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Folliculitis - Anogenital in
See also in: Overview,Hair and Scalp
Other Resources UpToDate PubMed

Folliculitis - Anogenital in

See also in: Overview,Hair and Scalp
Contributors: Priyanka Vedak MD, Lowell A. Goldsmith MD, MPH, Benjamin K. Fisher MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Folliculitis occurs due to inflammation of the superficial hair follicle, resulting in follicularly centered papules and pustules.

The etiology of folliculitis can be variable, with bacterial, fungal, viral, parasitic, and noninfectious causes reported. A detailed history of comorbid conditions, exposures, and medications, in conjunction with appropriate ancillary testing, can be helpful.

In immunocompetent patients, bacterial folliculitis may be considered, often due to a predisposing factor that allows for increased bacterial burden on the skin surface. Staphylococcus aureus and Streptococcus species are commonly implicated. These predisposing factors include nasal carriage of S. aureus, occlusion, maceration, hyperhydration, complicating pruritic skin diseases, vigorous application of topical medications, shaving, exposure to oils and certain chemicals, and exposure to heated or contaminated water.

In the genital area, in particular, shaving or other methods of hair removal may result in pseudofolliculitis from ingrown hairs or true bacterial folliculitis. Infection may result due to autoinoculation, contamination of tools, normal skin flora, or colonization of the individual performing the procedure. Pustular folliculitis secondary to Candida spp. (see candidiasis) has also been reported in immunocompetent adults, particularly in skin folds. Viral folliculitis secondary to varicella zoster virus, herpes simplex virus, and molluscum contagiosum have been described.

In immunocompromised patients, folliculitis can occur secondary to etiologies similar to those discussed above. For example, bacterial folliculitis may evolve into furunculosis, or inflammation involving deeper aspects of the pilosebaceous unit, in patients with certain risk factors such as diabetes mellitus, immunosuppression, or human immunodeficiency virus (HIV) infection.

Codes

ICD10CM:
L73.8 – Other specified follicular disorders

SNOMEDCT:
13600006 – Folliculitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Molluscum contagiosum in the pubic area is often mistaken for folliculitis. A correlation has been noted between pubic hair removal and sexually transmitted molluscum contagiosum.
  • Arthropod bite or sting
  • Flat wart
  • Genital wart
  • Milia
  • Vulvovaginal candidiasis
  • Ingrown hair
  • Immunosuppression-associated eosinophilic folliculitis (seen in AIDS)
  • Genital herpes simplex virus
  • Herpes zoster

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:03/01/2017
Last Updated:08/16/2021
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Patient Information for Folliculitis - Anogenital in
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Folliculitis - Anogenital in
See also in: Overview,Hair and Scalp
A medical illustration showing key findings of Folliculitis : Buttocks, Follicular configuration, Folliculitis, Superior chest, Upper back, Legs
Clinical image of Folliculitis - imageId=320768. Click to open in gallery.  caption: 'A close-up of follicularly based papules and a pustule.'
A close-up of follicularly based papules and a pustule.
Copyright © 2024 VisualDx®. All rights reserved.