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LETTER TO EDITOR
Year : 1998  |  Volume : 64  |  Issue : 4  |  Page : 207-208

Mupirocin in folliculitis cruris pustulosa et atrophicans




Correspondence Address:
Bhushan Kumar


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Source of Support: None, Conflict of Interest: None


PMID: 20921769

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How to cite this article:
Kumar B, Muralidhar S. Mupirocin in folliculitis cruris pustulosa et atrophicans. Indian J Dermatol Venereol Leprol 1998;64:207-8

How to cite this URL:
Kumar B, Muralidhar S. Mupirocin in folliculitis cruris pustulosa et atrophicans. Indian J Dermatol Venereol Leprol [serial online] 1998 [cited 2019 Dec 9];64:207-8. Available from: http://www.ijdvl.com/text.asp?1998/64/4/207/4698



  To The Editor, Top


Chronic folliculitis of the legs is known to dermatologists since many years and was referred to by different names including folliculitis decalvans, epilating folliculitis of glabrous skin etc.[1] This chronic folliculitis has been consistently shown to be due to Staphylococcus aureus. Different modalities including antiseptics, dyes,[1] tincture iodine,[2] cotrimoxazole, dapsone and PUVA therapy[3] have been used with varying results. Mupirocin is a new topical antibiotic reported to be as effective as systemic antibiotics, especially against Staphylococcus aureus.[4] Hence we tried topical mupirocin 2% ointment in the management of these patients.

Three patients with chronic folliculitis were treated. All three of them were young adults in the group of 20-30 years. Two of them had the disease for 3-4 years and the third patient had it for a long duration of 10 years. One was a gardener by occupation, second was a peon in an office and third patient was a manual labourer. None of them was involved in cutting sugarcane or fishing, the occupation which have been implicated as etiological factors.

Patients were advised to use topical mupirocin ointment twice daily after washing and were followed at weekly intervals. Response was impressive with 50% improvement in 7 days and complete clearing in 4 weeks. The first patient had no recurrence over 6 months follow up, whereas other patients have just completed the treatment one month back and are on follow-up.

Mupirocin, is an antibiotic with a unique mode of action. It acts as a competitive inhibitor of the enzyme isoleucyl transfer RNA synthetase and competes with the amino acid isoieucine for binding sites and thus inhibits protein synthesis. Its MIC against Staphylococcus aureus is 0.25 mcg/ml and it has a very low sensitizing potential and is devoid of serious side effects. Because of the unique mode of action, it is unlikely to lead to cross resistance with other systemically used antibiotics. In our experience mupirocin has been very effective in the treatment of folliculitis cruris pustulosa et atrophicans. A larger controlled trial is needed for assessing its full potential and a longer follow up to determine recurrences.



 
  References Top

1.Sugthan P, Zachariah J, Joy MI. Folliculitis cruris pustulosa et atrophicans. Indian J Dermatol Venereal Leprol 1973;39:35-40.  Back to cited text no. 1    
2.Harman RRM. Dermatitis cruris pustulosa et atrophicans. The Nigerian shin disease. Br J Dermatol 1968;80:97-107.  Back to cited text no. 2    
3.Shenoy K, Srinivas CR, Sharma S, et al. Efficacy of cotrimoxazole and PUVA for the management of chronic folliculitis of legs. Indian J Dermatol Venereol Leprol 1990;56:223-225.  Back to cited text no. 3    
4.Ferghani NEL. An open study of mupirocin in Libyan patients with skin infections. J Int Medical Res 1995;23:508-517.  Back to cited text no. 4    




 

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