HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
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EtiopathogenesisThis section has been translated automatically.
Etio: discussed is an initial staphylococcal folliculitis after short haircut or shaving. There is no pathogenetic relationship to acne (localization, absence of comedones). From unknown cause transition to a chronic fibrosing process with tissue hyperplasia and pressure atrophy of the follicles.
ManifestationThis section has been translated automatically.
Occurs only in men, after the age of puberty; preferred in people with dark skin.
LocalizationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
Initially individual, small, red, follicular papules and pustules, from which develop hard, dark red, hemispherical, shiny, differently sized, solid papules and nodules pierced by a terminal or vellus hair, which can confluent to form larger plate-like structures.
Later increasing sclerotic, almost board-like hardening of the skin between them.
Beam-like, transverse, coarse, bulging keloids with tufts of hair.
Deep epithelium-lined fistula ducts.
Peripheral continuous sometimes intermittent progression of the sclerosing inflammation over a period of years.
Differential diagnosisThis section has been translated automatically.
- Boils: Highly painful, acute; starting from 1 follicle; no multiple pustules on the surface; clearly fluctuating.
- Folliculitis decalvans: Eminently chronic course of the disease mostly over years; scarred alopecia; highly red skin changes in the centre mostly atrophic shiny and peripheral follicular papules; later pustular transformation and crust formation. Irregularly shaped scar foci with small spots of irreversible hair loss result. Formation of tuft hairs.
- Tinea capitis profunda: Mostly occurring in children! Subacute or acute course; itchy or moderately painful, 0.5-5.0 cm large, usually well defined, cushion-like raised, purulent, highly red plaques or nodules. Pus can be emptied under pressure. Hair is missing in the lesion; existing hair can be easily and usually painlessly extracted; preparation of a native preparation for fungal detection.
TherapyThis section has been translated automatically.
- Intralesional injections with glucocorticoids such as triamcinolone acetonide (e.g. Volon A 10 crystal suspension) diluted 1:3 to 1:5 with physiological NaCl solution or local anaesthetic such as mepivacaine, several times at weekly intervals. In inflammatory phases local disinfectant solutions polihexanide (Serasept, Prontoderm), polyvidon iodine solution(e.g. Betaisodona).
- Excise small foci en bloc, cover larger foci plastically after excision with a full-thickness skin graft or stretching plastic surgery.
- Treatment trial with tetracyclines (e.g. tetracycline Wolff) 4 times/day 250 mg p.o. or with isotretinoin (e.g. isotretinoin-ratiopharm; acne normin) 0.5 mg/kg bw/day p.o. Cave! Women of childbearing age!
Progression/forecastThis section has been translated automatically.
LiteratureThis section has been translated automatically.
- Adamson HG (1914) Dermatitis papillaris capillittii (Kaposi). Acne keloid. Br J Dermatol 26: 69-83
- Alexis A et al (2014) Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach? Dermatol Clin 32:183-191
- Gloster HM Jr (2000) The surgical management of extensive cases of acne keloidalis nuchae. Arch Dermatol 136: 1376-1379
- Hebra v. F, Kaposi M (1860) Textbook on skin diseases. Enke, Erlangen, vol. 1, p. 506
- Kaposi M (1894) On some unusual forms of acne (folliculitis). Arch Dermatol Syph 26: 87-96
- Kelly AP (2003) Pseudofolliculitis barbae and acne keloidalis nuchae. Dermatol Clin 21: 645-653
- Sparrow LC (2000) Acne keloidalis is a form of primary scarring alopecia. Arch Dermatol 136: 479-484
Shapero J et al (2011) Acne keloidalis nuchae is scar and keloid formation condary
to mechanically induced folliculitis. J Cutan Med Surg 15:238-240
Incoming links (9)Folliculite pilo-sebacée chronic; Folliculitis scleroticans nuchae; Keloidal folliculitis; Neck keloid; Papillary dermatitis capillitii; Perifolliculitis capitis abscedens et suffodiens; Sycosis framboesiformis; Sycosis nuchae sclerotisans; Tinea capitis profunda;
Outgoing links (19)Acne (overview); Boils; Disinfectants; Excision; Folliculitis decalvans; Folliculitis (overview); Full skin grafts; Glucocorticosteroids systemic; Isotretinoin; Papel; ... Show all
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