Publication:

Clinico-etiological profile and antibiotic sensitivity pattern of chronic folliculitis: a common but less focussed disease of tropics

Background Chronic folliculitis (CF), a common disease of the tropics caused by Staphylococcus aureus (SA) is a less focussed therapeutic area.

Methods We estimated the prevalence of CF, clinical types, seasonal variation through this prospective observational study and carried out routine laboratory investigations, gram stain, KOH mounting, Tzanck smear, and culture and sensitivity (C&S).

Results Of 50 patients (prevalence 1.2%), 44 were men. Mean age was 36.5 years (range 18-55 years). Patients were from lower socioeconomic class (7%), comprised of unskilled (82%) workers, and presented with pustules (6%) and pruritis (18%). Dermatitis cruris pustulosa et atrophicans (78%) and folliculitis barbaetraumatics (6%), lesions on the lower limbs (74%), and beard area in men (18%), human immunodeficiency virus infection (8%) and diabetes mellitus (4%) were common observations. Shorter duration (6-8 months) was reported in more number of women (4/6,) while men (35/44) had a long-standing disease (8 months-2 years). Six had a duration of >2 years. Summer aggravated the symptoms (90%). Contact with soil, cow dung, intake of animal protein, excess alcohol, excessive sweating were the precipitating factors. Culture positive coagulase negative SA (98.0%) was the most common isolate. Organisms were sensitive to ceftriaxone (9%), cepholathin (7%) and resistant to penicillins (68%); there was no resistance against gatifloxacin, imipenam, vancomycin, and teicoplanin. Twenty seven patients had a complete cure.

Conclusions CF is a recurrent condition with seasonal variation, predominantly involves legs, and affects adult labourers. Avoiding aggravating factors (trauma) is helpful in achieving the treatment goal and minimising recurrence. Prescription of Antibiotics should be considered after testing for C&S.