Fungal folliculitis

HIV Infection and Atopic Dermatitis

Published in Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld, Atopic Dermatitis and Eczematous Disorders, 2014

Adam Friedman, Donald Rudikoff, Francis Iacobellis

Dermatophyte infections may be exaggerated in HIV-seropositive patients and can sometimes be confused with atopic dermatitis. These may manifest as dry scaly patches extending from the buttocks (Fig 22.8), tinea pedis extending to the dorsa of the feet, or lichenified or prurigo nodularis lesions on the shins resulting from picking, scratching, and rubbing of fungal folliculitis (Majocchi granuloma). KOH examination, cultures, and biopsy will identify fungal hyphae.

Transfollicular elimination of sebaceous glands in a patient with disseminate and recurrent infundibulofolliculitis

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Journal Information

Published in Baylor University Medical Center Proceedings, 2021

Mahmud Alkul, Travis S. Dowdle, Jay Truitt, Michelle B. Tarbox

Differential diagnoses for DRIF include bacterial and fungal folliculitis, follicular eczema, keratosis pilaris, and truncal acne, among others.3 Although rare Pityrosporum yeast were demonstrated on biopsy, their presence in only some of the follicles make this diagnosis less likely. Follicular eczema is characterized by inflammatory infiltrate not limited to the infundibulum of the hair follicle.2 Keratosis pilaris is clinically significant for hyperkeratinization.2 Lesions may be differentiated from truncal acne vulgaris by histopathology revealing follicular dilation, increased sebum production, and accumulation of keratin.4 DRIF has been associated with other dermatologic conditions such as hidradenitis suppurativa, a chronic inflammatory disease of the pilosebaceous unit, especially in patients with trisomy 21.5

Fungal folliculitis

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HIV Infection and Atopic Dermatitis

Transfollicular elimination of sebaceous glands in a patient with disseminate and recurrent infundibulofolliculitis