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CASE REPORT
Year : 1992  |  Volume : 58  |  Issue : 2  |  Page : 118-119

Psuedofolliculitis vibrissa




Correspondence Address:
Sanjay Singh


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  Abstract 

Pseudofolliculitis vibrissa is a rare type of psuedofolliculitis. First author developed a painful, erythematous and tender papule due to re-entry of a recently cut hair in anterior naris. The symptoms and lesion vanished on dislodging the ingrown hair from its tunnel. The distal cut end of the hair was beveled and had a sharp spearlike tip. Close cutting of nasal hair may produce such hair and pseudofolliculitis.


Keywords: Pseudofolliculitis vibrissa


How to cite this article:
Singh S, Kaur V. Psuedofolliculitis vibrissa. Indian J Dermatol Venereol Leprol 1992;58:118-9

How to cite this URL:
Singh S, Kaur V. Psuedofolliculitis vibrissa. Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2019 May 26];58:118-9. Available from: http://www.ijdvl.com/text.asp?1992/58/2/118/3768



  Introduction Top


Sharp tip of obliquely cut hair becomes a spear ready to re-enter skin. Curly hair of negroes often go haywire in this way producing pseudofolliculitis. The condition, not confined to negroes, commonly localizes to beard and its mechanism has deserved vivid description. [1],[2] Pseudofolliculitis vibrissa [3] represents a rare variant. We report a case.


  Case Report Top


A painful papule, erythematous and tender, appeared in the anteromedial part of right anterior naris of first author aged 28 years. The next 2 days saw it gaining a diameter of 3 mm and the pain becoming severe. Finally, repeated applications over this period of 2% sodium fusidate ointment having failed in the face of an unyielding lesion, the author was forced to have a closer look at the problem. The lesion was not one of folliculitis. A hair, which was cut a few days ago, had run obliquely outwards exiting the follicular orifice at an acute angle only to tunnel in the lesion near its summit [Figure - 1].

The distal end of the hair was pulled out, with the help of a pin, of its ingenious tunnel. The external portion of the hair from exit to re-entry was about 2 mm and the re-entered part was about 1 mm in length. The pain and tenderness vanished within minutes of pulling out of the hair and so did the lesion in about a day. The hair was cut and looked at under microscope, its distal cut end was beveled and had a sharp spear-like tip.


  Comments Top


Hair is a symbol of beauty and youth. Too much or too little of it can cause problems, and a disoriented hair can produce pseudofolliculitis. The condition, also called pili incarnati, [1] deserves the name pseudofolliculitis not only because it is clinically confused with folliculitis; but also because in this a pseudofollicle [1],[2],[3],[4] forms as the ingrowing beveled hair tip proceeds into the dermis and epithelial cells downgrow and attempt to ensheathe it. If one uses a hand lens and remembers the morphology, the condition can be easily differentiated from folliculitis and perforating folliculitis of the nose; [2] confusion being more in designations than real.

Close cutting of nasal hair may produce pseudofolliculitis vibrissa, [3] because only short, stiff hair can re-enter the skin, the long ones simply bend. [2] As the hair enters the dermis a more severe inflammatory reaction develops along with the formation of an abscess within the pseudofollicle and a foreign body giant cell reaction at the tip of the invading hair. [4] Thus, as often held, [1] the formation of a pustule does not necessarily indicate secondary infection. As the downward penetration reaches a maximum depth of 2 to 3 mm, it exerts a tension on the external loop which acts like a spring to pull the ingrown tip out, a process invariably resulting in spontaneous involution of the disorder. [1],[2] Waiting for this happy ending will be very painful, so something needs to be done. Unlike pseudofolliculitis barbae where lifting-out of re-entrant hairs is tedious, [5] dislodging the ingrown hair should be the treatment of choice for pseudofolliculitis vibrissa(e) because often one or a few hairs are disorientated.

 
  References Top

1.Draper WS. Pseudofolliculitis barbae. In: Biology and diseases of the hair (Toda K, Ishibashi Y, Hori Y, et al, eds), Baltimore: University Park Press, 1976; 563-73.  Back to cited text no. 1    
2.Maibach HI, Aly R, Noble W. Bacterial infections of the skin. In: Dermatology (Moschella SL, Hurley HJ, eds), 2nd edn. Philadelphia: WB Saunders Company, 1985; 599-642.  Back to cited text no. 2    
3.White SW, Rodman OG. Pseudofolliculitis vibrissa. Arch Dermatol 1981; 117: 368-9.  Back to cited text no. 3  [PUBMED]  
4.Strauss JS, Kligman AM. Pseudofolliculitis of the beard. Arch Dermatol 1956; 74 : 533-42.  Back to cited text no. 4    
5.Roberts SOB, Highet AS. Bacterial infections. In: Textbook of Dermatology (Rook A, Wilkinson DS, Ebling FJG, et al, eds), 4th edn. Bombay: Oxford University Press, 1987; 725-90.  Back to cited text no. 5    


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