By Gary M. White, MD
Folliculitis of the trunk is usually acneiform in appearance and may indeed just be acne.
- Many patients area young adults that work out/sweat significantly.
- Predisposing factors include applying heavy creams and much sweating.
One should also consider pityrosporum and staphylococcus as infectious causes. See folliculitis.
Multiple red inflammatory papules and occasional pustules are scattered on the trunk.
- Culture a pustule.
- No moisturizers.
- Shower off immediately after any workout/sweating.
- Benzoyl peroxide wash or antibacterial soap
- Clindamycin topically.
- A month-long course of an oral antibiotic e.g. doxycycline 100 mg BID.
- Trial of itraconazole 100 mg/day x 10 days to exclude pityrosporum folliculitis.
If possible, culture a pustule and treat accordingly. If the culture is sterile, consider acne (e.g., doxycycline 100 mg BID or minocycline 100 BID x 6 weeks) or pityrosporum folliculitis (10 day course of itraconazole 100 mg/day).
If these fail, a course of isotretinoin may be needed.
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