Diagnosis
The diagnosis of folliculitis is typically a gaze diagnosis for the doctor. The doctor is presented with small inflamed areas of skin with centrally growing hair and possibly visible pus. If the diagnosis is not so obvious and easy to make or if folliculitis occurs repeatedly, systemic diseases such as diabetes mellitus or an immune deficiency should be excluded as a cause of folliculitis.
Sometimes it is difficult to make a diagnosis because folliculitis does not necessarily present itself with the classic symptoms, but shows some additional symptoms such as scarred healing. In some cases, a test biopsy of the affected area may be useful. In this case a small area of skin is taken and finally histologically examined.
Folliculitis capitis
Folliculitis can also occur on the scalp.This is then medically called folliculitis capitis. Folliculitis capitis is also described as Pyoderma fistulans significa or as an atrophying disease with tufted hairs. In contrast to general folliculitis, it is a comparatively rare disease.
Folliculitis of the scalp occurs almost exclusively in men. A characteristic feature of folliculitis of the scalp is the formation of a ganglion in the course of an inflammation of the hair follicles. Such ducts are also called fistulas.
A frequent occurrence of hair folliculitis is observed in the context of acne diseases. There could therefore be a connection with increased sebum production, which could be a triggering factor. Folliculitis of the scalp is also associated with the formation of small pustules and papules, which are usually painless.
Typical for this disease are the small corridors below the scalp that form during the course of the disease and connect the individual inflamed areas. Unfortunately, the healing process is accompanied by the formation of scars, from which the name atrophic disease is derived. The scars form bridges between the individual sites of inflammation, often in the course of the fistula ducts. At these sites the hair follicles perish and hairless areas are formed. It is important to distinguish folliculitis capitis from folliculitis declavans, as it represents a different clinical picture.
