00:01
In dermatology we'll take a look at those
that are infectious in nature.
00:05
Uh, there are a lot of repetition here with
microbiology as well as you can imagine.
00:12
We begin our topic by looking at
folliculitis.
00:14
And I want to make sure that by the time
we're completed with our discussion that
you're quite clear as to what is, what does
it mean to have folliculitis in a form called
carbuncle and abscess.
00:25
So on and so forth. First, think of a
follicular unit and that basically is going
to house your hair.
00:32
Right. So think about the hair that's coming
out of your skin.
00:35
And it's coming through a follicular unit.
00:37
So infection of the hair follicle is what
folliculitis is.
00:42
Usually refers to bacterial folliculitis.
00:44
Usually. So that's where you want to go with
this.
00:47
And it's continuum of furuncles, carbuncles
and abscesses.
00:55
You think of it as such from henceforth.
00:58
You'll be in good shape.
00:59
So say that you had an infection of the
follicular unit and it wasn't properly
managed. And at some point in time, you can
imagine that that infection is going to get
more severe.
01:10
And with the continuum, it's the furuncle,
carbuncle and an abscess formation on the
skin, which could then also include the
follicular unit.
01:19
Are we clear about the big picture of
folliculitis.
01:22
And if you take a look at the image that has
been provided, that I'm showing you
folliculitis where a hair follicle unit has
been infected.
01:34
The demographics can occur at any age group,
can involve terminal and vellus hairs.
01:40
Almost all cases are caused by staph aureus.
01:44
That's where your focus should be on.
01:46
Cases in the groin may be caused by what's
known as your gram-negative type of bacteria.
01:53
And degree of inflammation then dictates the
presentation.
01:57
The culture must be done so that you could
then look for your particular organism.
02:03
Management of folliculitis, oral antibiotics
such as dicloxacillin or cephalexin.
02:11
Consider culture for those that are
non-responding and 25% recurrence in all
comers anyway.
02:19
Incision and drainage for large fluctuant
lesions.
02:21
Imagine that now.
02:22
The folliculitis then goes on to become an
abscess and drainage is necessary.
02:27
Packing and marsupialization rarely
required.
02:32
So please do not choose this as being an
answer choice.
02:35
It would be a distractor when it comes to
folliculitis.
02:39
Differential diagnoses.
02:41
If it's acne vulgaris, remember that this
would be a condition that's taking place in
your pubertal age of population and anarchy.
02:50
Usually on the face and upper trunk only,
and the fact that you have comedones as being
a feature of acne and not of folliculitis.
02:58
And in folliculitis, you're focusing upon
the hair unit.
03:04
Another differential diagnosis here, it's
called prurigo nodule, which is more or less
a neurodermatitic type of excoriation, not
necessarily follicular-based.
03:15
And the fact that it's limited to those
areas that are reachable because here you're
thinking about this being a neurodermatitic
type of condition.
03:26
A differential diagnosis also known as your
prickly heat, and by that we mean miliaria
and with miliaria occlusion of your eccrine
sweat duct.
03:39
I'm not referring to malaria, but this is
miliaria.
03:42
Extravasation of sweat into your dermis with
inflammation and often in body folds and
areas in contact with the occlusion.