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Candida viral and parasitic folliculitis introduction
Candida folliculitis
Viral folliculitis
Parasitic folliculitis
Candida viral and parasitic folliculitis references
Candida
viral and parasitic folliculitis introduction
Every hair on the human body grows from a follicle. The pilosebaceous
unit (relating to hair and the sebaceous glands) of the follicle
is divided into three main parts: the infundibulum (superficial
part, outlined by the sebaceous duct), the isthmus (the middle
segment between the sebaceous duct and arrector pili protuberance),
and the inferior segment (stem and hair bulb). Folliculitis
is the condition caused by the inflammation of the superficial
aspect of the hair follicles, usually due to an infection, injury,
or irritation.
The human skin normally hosts a variety of microorganisms including
bacteria and fungi. Some of these are useful to the body; some
cause no harm or benefits, while others may cause harmful infections.
These bacteria, fungi, parasites or viruses often cause infectious
folliculitis (inflammation of a follicle), which is typically
characterized by tender, swollen areas that form around hair
follicles.
Candida
folliculitis
Fungal infections are caused by microscopic organisms (fungi)
that can live on the skin. They can live on the dead tissues
of the hair, nails and outer skin layers. Fungal infections
can be caused by mold-like fungi (dermatophytes, which cause
tinea infections), yeast-like fungi (pityrosporum) and candida;
ubiquitous fungi that are present on almost any skin surface,
but more often in warm, moist, creased areas of the body.
Candida folliculitis is folliculitis caused by infection of
the skin with the Candida species. Pustular folliculitis caused
by Candida albicans is a rare condition most frequently reported
in individuals who are heroin addicts. Candida folliculitis
is manifested as pustules (vesicles containing pus) and nodules
(circumscribed depth implied solid lesions greater than 1 cm)
in the hair bearing areas. Pustular folliculitis involves candidemia
or invasive candidiasis, a condition that occurs when Candida
species enter the blood causing a bloodstream infection, and
then spread throughout the body. Pustular folliculitis has also
been occasionally reported in healthy individuals with painful
lesions.
Candida folliculitis is treated with oral itraconazole (200
mg/day), which is a broad-spectrum antifungal agent.
Viral
folliculitis
Viral folliculitis is an infrequently reported entity involving
viral infections limited to the hair follicle which can be
transmitted by direct skin-to-skin contact. This kind of folliculitis
may be caused by the herpes simplex virus or by molluscum
contagiosum (a skin condition caused by a pox virus infection).
The clinical presentation of folliculitis caused by the herpes
simple virus (HSV) appears as clustered vesicles (small circumscribed
elevation of the skin containing serum) on an erythematous
(reddened) base. This eruption often progress to form pustular
or ulcerated lesions, and eventually a crust. The blisters
(a vesicle of the skin, containing watery matter or serum)
are usually painful and may cause itching, burning and tenderness
around the infected area. Frequently, people with herpetic
folliculitis have a history of repeated herpes infection of
the face.
There are also some reports of folliculitis caused by herpes
zoster infection, a viral infection characterized by painful
blisters that appear in a linear distribution on the skin
following nerve pathways.
Cases caused by molluscum contagiosum may be considered a
sign of immunosuppression (such as infection with human immunodeficiency
virus, HIV) in some people and this common viral disease is
confined to the skin and mucous membranes. Transmission of
the infection requires direct contact with infected hosts
or contaminated fomites, and the onset is gradual. The lesions
begin as a group of minute papules in one to two areas. Individual
lesions are discrete, smooth, and pearly to flesh-colored
dome-shaped papules which centrally umbilicate (form of a
depression at the apex of a papule, vesicle, or pustule).
The clinical appearance of molluscum contagiosum is in most
cases diagnostic. Histological examination of a curetted or
biopsy lesion can also aid in the diagnosis in cases that
are not so clinically obvious.
The generally recommended treatment for viral herpetic folliculitis
entails administration of oral antihistamines or acyclovir
200 mg five times daily for 5 days. Acyclovir belongs to the
family of medicines called antivirals, and it is used to treat
the symptoms of chickenpox, shingles and herpes virus infections.
Although acyclovir does not cure herpes, it does help to relieve
the pain and discomfort and promotes the sores to heal faster.
There is no single perfect treatment for infection by molluscum
contagiosum, though several are in use including:
-
Cryotherapy. Cryotherapy is considered as
one of the most common and efficient methods of treatment.
Liquid
nitrogen or dry ice is applied to each individual
lesion for a few seconds, and repeated treatments in 2–3-week
intervals may be required. Hyper- or hypo-pigmentation and
scarring
may be caused by this treatment.
-
Curettage. Scraping
off the bumps using a tool called a curette is a common
way to surgically remove the lesions.
Curettage has the advantage of providing a reliable tissue sample to
confirm the diagnosis.
-
Cantharidin. Cantharidin
(0.9% solution of collodian and acetone) has been used
as a successful treatment measure.
This agent is applied cautiously to the dome of the lesion with or without
occlusion and left in place for at least 4
hours before being washed off.
-
Podophyllotoxin. Podophyllotoxin,
a suspension in a tincture of benzoin or alcohol may
be applied once
a week. This treatment requires some precautions because of it can cause
severe erosive
damage in adjacent normal skin.
Parasitic
folliculitis
Parasites causing folliculitis (inflammation of a follicle)
are usually small pathogens that burrow into the hair follicle
to live there or lay their eggs. Mites such as Demodex folliculorum
and Demodex brevis are natural parasites of the human pilo-sebaceous
follicle, and Demodicosis is the name of the disease or condition
caused by these parasites. These mites are found in higher
concentration in areas of the body with more sebaceous glands,
as well as in abundant sebum production areas such as the
chest, back, temple, periorbital area and nose. Usually these
mites live in our hair follicles without cuasing any problems
beyond some itching, but sometimes the response of the body
to these parasites can be more severe. It is believed that
the mites can act by provoking a small allergic reaction in
the follicle, blocking the follicle, or allowing other microorganisms
to infect the skin.
The spectrum of the skin disorders due to these follicle
parasites includes:
-
Follicular pityriasis (skin disease characterized
by epidermal shedding of flaky scales), eruptions
of the scalp with or without pus
-
Acne rosacea (a chronic
dermatitis of the face characterized
by a red or rosy coloration with deep-seated
papules and pustules)
-
Some cases of blepharitis (inflammation
of the eyelids)
-
Perioral dermatitis
-
Pustular folliculitis
-
Hyper-pigmented
plaques (superficial elevated solid lesions greater
than 1 cm)
All these conditions show rapid response to topical permethrin
cream (a topical insecticide used to treat mites) or systemic
ivermectin or itraconazole (where a complicating fungal infection
along with the mites is suspected).
Candida
viral and parasitic folliculitis references
- Walsh N, Boutilier R, Glasgow D, Shaffelburg M. Exclusive
involvement of folliculosebaceous units by herpes: a reflection
of early herpes zoster. Am J
Dermatopathol. 2005 Jun;27(3):189-94.
PMID: 15900120
- Foti C, Filotico R, Calvario A, Conserva A, Antelmi A, Angelini
G. Relapsing herpes simplex-2 folliculitis
in the beard area. Eur J Dermatol. 2004 Nov-Dec;14(6):421-3.
PMID: 15564209
- Karincaoglu Y, Bayram N, Aycan O, Esrefoglu M. The clinical
importance of demodex folliculorum presenting with nonspecific
facial signs and symptoms. J Dermatol. 2004
Aug;31(8):618-26.
PMID: 15492434
- Crawford GH, Pelle MT, James WD.
Rosacea: I. Etiology, pathogenesis, and subtype classification.
J Am Acad Dermatol. 2004 Sep;51(3):327-41; quiz 342-4. PMID:
15337973
- Opie KM, Heenan PJ, Delaney TA, Rohr JB. Two cases of eosinophilic
pustular folliculitis associated with parasitic infestations.
Australas J Dermatol. 2003 Aug;44(3):217-9.
PMID: 12869050
- Anliker MD, Itin P. [Herpetic folliculitis
barbae. A rare cause of folliculitis] Hautarzt. 2003 Mar;54(3):265-7.
PMID: 12634996
- Al-Dhafiri SA, Molinari R. Herpetic
folliculitis. J Cutan Med Surg. 2002 Jan-Feb;6(1):19-22. PMID:
11896419
- Jang KA, Kim SH, Choi JH, Sung KJ, Moon KC, Koh JK. Viral
folliculitis on the face. Br J Dermatol. 2000 Mar;142(3):555-9.
PMID: 10735972
- Kurita M, Kishimoto S, Kibe Y, Takenaka H, Yasuno H. Candida
folliculitis mimicking tinea barbae. Acta Derm Venereol. 2000
Mar-Apr;80(2):153-4. PMID: 10877146
- Suss K, Vennewald I, Seebacher C.
Case report. Folliculitis barbae caused by Candida albicans.
Mycoses. 1999;42(11-12):683-5.
PMID: 10680449
- Weinberg JM, Turiansky GW, James WD.
Viral folliculitis. AIDS Patient Care STDS. 1999 Sep;13(9):513-6.
PMID: 10813030
- Weinberg JM, Mysliwiec A, Turiansky GW, Redfield R, James
WD. Viral folliculitis. Atypical presentations
of herpes simplex, herpes zoster, and molluscum contagiosum.
Arch Dermatol. 1997 Aug;133(8):983-6.
PMID: 9267244
- Leclech C, Cimon B, Chennebault JM, Verret JL. [Pustular
candidiasis in heroin addicts] Ann Dermatol Venereol. 1997;124(2):157-8.
PMID: 9740826
- Ross EV, Baxter DL Jr. Widespread
Candida folliculitis in a nontoxic patient. Cutis. 1992 Apr;49(4):241-3.
PMID: 1521475
- Kalibala S. Skin conditions common
to people with HIV infection or AIDS. AIDS Action. 1990 Apr;(10):2-3.
PMID: 12342834
- Darcis JM, Etienne M, Demonty J, Christophe J, Pierard GE.
Candida albicans septicemia with folliculitis
in heroin addicts. Am J Dermatopathol. 1986 Dec;8(6):501-4.
PMID: 3812924
- Czarnetzki BM, Springorum M. Larva
migrans with eosinophilic papular folliculitis. Dermatologica.
1982 Jan;164(1):36-40.
PMID: 7067878
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