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Macit Ilkit - One of the best experts on this subject based on the ideXlab platform.
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high accuracy of recognition of common forms of Folliculitis by dermoscopy an observational study
Journal of The American Academy of Dermatology, 2019Co-Authors: Murat Durdu, Enzo Errichetti, Ali Haydar Eskiocak, Macit IlkitAbstract:Background Clinical differentiation of Folliculitis types is challenging. Dermoscopy supports the recognition of Folliculitis etiology, but its diagnostic accuracy is not known. Objective To assess the diagnostic accuracy of dermoscopy for Folliculitis. Methods This observational study included patients (N = 240) with Folliculitis determined on the basis of clinical and dermoscopic assessments. A dermoscopic image of the most representative lesion was acquired for each patient. Etiology was determined on the basis of cytologic examination, culture, histologic examination, or manual hair removal (when ingrowing hair was detected) by dermatologist A. Dermoscopic images were evaluated according to predefined diagnostic criteria by dermatologist B, who was blinded to the clinical findings. Dermoscopic and definitive diagnoses were compared by dermatologist C. Results Of the 240 Folliculitis lesions examined, 90% were infections and 10% were noninfectious. Infectious Folliculitis was caused by parasites (n = 71), fungi (n = 81), bacteria (n = 57), or 7 viruses (n = 7). Noninfectious Folliculitis included pseudoFolliculitis (n = 14), Folliculitis decalvans (n = 7), and eosinophilic Folliculitis (n = 3). The overall accuracy of dermoscopy was 73.7%. Dermoscopy showed good diagnostic accuracy for Demodex (88.1%), scabietic (89.7%), and dermatophytic Folliculitis (100%), as well as for pseudoFolliculitis (92.8%). Limitations The diagnostic value of dermoscopy was calculated only for common Folliculitis. Diagnostic reliability could not be calculated. Conclusion Dermoscopy is a useful tool for assisting in the diagnosis of some forms of Folliculitis.
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Clinical and Laboratory Features of Six Cases of Candida and Dermatophyte Folliculitis and a Review of Published Studies
Mycopathologia, 2016Co-Authors: Murat Durdu, Mümtaz Güran, Macit Ilkit, Hazal Kandemir, Seyedmojtaba SeyedmousaviAbstract:Although some studies have investigated the epidemiological characteristics of Malassezia Folliculitis (MF), little is known about the clinical features and laboratory characteristics of Folliculitis caused by other fungi. In this prospective study, 158 patients with Folliculitis were identified, and cytological and mycological examinations were performed. The positive fungal cultures were confirmed using conventional methods, ITS sequencing and HWP1 analysis. Additionally, an in vitro antifungal susceptibility test was performed. Of 158 patients with Folliculitis, 65 (41.1 %) were found to have fungal Folliculitis. The most common (90.8 %) fungal Folliculitis was MF. Non-MF fungal Folliculitis was detected in 6 (9.2 %) patients. Four patients were diagnosed with dermatophytic Folliculitis ( Trichophyton rubrum in three patients and Arthroderma vanbreuseghemii in one patient), and two patients were diagnosed with Candida albicans Folliculitis. Although only 5 of the 6 samples were found to be positive via a potassium hydroxide test, all May–Grünwald–Giemsa-stained samples were positive. Both of the C . albicans isolates demonstrated a susceptibility profile to itraconazole, and all four dermatophytes were susceptible to terbinafine. All six patients completely recovered with systemic and topical treatment. This study revealed that dermatophytes and C. albicans are the primary causative agents of non- Malassezia fungal Folliculitis. We compared our findings with published reports on fungal Folliculitis.
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first step in the differential diagnosis of Folliculitis cytology
Critical Reviews in Microbiology, 2013Co-Authors: Murat Durdu, Macit IlkitAbstract:Folliculitis is a superficial inflammation of the hair follicles, and can be observed in individuals of any age or race. The incidence of Folliculitis is unknown because most patients only consult a doctor in cases of increasing lesions. There are various infectious and non-infectious causes of Folliculitis, and the most common causative agent is Staphylococcus aureus. In addition, several Gram-negative bacterial, fungal, parasitic, and viral pathogens can cause follicular papules and pustules. In routine practice, however, these lesions are usually thought to be bacterial. Therefore, topical and/or systemic antibacterial treatment is recommended, but this involves the risk of being misused for months or even years. Cytology, a simple, rapid, inexpensive, and repeatable diagnostic method, can reveal various bacterial, fungal, viral, and parasitic pathogens. This review discusses the use of clinical sampling and staining of cytologic samples for the differential diagnosis of Folliculitis, cytologic findings, and the frequency with which dermatologists use cytology to diagnose Folliculitis, particularly in the age of molecular biology and more expensive, sophisticated investigations.
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Epidemiological characteristics of Malassezia Folliculitis and use of the May-Grünwald-Giemsa stain to diagnose the infection.
Diagnostic Microbiology and Infectious Disease, 2013Co-Authors: Murat Durdu, Mümtaz Güran, Macit IlkitAbstract:Various bacterial, fungal, parasitic, and viral pathogens can cause Folliculitis, which is often mistakenly treated with antibiotics for months or even years. A laboratory diagnosis is required before therapy can be planned. Here, we describe the prevalence and risk factors, as well as the clinical, cytological, and mycological characteristics, of patients with Malassezia Folliculitis (MF) in Adana, Turkey. We also report the treatment responses of the MF patients and describe the Malassezia spp. using culture-based molecular methods. Cytological examinations were performed in 264 Folliculitis patients, 49 of whom (18.5%) were diagnosed with MF. The positivity of the May-Grunwald-Giemsa (MGG) smear was higher (100%) than that of the potassium hydroxide test (81.6%). Using Wood's light, yellow-green fluorescence was observed in 66.7% of the MF patients. Identification using the rDNA internal transcribed spacer region revealed that Malassezia globosa was the most common species, followed by Malassezia sympodialis, Malassezia restricta, and Malassezia furfur. The MF patients were treated with itraconazole capsules (200 mg/d) for 2 weeks. Complete recovery was observed in 79.6% of the patients. These novel findings help improve our current understanding of the epidemiological characteristics of MF and establish MGG as a practical tool for the diagnosis of MF.
Murat Durdu - One of the best experts on this subject based on the ideXlab platform.
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high accuracy of recognition of common forms of Folliculitis by dermoscopy an observational study
Journal of The American Academy of Dermatology, 2019Co-Authors: Murat Durdu, Enzo Errichetti, Ali Haydar Eskiocak, Macit IlkitAbstract:Background Clinical differentiation of Folliculitis types is challenging. Dermoscopy supports the recognition of Folliculitis etiology, but its diagnostic accuracy is not known. Objective To assess the diagnostic accuracy of dermoscopy for Folliculitis. Methods This observational study included patients (N = 240) with Folliculitis determined on the basis of clinical and dermoscopic assessments. A dermoscopic image of the most representative lesion was acquired for each patient. Etiology was determined on the basis of cytologic examination, culture, histologic examination, or manual hair removal (when ingrowing hair was detected) by dermatologist A. Dermoscopic images were evaluated according to predefined diagnostic criteria by dermatologist B, who was blinded to the clinical findings. Dermoscopic and definitive diagnoses were compared by dermatologist C. Results Of the 240 Folliculitis lesions examined, 90% were infections and 10% were noninfectious. Infectious Folliculitis was caused by parasites (n = 71), fungi (n = 81), bacteria (n = 57), or 7 viruses (n = 7). Noninfectious Folliculitis included pseudoFolliculitis (n = 14), Folliculitis decalvans (n = 7), and eosinophilic Folliculitis (n = 3). The overall accuracy of dermoscopy was 73.7%. Dermoscopy showed good diagnostic accuracy for Demodex (88.1%), scabietic (89.7%), and dermatophytic Folliculitis (100%), as well as for pseudoFolliculitis (92.8%). Limitations The diagnostic value of dermoscopy was calculated only for common Folliculitis. Diagnostic reliability could not be calculated. Conclusion Dermoscopy is a useful tool for assisting in the diagnosis of some forms of Folliculitis.
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Clinical and Laboratory Features of Six Cases of Candida and Dermatophyte Folliculitis and a Review of Published Studies
Mycopathologia, 2016Co-Authors: Murat Durdu, Mümtaz Güran, Macit Ilkit, Hazal Kandemir, Seyedmojtaba SeyedmousaviAbstract:Although some studies have investigated the epidemiological characteristics of Malassezia Folliculitis (MF), little is known about the clinical features and laboratory characteristics of Folliculitis caused by other fungi. In this prospective study, 158 patients with Folliculitis were identified, and cytological and mycological examinations were performed. The positive fungal cultures were confirmed using conventional methods, ITS sequencing and HWP1 analysis. Additionally, an in vitro antifungal susceptibility test was performed. Of 158 patients with Folliculitis, 65 (41.1 %) were found to have fungal Folliculitis. The most common (90.8 %) fungal Folliculitis was MF. Non-MF fungal Folliculitis was detected in 6 (9.2 %) patients. Four patients were diagnosed with dermatophytic Folliculitis ( Trichophyton rubrum in three patients and Arthroderma vanbreuseghemii in one patient), and two patients were diagnosed with Candida albicans Folliculitis. Although only 5 of the 6 samples were found to be positive via a potassium hydroxide test, all May–Grünwald–Giemsa-stained samples were positive. Both of the C . albicans isolates demonstrated a susceptibility profile to itraconazole, and all four dermatophytes were susceptible to terbinafine. All six patients completely recovered with systemic and topical treatment. This study revealed that dermatophytes and C. albicans are the primary causative agents of non- Malassezia fungal Folliculitis. We compared our findings with published reports on fungal Folliculitis.
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first step in the differential diagnosis of Folliculitis cytology
Critical Reviews in Microbiology, 2013Co-Authors: Murat Durdu, Macit IlkitAbstract:Folliculitis is a superficial inflammation of the hair follicles, and can be observed in individuals of any age or race. The incidence of Folliculitis is unknown because most patients only consult a doctor in cases of increasing lesions. There are various infectious and non-infectious causes of Folliculitis, and the most common causative agent is Staphylococcus aureus. In addition, several Gram-negative bacterial, fungal, parasitic, and viral pathogens can cause follicular papules and pustules. In routine practice, however, these lesions are usually thought to be bacterial. Therefore, topical and/or systemic antibacterial treatment is recommended, but this involves the risk of being misused for months or even years. Cytology, a simple, rapid, inexpensive, and repeatable diagnostic method, can reveal various bacterial, fungal, viral, and parasitic pathogens. This review discusses the use of clinical sampling and staining of cytologic samples for the differential diagnosis of Folliculitis, cytologic findings, and the frequency with which dermatologists use cytology to diagnose Folliculitis, particularly in the age of molecular biology and more expensive, sophisticated investigations.
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Epidemiological characteristics of Malassezia Folliculitis and use of the May-Grünwald-Giemsa stain to diagnose the infection.
Diagnostic Microbiology and Infectious Disease, 2013Co-Authors: Murat Durdu, Mümtaz Güran, Macit IlkitAbstract:Various bacterial, fungal, parasitic, and viral pathogens can cause Folliculitis, which is often mistakenly treated with antibiotics for months or even years. A laboratory diagnosis is required before therapy can be planned. Here, we describe the prevalence and risk factors, as well as the clinical, cytological, and mycological characteristics, of patients with Malassezia Folliculitis (MF) in Adana, Turkey. We also report the treatment responses of the MF patients and describe the Malassezia spp. using culture-based molecular methods. Cytological examinations were performed in 264 Folliculitis patients, 49 of whom (18.5%) were diagnosed with MF. The positivity of the May-Grunwald-Giemsa (MGG) smear was higher (100%) than that of the potassium hydroxide test (81.6%). Using Wood's light, yellow-green fluorescence was observed in 66.7% of the MF patients. Identification using the rDNA internal transcribed spacer region revealed that Malassezia globosa was the most common species, followed by Malassezia sympodialis, Malassezia restricta, and Malassezia furfur. The MF patients were treated with itraconazole capsules (200 mg/d) for 2 weeks. Complete recovery was observed in 79.6% of the patients. These novel findings help improve our current understanding of the epidemiological characteristics of MF and establish MGG as a practical tool for the diagnosis of MF.
Karen Wiss - One of the best experts on this subject based on the ideXlab platform.
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Pityrosporum Folliculitis: A retrospective review of 110 cases
Journal of the American Academy of Dermatology, 2017Co-Authors: Brea Prindaville, Leah Belazarian, Nikki A. Levin, Karen WissAbstract:Background Pityrosporum Folliculitis is an under-recognized eruption of the face and upper portion of the trunk that may be confused with, or occur simultaneously with, acne vulgaris. Objective We sought to characterize risk factors for Pityrosporum Folliculitis, its clinical presentation, and its response to treatment. Methods A retrospective chart review was performed on all patients age 0 to 21 years seen at our facility from 2010 to 2015 with Pityrosporum Folliculitis confirmed by a potassium hydroxide preparation. Results Of 110 qualifying patients, more than 75% had acne that had recently been treated with antibiotics, and when recorded, 65% reported pruritus. Clinical examination demonstrated numerous 1- to 2-mm monomorphic papules and pustules that were typically on the forehead extending into the hairline and on the upper portion of the back. The most common treatment was ketoconazole shampoo, which led to improvement or resolution in most cases. Some patients required oral azole antifungals. Limitations This study was retrospective and relied on providers describing and interpreting the clinical findings and potassium hydroxide preparations. No standard grading system was used. Conclusion Unlike classic acne vulgaris, Pityrosporum Folliculitis was more common after antibiotic use. It presented as fine monomorphic, pruritic papules and pustules along the hairline and on the upper portion of the back, and it improved with topical or oral azole antifungal therapy.
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Pityrosporum Folliculitis: diagnosis and management in 6 female adolescents with acne vulgaris.
Archives of pediatrics & adolescent medicine, 2005Co-Authors: Katherine Ayers, Susan M. Sweeney, Karen WissAbstract:Background Pityrosporum Folliculitis is a common inflammatory skin disorder that may mimic acne vulgaris. Some adolescents with recalcitrant follicular pustules or papules may have acne and Pityrosporum Folliculitis simultaneously. Clinical response is dependent on treating both conditions. Objectives To demonstrate the similarity in clinical manifestation between acne vulgaris and Pityrosporum Folliculitis, the benefit of potassium hydroxide preparation, and the benefit of appropriate antifungal therapy. Patients We describe 6 female adolescents with concurrent Pityrosporum Folliculitis infection and acne vulgaris. Intervention A potassium hydroxide examination was performed on all 6 patients from the exudate of follicular pustules exhibiting spores consistent with yeast. All patients were treated with oral antifungals, and 5 of the 6 patients were also treated with topical antifungals. Results Six of 6 patients improved with antifungal treatment. All patients also required some ongoing therapy for their acne. Conclusions These patients demonstrate that follicular papulopustular inflammation of the face, back, and chest may be due to a combination of acne vulgaris and Pityrosporum Folliculitis, a common yet less frequently identified disorder. Symptoms often wax and wane depending on the patient’s activities, time of the year, current treatment regimens, and other factors. Pityrosporum Folliculitis will often worsen with traditional acne therapy and dramatically respond to antifungal therapy.
Kenji Kabashima - One of the best experts on this subject based on the ideXlab platform.
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human polyomavirus 6 detected in cases of eosinophilic pustular Folliculitis
The Journal of Infectious Diseases, 2021Co-Authors: Yumiko Hashida, Tomonori Higuchi, Saeko Nakajima, Kimiko Nakajima, Takako Ujihara, Kenji Kabashima, Shigetoshi Sano, Masanori DaibataAbstract:BACKGROUND Human polyomaviruses (HPyVs) have been associated with several cutaneous inflammatory conditions. More investigation is needed to identify further presentations of cutaneous pathology associated with HPyVs. Our aim was to investigate the possible association of skin-tropic HPyVs with Folliculitis, particularly eosinophilic pustular Folliculitis (EPF). METHODS This study included 55 Japanese patients, comprising 13 patients with EPF and 42 patients with suppurative Folliculitis. HPyV DNAs were detected by quantitative polymerase chain reaction. Expression of viral antigen and geographically related viral genotypes were also assessed. RESULTS Human polyomavirus 6 (HPyV6) DNA was found in 9 of 13 (69%) patients with EPF, a rate significantly higher than that found in suppurative Folliculitis (1/42; 2%). Of the 7 HPyV6 DNA-positive EPF specimens analyzed, 4 were positive for HPyV6 small tumor antigen. All the HPyV6 strains detected in this study were of the Asian/Japanese genotype. CONCLUSIONS The predominant detection of HPyV6 DNA and the expression of viral antigen suggest a possible association between HPyV6 infection and EPF in a subset of patients. Worldwide studies are warranted to determine whether Asian/Japanese genotype HPyV6 is associated preferentially with the incidence and pathogenesis of this eosinophil-related skin disease that has an ethnic predilection for the East Asian population.
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Human Polyomavirus 6 Detected in Cases of Eosinophilic Pustular Folliculitis.
The Journal of infectious diseases, 2020Co-Authors: Yumiko Hashida, Tomonori Higuchi, Saeko Nakajima, Kimiko Nakajima, Takako Ujihara, Kenji Kabashima, Shigetoshi Sano, Masanori DaibataAbstract:BACKGROUND Human polyomaviruses (HPyVs) have been associated with several cutaneous inflammatory conditions. More investigation is needed to identify further presentations of cutaneous pathology associated with HPyVs. Our aim was to investigate the possible association of skin-tropic HPyVs with Folliculitis, particularly eosinophilic pustular Folliculitis (EPF). METHODS This study included 55 Japanese patients, comprising 13 patients with EPF and 42 patients with suppurative Folliculitis. HPyV DNAs were detected by quantitative polymerase chain reaction. Expression of viral antigen and geographically related viral genotypes were also assessed. RESULTS Human polyomavirus 6 (HPyV6) DNA was found in nine of 13 (69%) patients with EPF, a rate significantly higher than that found in suppurative Folliculitis (1/42; 2%). Of the seven HPyV6 DNA-positive EPF specimens analyzed, four were positive for HPyV6 small T-antigen. All the HPyV6 strains detected in this study were of the Asian/Japanese genotype. CONCLUSIONS The predominant detection of HPyV6 DNA and the expression of viral antigen suggest a possible association between HPyV6 infection and EPF in a subset of patients. Worldwide studies are warranted to determine whether Asian/Japanese genotype HPyV6 is associated preferentially with the incidence and pathogenesis of this eosinophil-related skin disease that has an ethnic predilection for the East Asian population.
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therapeutic effectiveness of various treatments for eosinophilic pustular Folliculitis
Acta Dermato-venereologica, 2009Co-Authors: Shoko Fukamachi, Kenji Kabashima, Kazunari Sugita, Miwa Kobayashi, Y TokuraAbstract:Eosinophilic pustular Folliculitis is a rare dermatosis. Recently, in addition to oral indomethacin, other treatments have been applied for eosinophilic pustular Folliculitis. The aim of this study was to assess the effectiveness of various therapies encompassing conventional to newly applied drugs for eosinophilic pustular Folliculitis. Twenty patients with eosinophilic pustular Folliculitis seen in our department were investigated. The effectiveness of each treatment was assessed by a severity score index. Eleven patients were treated with oral indomethacin, and the severity scores of all patients were decreased after the treatment. Oral cyclosporine was markedly effective in all 11 patients treated, and topical tacrolimus ointment alleviated eosinophilic pustular Folliculitis in 3 of 7 with one patient showing a remarkable reduction in the severity score. In addition to indomethacin or other oral non-steroidal anti-inflammatory drugs, oral cyclosporine and topical tacrolimus may be beneficial choices when patients have been resistant to previous treatments.
Jennifer M Mcniff - One of the best experts on this subject based on the ideXlab platform.
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expanding the histologic findings in smallpox related post vaccinial non viral Folliculitis
Journal of Cutaneous Pathology, 2013Co-Authors: Christopher G Bunick, Kavita Mariwalla, Omer Ibrahim, Badri Modi, Suguru Imaeda, Jennifer M McniffAbstract:Post-vaccinial non-viral Folliculitis has been recognized in the past decade as a new adverse cutaneous reaction to smallpox vaccination. Contrary to more serious smallpox vaccine reactions, post-vaccinial non-viral Folliculitis has a benign course and resolves spontaneously within approximately 7 days. We describe additional histopathologic findings associated with post-vaccinial non-viral Folliculitis, which has only been described once previously. New findings include the presence of a neutrophilic or lymphohistiocytic infiltrate that is concentrated around the hair follicles. We compare our findings to the follicular nature of varicella and herpes zoster infections, generating the hypothesis of deposition of vaccinia protein within folliculosebaceous units as a potential pathophysiologic mechanism behind post-vaccinial non-viral Folliculitis.
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A case of recurrent pseudolymphomatous Folliculitis: A mimic of cutaneous lymphoma
Journal of the American Academy of Dermatology, 2009Co-Authors: Eun Ji Kwon, Arni Kristjansson, Howard J. Meyerson, Gregory M. Fedele, Rebecca C. Tung, Klaus Sellheyer, Ralph J. Tuthill, Kord Honda, Anita C. Gilliam, Jennifer M McniffAbstract:Pseudolymphomatous Folliculitis is a rare entity. We present a 62-year-old man with a recurrent solitary nodule on his nose requiring multiple excisions. Microscopic examination of the excisions showed a dense lymphocytic infiltrate containing numerous histiocytes and S100 + , CD1a + dendritic cells that surrounded and infiltrated hypertrophic hair follicles. Diffuse sheets of CD3 + T cells and nodular clusters of CD20 + B cells were also seen. There was normal reactive pattern of follicular centers. Light chain restriction was not detected. T-cell receptor and immunoglobulin heavy chain gene rearrangements by polymerase chain reaction revealed negative findings. A diagnosis of pseudolymphomatous Folliculitis was made based on the hypertrophic hair follicles, periadnexal S100 + and CD1a + dendritic cells, and negative clonal gene rearrangement study findings. This case of recurrent pseudolymphomatous Folliculitis is instructive because of the resemblance to cutaneous lymphomas and cutaneous lymphoid hyperplasias, and the need for correct diagnosis to avoid overtreatment of this indolent condition.