Folliculitis (cont.)
What is the prognosis (outlook) with folliculitis?
The prognosis with folliculitis is very good. Overall, folliculitis tends to
be an easily treated and curable skin condition. Typically, it is a
noncontagious, self-limited condition. Rarely, more widespread folliculitis
may be cosmetically disfiguring and psychologically distressing.
How is folliculitis diagnosed?
The diagnosis of folliculitis is generally based on the appearance of the
skin. In some situations, a small skin biopsy may be used to help the doctor
confirm the diagnosis. Other times, a skin bacterial culture may be taken by a
cotton-tip applicator to assist in detecting an infectious cause of the folliculitis. A few other medical conditions may look just like folliculitis and
need to be examined more closely by a dermatologist.
Usually, no specific laboratory tests are needed in the diagnosis of common
folliculitis. A bacterial culture may be useful to check for bacteria on the
skin. Microscopic skin tests and fungal tests using potassium hydroxide may help
to determine if the folliculitis is caused by yeast or a fungus. Skin biopsy
(surgically taking a small piece of skin using local numbing medicine) with
histopathological (exam of tissue under the microscope) evaluation may be useful
in atypical or widespread cases. Sometimes skin biopsies help to exclude other
possible diagnoses.
Histopathology of folliculitis shows the epidermis
with mild hyperkeratosis (thickening of the skin epidermis), clustering of white
blood cells around the hair follicle, and possible bacteria in the follicles.
The upper dermis (layer of the skin) may have some microscopic inflammation,
referred to as mild superficial perivascular lymphocytic inflammatory changes.
What else could folliculitis look like?
Other medical conditions that can mimic folliculitis include keratosis
pilaris, acne, milia (whiteheads), eczema, impetigo, atopic dermatitis, facial
rosacea, contact dermatitis, fire ant bites, heat rash (miliaria), insect bites,
sea bather's eruption, or dry skin (xerosis).
Less common mimickers include chickenpox, herpes, pustular psoriasis,
molluscum contagiosum, viral warts, Fox-Fordyce disease,
Graham-Little-Piccardi-Lasseur syndrome, pruritic papular eruption of HIV
disease, and erythema toxicum neonatorum. Folliculitis may also resemble
uncommon skin conditions like lichen spinulosus, pityriasis rubra pilaris,
phrynoderma (vitamin A deficiency), ulerythema oophryogenes, ichthyosis
vulgaris, eruptive vellus hair cysts, ethromelanosis follicularis faciei et
colli, keratosis follicularis (Darier disease), Kyrle disease, lichen nitidus,
lichen spinulosus, perforating folliculitis, and trichostasis spinulosa.
Next: What causes folliculitis? Does diet have anything to do with folliculitis? »
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