases/drug therapy , Breast Diseases/microbiology , Folliculitis/drug therapy , Folliculitis/microbiology , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Travel-Related Illness , Breast Diseases/diagnosis , Child , Ciprofloxacin/therapeutic use , Dominican Republic , Female , Folliculitis/diagnosis , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/transmission , Humans , Microbial Sensitivity Tests , Swimming Pools , Water MicrobiologyABSTRACT
Lymphomatoid papulosis (LyP) is an uncommon CD30 lymphoproliferative disorder with a relatively excellent prognosis. Ten to twenty percent of cases, however, are associated with a lymphoma, typically systemic or cutaneous anaplastic large cell lymphoma, mycosis fungoides, or Hodgkin lymphoma. Subtypes divide LyP into infiltrate-descriptive categories along a spectrum of histological manifestation. Classically, LyP shows a patchy, wedge-shaped, perivascular dermal infiltrate of small- to intermediate-sized lymphoid cells, larger lymphoid, with one, 2, or multiple prominent nucleoli, and a variable admixture of neutrophils, eosinophils, and histiocytes. Follicular LyP shares these characteristics, although its infiltrate is folliculocentric. Variable folliculotropism, follicular dilation, rupture, and mucinosis can occur. This entity is commonly misdiagnosed and underreporting likely because its histopathologic features can masquerade as more common follicular-based entities. The authors present 2 cases of this rare variant to underscore the importance of clinicopathologic correlation in diagnosis. To the best of the authors' knowledge, this is the first report of the follicular LyP variant with concurrent mycosis fungoides. In the context of a literature review, diagnostic pitfalls and classification of this variant are discussed.
Subject(s)
Folliculitis/diagnosis , Hair Follicle/pathology , Lymphomatoid Papulosis/pathology , Skin Neoplasms/pathology , Child, Preschool , Diagnosis, Differential , Humans , Ki-1 Antigen/analysis , Lymphomatoid Papulosis/metabolism , Male , Skin Neoplasms/chemistrySubject(s)
Male , Humans , Adult , Scalp Dermatoses/diagnosis , Scalp Dermatoses , Folliculitis/diagnosis , Folliculitis , Gluconates/therapeutic useABSTRACT
Skin and soft tissue infections are a common reason for consultation in primary health care centers. Data from the local epidemiology of these infections are rare, but Staphylococcus aureus and Streptococcus pyogenes are known to be the major etiologic agents. The appearance in recent years of community-originated strains of methicillin-resistant S. aureus and erythromycin-resistant pyogenes raises controversy in the choice of initial empirical treatment. This national consensus is for pediatricians, dermatologists, infectiologists and other health professionals. It is about clinical management, especially the diagnosis and treatment of community-originated skin and soft tissue infections in immunocompetent patients under the age of 19.