Folliculitis superficial L01.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Bockhart's impetigo; folliculitis simplex; Folliculitis staphylogenes superficialis; Impetigo follicularis hard as a rock; Impetigo hard as a rock; Ostiofolliculitis Hard rock; Pimples; pustular folliculitis; Staphylodermia Bockhart; superficial folliculitis; Superficial folliculitis

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Bockhart, 1887

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Frequent, solitary or multiple, acute or chronic, purulent infection of the superficial part of the hair follicle, bound to the hair follicle, which is mainly caused by staphylococci (commonly known as pimples or pustule). This type of folliculitis occurs mainly in the warm and humid tropical zones.

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Infection of the hair follicle by Staphylococcus aureus.


  • Microtrauma, e.g. by shaving (beard region and lower leg)
  • Moist maceration, moist warm intertriginous areas, sweating, treatment of certain skin areas that are too oily or too moist, plastic occlusion dressing.
  • Faulty occluding clothing in warm and humid climate
  • Defensive weakness.
  • Itchy scratched skin diseases

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Occurrence possible at any age, but especially in infancy and toddlers. No gender dominance.

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Especially face, cheeks, nose, armpits, extremities, lower legs after shaving. In principle possible on the whole integument where occlusion is caused by clothing or by close contact.

Clinical features
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Acutely occurring, solitary or multiple, punctiform (follicularly bound), also grouped, 0.1-0.2 cm large, flat, red papules or yellow-red papulo-pustules with a discreet red border. The follicular inflammations are often pierced by a central hair. This finding is easily recognizable in the case of an infestation of terminal hair follicles (Note: only the clear follicular infestation defines the diagnosis! If vellus hair regions are affected (e.g. trunk), the relation to the follicle is not always clearly evident).

The superficial folliculitis does not exceed the follicular border. There is no perifollicular abscess formation (boils).

There is a slight painfulness of the single folliculitis, if necessary also of the region, but more often itching. After approx. 5 days drying out and formation of a yellow-brown crust. Complete healing without scarring. Recurrences are frequent if the cause is not eliminated.

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Follicularly bound, neutrophil infiltration of the superficial parts of the follicle.

Differential diagnosis
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External therapy
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After initial disinfection with alcoholic solutions (70% isopropanol), polihexanide (Serasept, Prontoderm), octenidine (Octenisept) or polyvidone-iodine solutions(e.g. Betaisodona solution) mechanical opening of the pustules. Then, several times a day, moist compresses with antiseptic additives such as polihexanide, potassium permanganate (light pink) or quinolinol (e.g. Chinosol 1:1000 or R042 ). Alternatively, disinfectant lotio or creams such as 0.5-2.0% Clioquinol-Lotio R050, Linola-Sept.

Internal therapy
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For extensive infections Dicloxacillin (e.g. InfectoStaph) 3-4 times/day 2 Kps. p.o.

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Bacterial or non-bacterial folliculitis not induced by staphylococci are generally identified with the causative pathogen: demodex folliculitis, pityrosporum folliculitis, gram-negative folliculitis , etc.

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  1. Durdu M et al (2013) First step in the differential diagnosis of folliculitis: cytology. Crit Rev Microbiol 39:9-25
  2. Edlich RF et al (2005) Bacterial diseases of the skin. J Long Term Eff Med Implants 15:499-510
  3. Fourtillan E et al (2013) Treatment of superficial bacterial cutaneous infections: a survey among general practitioners in France. Ann Dermatol Venereol 140: 755-762
  4. LaBerge L et al (2012) Actinic superficial folliculitis in a 29-year-old man. J Cutan Med Surgery 16:191-193
  5. Kaimal S et al (2009) Dermatitis cruris pustulosa et atrophicans revisited: our experience with 37 patients in south India. Int J Dermatol 48:1082-1090
  6. Palit A et al (2010) Current concepts in the management of bacterial skin infections in children. Indian J Dermatol Venereol Leprol 76:476-488


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 29.10.2020