Folliculitis - Anogenital in
See also in: Overview,Hair and ScalpAlerts and Notices
Synopsis
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
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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.
- Insect bites
- Flat warts
- Condyloma acuminatum
- Milia
- Candidiasis
- Ingrown hairs
- Eosinophilic folliculitis (seen in AIDS)
- Herpes simplex
- Herpes zoster
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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.Subscription Required
References
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Last Reviewed:03/01/2017
Last Updated:08/16/2021
Last Updated:08/16/2021
Folliculitis - Anogenital in
See also in: Overview,Hair and Scalp