Folliculitis superficial L01.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 12.01.2024

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

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Infection of the hair follicle by Staphylococcus aureus.


  • Microtrauma, e.g. due to shaving (beard region and lower legs).
  • Moist maceration, moist warm intertriginous areas, sweating, too greasy or too moist treatment of certain skin areas, plastic occlusive dressing
  • Faulty occluding clothing in warm and humid climate
  • Weakness of the immune system
  • 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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Mainly face, cheeks, nose, armpits, extremities, lower legs after shaving. In principle possible on the entire integument, where occlusion occurs through clothing or through close contact.

Clinical features
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Acutely occurring, solitary or multiple, punctate (follicularly bound), also grouped, 0.1-0.2 cm, flat, red papules or yellow-red papulo-pustules with a discrete red fringe. The follicular inflammations are often pierced by a central hair. This finding is easily recognized when terminal hair follicles are involved (Note: only clear follicular involvement defines the diagnosis! If vellus hair regions are affected (e.g. trunk), the relation to the follicle is not always clear).

Superficial folliculitis does not cross the follicular boundary. There is no perifollicular abscess formation (furuncle).

There is slight painfulness of the individual florescence, possibly also of the region, but more frequently itching. After about 5 days, drying and formation of a yellow-brown crust. Complete healing without scarring. Recurrences are common if the triggering cause is not removed.

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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: 12.01.2024