Definition of Perforating Folliculitis

Perforating folliculitis is a topical skin condition that resembles regular folliculitis but instead has a keratin, or harder skin, core. The condition can be mild or progress to more severe cases in which large areas of skin are covered with lesions. Mild cases usually resolve themselves with no further problems. More severe cases might resolve, then reappear later and last for months or years. Severe cases can require a variety of treatments, from corticosteroids to antibiotics, and can be indicative of an underlying disease.

Appearance

Perforating folliculitis appears as swollen, reddened papules (bumps) on the skin with a keratin center. Keratin, which is found on the outer layers of skin, the nails and the hair, is normally exfoliated from the skin to allow new skin to grow. Tiny hair(s) are at the center of the papules. In perforating folliculitis, altered keratin and other skin debris can cause the papules to be hardened and reddish. Connective tissue fibers are pushed through the skin, causing a keratin plug.

Causes

Perforating folliculitis is usually found in adults and sometimes forms without an identifiable cause. It can be associated with chronic renal failure and, more commonly, diabetes mellitus. Other contributors might be hypertension, atherosclerotic disease and psoriasis. Skin trauma or contact dermatitis can also be a factor in developing perforating folliculitis.

Symptoms

Papules are most often found on the extremities and buttocks where there are hair follicles (areas of the skin though which hair grows). They can be itchy, disappear, and then reappear, often for months or years.

Size

Perforating folliculitis lesions are usually smaller than 1/4 inch and resemble pimples. They can have a scaly surface with varying redness and irritation around a white center.

Treatment

Superficial cases of perforating folliculitis are usually treated with topical creams or lotions that prevent itching. In more severe cases, ultraviolet therapy may help control itching. Treatment of cases having underlying diseases are directed toward the particular disease, such as vitamin therapy, diabetic therapy, or therapy for chronic renal failure. Treatment of hypertension, atherosclerosis (arterial plaques), and/or psoriasis may also be indicated.

Warning

If papules persist and do not resolve completely or reappear see you doctor for further medical care to rule out or treat possible underlying medical conditions. Laboratory testing and biopsy may be indicated for more serious cases of perforating folliculitis or if you have a preexisting condition that you think may be a cause for the condition.

References

• Perforating Folliculitis
• Folliculitis
• Perforating Folliculitis

Resources

• Folliculitis
• Folliculitis