Perifolliculitis capitis

Perifolliculitis capitis is a type of hair follicle inflammation that affects the scalp. It is also known as perifolliculitis of the scalp or perifolliculitis capitis abscedens et sufficient, is a rare form of acne-like inflammatory skin disease that affects the hair follicles of the scalp. It is characterized by the formation of pimple-like bumps, nodules, or abscesses around hair follicles. These eruptions can cause pain, itching, and scarring, and may result in permanent hair loss. This condition is usually caused by a bacterial infection, but can also occur as a result of underlying skin conditions like acne, or an autoimmune disorder. Treatment for perifolliculitis capitis may involve antibiotics, topical creams, and in severe cases, surgery.

Causes

The exact cause of perifolliculitis capitis is unknown, but several factors are believed to contribute to its development:

  1. Genetics: There is some evidence to suggest that perifolliculitis capitis may have a genetic component. Some individuals may have a genetic predisposition to the disease, which makes them more susceptible to its development.
  2. Hormonal Imbalances: Hormonal imbalances, particularly an increase in androgen levels, have been linked to the development of perifolliculitis capitis.
  3. Bacterial Infections: Bacterial infections, such as Propionibacterium acnes and Staphylococcus aureus, can cause an inflammatory response in the hair follicles and lead to perifolliculitis capitis.
  4. Immune System Disorders: Individuals with weakened immune systems may be more prone to developing perifolliculitis capitis.
  5. Trauma: Physical trauma to the scalp, such as hair plucking or tight braids, can lead to perifolliculitis capitis by causing irritation and inflammation of the hair follicles.
  6. Environmental Factors: Exposure to harsh chemicals and pollutants can also contribute to the development of perifolliculitis capitis by damaging the hair follicles and causing an inflammatory response.
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It is important to note that perifolliculitis capitis is a complex disease, and the exact cause may vary from person to person. In some cases, multiple factors may contribute to its development.

Symptoms

The main symptoms of perifolliculitis capitis include:

  1. Inflammation: This condition is characterized by inflammation and swelling around the hair follicles, causing redness and pain.
  2. Bumps and pimple-like formations: Perifolliculitis capitis may cause the formation of small bumps and pimple-like formations around the hair follicles.
  3. Scalp tenderness: The affected area of the scalp may be tender to the touch, and people may experience discomfort or pain when combing their hair.
  4. Scarring: In severe cases, the inflammation and infections associated with perifolliculitis capitis may cause scarring, leading to permanent hair loss.
  5. Drainage of pus: The bumps or pimple-like formations may become infected and start to drain pus, which can be accompanied by a foul odor.

These symptoms can vary in severity, and some people may experience more severe symptoms than others. If you suspect you have perifolliculitis capitis, it is important to see a doctor for a proper diagnosis and treatment plan.

Diagnosis

Diagnosis of perifolliculitis capitis is primarily based on physical examination, where the dermatologist would look for the characteristic signs and symptoms of the condition.

Some tests that may be done to confirm the diagnosis and rule out other potential causes of the symptoms include:

  1. Skin biopsy: A small sample of affected skin is taken for analysis under a microscope.
  2. Blood tests: To check for underlying medical conditions that may be contributing to the symptoms.
  3. Culture tests: To rule out a bacterial or fungal infection.
  4. KOH test: To examine the skin under a microscope to identify any fungal elements.
  5. Hair pluck test: A sample of hairs is taken from the affected area for examination under a microscope.
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Overall, the diagnosis of perifolliculitis capitis is usually straightforward, but a thorough evaluation and testing may be needed to exclude other potential causes of the symptoms.

Treatment

The main goal of treatment is to reduce inflammation and prevent scarring.

Here are the main treatments for perifolliculitis capitis:

  1. Antibiotics: Antibiotics such as minocycline and doxycycline can be prescribed to reduce the bacteria that causes inflammation and prevent scarring.
  2. Topical Steroids: Topical corticosteroids can be used to reduce inflammation and provide relief from pain and itching.
  3. Isotretinoin: This is a type of oral medication that is used to reduce oil production in the skin and help to resolve the underlying causes of perifolliculitis capitis.
  4. Surgical Excision: In severe cases, surgical excision may be necessary to remove scar tissue and provide relief from the symptoms.
  5. Other Therapies: Other therapies such as phototherapy, cryotherapy, and laser therapy can also be used to treat perifolliculitis capitis.

It is important to work with a dermatologist to determine the most appropriate treatment plan for perifolliculitis capitis. It is also important to follow a healthy lifestyle, maintain good hygiene, and avoid irritants to prevent the condition from reoccurring.

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References