What Is Pityrosporum Folliculitis?

Malassezia folliculitis, once known as furfurella sporiformis folliculitis, is a chronic recurrent folliculitis dermatitis caused by malassezia. Blockage of hair follicles may be the main cause of the disease. The disease is more common in seborrheic areas, more common in summer and autumn. Skin lesions are dense or scattered red follicular erythema, pimples, and pustules.

Basic Information

nickname
Malassezia folliculitis
Visiting department
Dermatology
Multiple groups
Significantly more men than women
Common locations
skin
Common causes
The pathogen of this disease is Malassezia, which can invade not only the skin surface and the top of the funnel of the hair follicle, but also the deep part of the hair follicle.
Common symptoms
The skin lesions are hemispherical inflammatory follicular papules or small pustules, with a diameter of 2 to 4 mm, with a consistent shape and size, dense or scattered distribution, a large number, and itching

Etiology of furfurella folliculitis

The pathogen of this disease is Malassezia, which can invade not only the skin surface and the top of the funnel of the hair follicle, but also the deep part of the hair follicle. Long-term use of antibiotics, glucocorticoids, and immunosuppressants will promote the proliferation of pathogenic bacteria in the hair follicles. Its lipolytic enzymes change the triglycerides of the hair follicles into free fatty acids, stimulate the hair follicle mouth to produce desquamation, and cause the hair follicle ducts to become blocked. The accumulation of cell debris and the stimulation of free fatty acids cause the blocked hair follicles to expand and then rupture. The contents are released into the tissue and cause inflammation.

Clinical manifestations of furfurella folliculitis folliculitis

This disease is more common in young and middle-aged men. It occurs in the neck, chest, shoulders, and back. The typical skin lesion is a hemispherical inflammatory follicular papule or small pustule. Distribution, a large number, may have itching, not complicated by pityriasis versicolor, skin lesions in a few patients can occur on the face.

Examination of furfurella folliculitis

1. Laboratory inspection (1) Direct microscopy: Take a rash, hair follicle horn plug and 15% potassium hydroxide solution for direct microscopy, see short thick hyphae or piles of round or oval thick-walled spores.
(2) Fungal culture: Add 1 to 2 ml of olive oil or other vegetable oils to the sandcastle medium, and incubate the scales at 37 ° C. After 3 days, creamy yeast-like colonies will grow.
2. Pathological examination (1) Excessive keratinization of the affected hair follicle epithelium, the formation of horn plugs in the funnel part of the hair follicle due to accumulation of horny substances. Infiltration of inflammatory cells in and around the hair follicle funnel.
(2) PAS staining, spherical or oval-shaped bud spores with positive PAS staining and amylase-negative, sterile filaments can be seen in the enlarged hair follicle cavity.

Diagnosis of furfurella folliculitis

1. Typical symptoms are more common in men than in women. They occur more frequently in areas rich in sebaceous glands, and the rash is relatively simple. Mainly manifested as red hair follicles with large dome-shaped papules, with a few pustules. Consciously have mild itching or discomfort.
2. Auxiliary inspection microscopic examination found short thick hyphae or piles of round or oval-shaped thick-walled spores in hair follicle corner plugs, or cultured with cream-colored yeast-like colonies to grow. Pathological examination showed spherical or oval spores with PAS staining and amylase negative staining in the hair follicle cavity.
The test results, combined with typical symptoms, are not difficult to diagnose.

Differential diagnosis of furfurella folliculitis

This disease should be mainly distinguished from acne. Acne occurs mostly in adolescence, and it occurs on the face and face, and a few on the chest and back. Whiteheads and blackheads are visible. Antibiotic treatment is effective.

Furfurella Folliculitis Treatment

1. Local treatment of this disease invades the hair follicles and the site is deeper. Topical antifungal drugs are less effective. Topical antifungal drugs containing penetrants have a significant effect, but are prone to recurrence. Take a bath with 2% ketoconazole lotion, once a day. After rubbing the affected part to foam, stay for 5 minutes, and then rinse with water. Combined application with other drugs can have synergistic effects. For topical use of bibenzolium tincture or cream, this product contains a penetrant, which has a good curative effect.
2. Systemic treatment can be oral itraconazole.

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