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Year : 1997  |  Volume : 63  |  Issue : 5  |  Page : 304-306

Chronic folliculitis - A clinico-epidemiological study

Correspondence Address:
PVS Prasad

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Source of Support: None, Conflict of Interest: None

PMID: 20944361

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50 male patients, diagnosed to have chronic folliculitis of legs (CFL), were included in a clinico epidemiological study. CFL affected predominantly young adults of the age group of 16 - 25 years. Severe pruritus was associated in 86% of patients with CFL, and this symptom preceded the onset of new lesions. Follicular papules were seen more often than pustules in 58% of patients. Staphylococcus aureus was isolated in 72.5%. The lesions were confined to both legs in 50%, extending upto thigh in 28% and in legs, thighs and forearms in 10% of individuals studied.

Keywords: Folliculitis, Pyoderma, Chronic folliculitis legs

How to cite this article:
Prasad P, Anandhi V, Jaya M. Chronic folliculitis - A clinico-epidemiological study. Indian J Dermatol Venereol Leprol 1997;63:304-6

How to cite this URL:
Prasad P, Anandhi V, Jaya M. Chronic folliculitis - A clinico-epidemiological study. Indian J Dermatol Venereol Leprol [serial online] 1997 [cited 2020 May 31];63:304-6. Available from: http://www.ijdvl.com/text.asp?1997/63/5/304/4600

  Introduction Top

Chronic folliculitis of legs (CFL) is a chronic infection of hair follicles predominantly seen on the legs. This is a common condition among Asians and Africans, especially young adult males in India.[1] In this, the inflammatory changes are confined to the ostium or slightly below it and heals without scar formation. Apart from coagulase positive Staphylococcus aureus, physical or chemical injury may also precipitate this condition. It involves the legs, thighs, forearms and arms. Combination therapy with antiseptic lotions, long term systemic antibiotics, topical antibiotics and avoidance of risk factors are essential in controlling the disease. [2,3]

  Materials and Methods Top

Fifty consecutive male patients with chronic folliculitis were included in the study. All relevant demographic factors were entered in a proforma. The type, number of lesions, sites affected were all noted down. Baseline investigations and liver function tests were done in all patients to rule out tuberculosis and jaundice. Pus from the lesions was collected for bacteriological culture and sensitivity, wherever possible. The patients wee followed up at regular intervals and precipitating factors if any were noted.

  Results Top

Forty-eight percent of the patients belonged to the younger age group i.e., 16-25 years. Majority (46%) attended the clinic within one year of the onset of the disease, whereas 4% were found to have the disease for more than 10 years. Majority (86%) of cases presented with a mixture of papules and pustules, whereas 12% patients had only papules and one patient had only pustules. Pruritus was the predominant symptom in 86% of patients. The other symptoms observed were severe burning sensation (28%), pain (4%) and oozing, bleeding and scaling in one each. The other associated diseases were vitiligo (2%), Hansen's disease (4%) and psoriasis (2%).

Forty-four percent of the patients were agricultural labourers and 28% were students. The rest of the group belonged to various other occupations.

The skin lesions were found confined to both legs in 50% of the patients. In 28%, the lesions were seen extending to the thighs also. In 10% they were seen on legs, thighs and forearms in addition. In 6%, the lesions were confined only to forearms. On the contrary, one had very extensive lesions on legs, thighs, forearms and arms.

Loss of hair following resolution of lesions was the predominant sign in 80% of patients. 34% also had mild atrophy of skin and 6% showed eczematous changes. Pus culture was done in 40 patients. Staphylococcus aureus was the commonest organism isolated from the lesions in 72.5% (29), whereas pseudomonas was seen n 7.5% (3) and klebsiella in 2.5% (1). The pus was sterile in the remaining.

  Discussion Top

Chronic folliculitis of the legs (CPL) predominantly affects the age group of 15-30 years.[1-4] Most of the patients in this age group were farmers, thus explaining the fact they are more prone for minor injuries and aberrations of the skin, paving way to the entry of the micro organisms. Severe pruritus was the symptom in 86% of patients. This conforms to the similar findings from Srilanka.[5] Pruritus persisted even after complete resolution of lesions and preceded the onset of new lesions. Thus pruritus could be a marker of relapse of folliculitis. Loss of hair, and atrophy of the skin were seen in some of our patients and were also observed earlier. [4,5] Bacteriological study revealed that the etiology in the majority was due to Staphylococcus aureus but pseudomonas and klebsiella could also be involved as the primary pathogens.[5]

Though our patients hail from coastal villages, there were only 3 fishermen in the study group. The finding is in contrast to the observations made earlier.[6]

  References Top

1.Highest AS, Hay RJ, Roberts SOB. Bacterial infections, in: Textbook of Dermatology, 5th ed, Editors, Champion RH, Burton JL Ebling FJG, Blackwell Scientific Publications, London, 1992; 973-974.  Back to cited text no. 1    
2.Shenoy K, Srinivas C R, Sharma S, et al. Efficacy of cotrimoxazole and PUVA for the management of chronic folliculitis of legs. Ind J Dermatol Venereol Leprol 1990;56:223-225.  Back to cited text no. 2    
3.Srinivas C R, Shenoy K. Control of chronic folliculitis of legs with PUVASOL and cotrimoxazole. Ind J Dermatol Venereol Leprol 1987;53:43-45  Back to cited text no. 3    
4.Sugathan P, Zacariah J, Joy MI. Folliculitis cruris pustulosa et atrophicans. Ind J Dermatol Venereol Leprol 1973;39:35  Back to cited text no. 4    
5.Kumarasinghe SPW, Kumarasinghe M P. Chronic folliculitis in Srilanka, Proceedings of the VII International Congress of Dermatology, New Delhi, India, 1994  Back to cited text no. 5    
6.Nair L V, Nandakumar G. Epilating folliculitis in fisherman. Ind J Dermatol Venereol Leprol, 1990;56:402-403.  Back to cited text no. 6    


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