Ann Dermatol Venereol 2017 Nov 2;144(11):666-675. Epub 2017 Aug 2.

Service de dermatologie, hôpital d'instruction des armées Sainte-Anne, 83800 Toulon, France. Electronic address:

Pseudomonas aeruginosa, a ubiquitous Gram-negative bacillus characterized by its greenish color and sweetish smell, is at the origin of potentially severe forms of dermatosis, such as ecthyma gangrenosum which marks immunosuppression or reveals blood-poisoning, especially in children. It frequently colonizes chronic wounds and serious burns, and spongiotic or acantholytic dermatosis, especially when severe or localized in skinfolds. It requires special care because of its high resistance to antibiotics and antiseptics. Read More

Burns 2017 May 6;43(3):642-653. Epub 2017 Feb 6.

University Hospital of Santander, Universidad Industrial de Santander, Colombia. Electronic address:

Introduction: Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. Read More

J Pediatric Infect Dis Soc 2017 Mar;6(1):e1-e3

Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Massachusetts.

Aeromonas species are rarely an identified cause of folliculitis. Here, we describe the case of a patient who had purulent folliculitis of the breast caused by an Aeromonas species and review 4 other cases presented in the literature, highlighting the commonalities observed. Aeromonas infection should be considered in patients who present with purulent folliculitis, particularly those with exposure to nonchlorinated pools or baths. Read More

JAMA Dermatol 2016 07;152(7):768-75

Department of Dermatology, University of Missouri, Columbia.

Importance: Evidence supports use of teleconsultation for improving patient access to dermatology. However, little is known about the quality of rapidly expanding direct-to-consumer (DTC) telemedicine websites and smartphone apps diagnosing and treating skin disease.

Objective: To assess the performance of DTC teledermatology services. Read More

Dermatol Clin 2016 Apr;34(2):225-8

Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98 Street, 5th Floor, New York, NY 10029, USA.

Acne vulgaris (AV) is considered a straightforward diagnosis made clinically without specific diagnostic testing. However, certain disorders may simulate AV, such as multiple small epidermal cysts or deep milia, multiple osteoma cutis, multiple small adnexal neoplasms, and follicular and/or infections characterized by multiple small papules and/or pustules such as gram-positive folliculitis, gram-negative folliculitis, Malassezia folliculitis, keratosis pilaris, and flat warts. This can lead to an erroneous diagnosis and improper management. Read More

Skinmed 2015 1;13(6):488-90. Epub 2015 Dec 1.

Institute of Genomics and Integrative Biology, Sukhdev Vihar, New Delhi, India.

Pediatr Infect Dis J 2016 Jan;35(1):118-9

Department of Laboratory Medicine, University Hospitals LeuvenDepartment of Microbiology and Immunology, KU LeuvenMicrobiological Laboratory, MCH Leuven, Leuven, Belgium.

Vet Dermatol 2015 Aug 12;26(4):287-e64. Epub 2015 May 12.

Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC, 27607, USA.

Background: Bacteria of the Burkholderia cepacia complex (Bcc) are ubiquitous Gram-negative bacilli associated with fatal nosocomial infections in humans; multi-antibiotic resistance makes this organism a serious threat in hospital settings.

Objective: To describe the historical, clinicopathological and treatment characteristics of Bcc-associated deep skin infections in dogs.

Animals: Six dogs with skin infections in which skin bacterial cultures resulted in pure growth of Bcc. Read More

Infection 2015 Oct 29;43(5):595-7. Epub 2015 Jan 29.

Department of Pathophysiology and Transplantation, Institute for Treatment and Research Cà Granda Ospedale Maggiore Policlinico Foundation, Università degli Studi di Milano, Via Pace 9, 20122, Milan, Italy.

We report a case of severe Citrobacter koseri folliculitis of the face in a boy with acne. A 15-year-old boy affected by acne was admitted because of a rash located on the face. Dermatological examination revealed two large plaques, with numerous pustules, eschars and crusts, located bilaterally and symmetrically on the cheeks. Read More

Dermatol Ther (Heidelb) 2014 Dec 12;4(2):233-48. Epub 2014 Sep 12.

Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, 400051, India.

Introduction: Skin and soft tissue infections involve microbial invasion of the skin and underlying soft tissues and are estimated to affect 7-10% of hospitalized patients worldwide. Nadifloxacin, a topical fluoroquinolone, has been shown to be effective against aerobic Gram-negative, Gram-positive (including MRSA and coagulase-negative staphylococci), and anaerobic bacteria. However, there is paucity of data comparing efficacy and safety of 1% nadifloxacin with other anti-bacterials for skin infections in Indian patients. Read More

Dtsch Med Wochenschr 2014 Jul 1;139(28-29):1459-61. Epub 2014 Jul 1.

Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München.

History And Admission Findings: A 15-year-old boy presented with painful nodules on his palms and discrete pustules on the forearm. Two days earlier he had taken a bath in a new whirlpool.

Investigations: Bacteriological examination of the pustules revealed Pseudomonas aeruginosa. Read More

Dermatol Online J 2012 Dec 15;18(12):19. Epub 2012 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.

We present a unique case of S. marcescens folliculitis of the trunk in a 46-year-old woman with a history of facial acne vulgaris during her teen years. Her eruption occurred at the time of elective ambulatory surgery when she was treated with pre and post-operative antibiotics. Read More

Int J Dermatol 2012 Nov;51 Suppl 1:24-6, 27-9

The diagnosis of acne is usually easy, but there are some pitfalls to be avoided. 'Keloid acne of the neck' and beard folliculitis are not acnes in the usual sense: both are inflammatory and fibrous reactions of the hair follicles and frizzy hair; no retentional lesions, blackheads and microcysts--are visible. Gram negative folliculitis classically occurs in acneic male subjects who have undergone extensive treatment with general antibiotics or local antiseptics, but 'de novo' cases do exist. Read More

Practitioner 2012 Jun;256(1752):15-7, 2

Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, UK.

Acne vulgaris is an inflammatory disorder of the pilosebaceous (hair follicle) units. It may be exacerbated by stress, topical greasy preparations that encourage blockage of the pores, trauma and humid climates. Certain medications may induce or exacerbate acne, including some oral and implanted contraceptives, and anabolic steroids. Read More

Crit Rev Microbiol 2013 Feb 29;39(1):9-25. Epub 2012 May 29.

Başkent University, Department of Dermatology, Adana Hospital, Adana, Turkey.

Folliculitis is a superficial inflammation of the hair follicles, and can be observed in individuals of any age or race. The incidence of folliculitis is unknown because most patients only consult a doctor in cases of increasing lesions. There are various infectious and non-infectious causes of folliculitis, and the most common causative agent is Staphylococcus aureus. Read More

Indian J Dermatol Venereol Leprol 2010 Sep-Oct;76(5):476-88

Department of Dermatology, Venereology and Leprosy, SBMP Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India.

Bacterial skin infections in children vary widely clinically, starting from mild superficial folliculitis to deep necrotizing fasciitis. The causative organisms are mostly Staphylococcus aureus and Streptococcus, with occasional involvement of Gram-negative organisms. Treatment of even the milder forms of bacterial skin infections is of importance because of the long-term morbidity associated with them. Read More

Exp Dermatol 2010 Dec 18;19(12):1107-9. Epub 2010 Aug 18.

Lipopolysaccharide (LPS) from Gram-negative bacteria has been reported to exert inflammatory reactions in epidermis, dermis, and sebaceous glands. Here, we demonstrated that the intradermal administration of Escherichia coli-derived LPS, three times a week for 4 weeks, to hamster auricle skin did not influence sebaceous morphology or sebum accumulation in sebaceous glands but in fact induced epidermal thickness. In addition, the administration of LPS, once a day for 2 days, augmented the production of cyclooxygenase 2 (COX-2) in sebaceous glands. Read More

Arch Pediatr 2010 Sep 5;17(9):1373-9. Epub 2010 Aug 5.

Service de chirurgie plastique, reconstructrice et esthétique, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 05, France.

The cutaneous infectious pathology of the child is varied and frequent. Authors deal with surgical infections seen in current pediatrics, which often have to appeal to a plastic pediatric surgeon for their treatment. Superficial infections of skin and pilo-sebaceous follicles are common in big children. Read More

J Dtsch Dermatol Ges 2010 Mar;8 Suppl 1:S24-30

Bioskin GmbH, Bergmannstr. 5, 10961 Berlin und Klinik für Dermatologie und Allergologie, Charité, Berlin, Germany.

Benzoyl peroxide was introduced as a basic treatment already in acne therapy 1934. The mechanism of action is the reduction of anaerobe bacteria by strong oxidation processes. No resistancies have been ever reported. Read More

Vet Pathol 2010 Mar 28;47(2):214-9. Epub 2010 Jan 28.

Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT 06269, USA.

Two groups of vespertilionid bats were collected from affected hibernacula. In group 1 (n, 14; pathology and microbiology), the average body weights of all species were at the lower limit of published ranges. Twelve bats (86%) had mycotic growth in the epidermis, hair follicles, and sebaceous glands. Read More

Pediatr Dermatol 2009 Sep-Oct;26(5):601-3

Department of Dermatology, Hospital Sant Joan de Déu, Barcelona, Spain.

Aeromonas species are ubiquitous, facultative, anaerobic, gram-negative flagellated rods, mainly found in aquatic ecosystems worldwide. Skin and soft-tissue infections, including cellulitis and wound infections, are the second most frequent location of isolations of Aeromonas spp. in clinical samples, after the gastrointestinal tract. Read More

Arch Dermatol Res 2009 Oct 4;301(10):747-52. Epub 2009 Aug 4.

Department of Dermatology and Allergology, Ludwig-Maximilian-University, Munich, Germany.

In many skin diseases such as Demodex folliculitis, rosacea- or steroid-induced rosacea Demodex mites are present in abundance and are at least partially held responsible for causing these disorders. Although it is known that these diseases respond well to tetracyclines, it is unclear if this is due to the antiinflammatory effects of the antibiotics or to an antibacterial effect on so far unknown bacteria within the Demodex mites. As in filariasis, where the response to doxycycline can be explained by the presence of Wolbachia within the filarial nematodes, this study was performed to see whether Wolbachia also use Demodex mites as their hosts. Read More

Australas J Dermatol 2008 Feb;49(1):39-41

Department of Dermatology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.

A 34-year-old man presented with a pubic eruption of 4 weeks duration, affecting both himself and his partner. He had been treated unsuccessfully with intravenous and oral dicloxacillin. The eruption was a severely inflammatory folliculitis, with haemo-serous exudate and marked oedema. Read More

J Am Acad Dermatol 2007 Oct 19;57(4):596-600. Epub 2007 Jul 19.

Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA.

Pseudomonas aeruginosa is a ubiquitous gram-negative rod that can cause a well-recognized, acquired skin infection from bacterial colonization of contaminated water called "hot tub folliculitis." We report an outbreak of pseudomonas skin infection associated with the use of a hot tub at a pool party in 33 children. In particular, 2 of the children were admitted to our hospital; both presented with high leukocyte counts, intermittent low grade fevers, and painful, erythematous nodules and papules on their palms and soles. Read More

J Dtsch Dermatol Ges 2006 Apr;4(4):293-300

Department of Dermatology and Venereology, Technical University of Munich, Germany.

Benzoyl peroxide (BPO) was introduced in the treatment of acne in 1934. Despite the fact that only few randomized trials have been published, BPO is considered the standard in topical acne treatment. Anaerobic bacteria are reduced by oxidative mechanisms and the induction of resistant strains is reduced. Read More

J Drugs Dermatol 2005 Nov-Dec;4(6 Suppl):s9-14

Baylor College of Medicine, Houston, TX 77030-2725, USA.

Dermatologists treat a variety of uncomplicated skin and skin structure infections (uSSSIs) such as folliculitis, impetigo, erysipelas, cellulitis, furuncles, carbuncles, and non-perirectal abscesses. Most uSSSIs are caused by Staphylococcus aureus and Streptococcus pyogenes. The new extended-spectrum cephalosporins (cefdinir, cefpodoxime) offer efficacy against most Gram-positive and Gram-negative pathogens. Read More

J Long Term Eff Med Implants 2005 ;15(5):499-510

University of Virginia Health System, Charlottesville, Virginia, USA.

When considering common bacterial diseases of the skin, rather distinct clinical responses to a variety of bacterial infections have been identified. In these cases, it is the specific site of infection and the attendant inflammatory responses that provide the characteristic clinical picture. When the pyoderma extends just below the stratum corneum, it is called impetigo. Read More

Clin Exp Dermatol 2005 May;30(3):256-8

Service de Médecine Intenne, CHU Tenon Peor France.

Gram-negative folliculitis usually involves the face and develops in patients with acne or rosacea during long-term antibiotic therapy. Numerous pathogens have been found, but not, until now, Acinetobacter baumanii which has previously been recognized as an important cause of nosocomial infections and hospital outbreaks. We report here a case of A. Read More

Expert Opin Pharmacother 2003 Aug;4(8):1259-75

College of Pharmacy, University of Minnesota, Weaver-Densford Hall 7-115C, 308 Harvard Street SE, Minneapolis, MN 55455, USA.

Bacterial skin and skin structure infections (SSSIs) are among the most frequently seen infectious entities in the community setting and occasionally in the institutional setting. A wide variety of SSSIs exist, with cellulitis, impetigo and folliculitis being the most common. Most SSSIs are caused by aerobic staphylococci and streptococci, with aerobic Gram-negative bacilli and anaerobes being involved in more complicated infections. Read More

Am J Clin Dermatol 2003 ;4(5):307-14

National Skin Centre, Singapore.

Acne vulgaris is a very common disorder, affecting virtually every adolescent at some point in time. Systemic antibacterials have been used in the treatment of acne for many years, and there are several commonly used antibacterials which have established efficacy and safety records. In recent years, the issue of antibacterials resistance has become more prominent, especially with concerns that Propionibacterium acnes can transfer antibacterials resistance to other bacteria within the resident skin flora. Read More

Am J Clin Dermatol 2003 ;4(4):273-6

Department of Dermatology, University Hospital, Zürich, Switzerland.

Gram-negative folliculitis may be the result of long-term antibacterial treatment in acne patients. It is caused by bacterial interference and replacement of the Gram-positive flora of the facial skin and the mucous membranes of the nose and infestation with Gram-negative bacteria. These Gram-negative bacteria include Escherischia coli, Pseudomonas aeruginosa, Serratia marescens, Klebsiella and Proteus mirabilis. Read More

Am Fam Physician 2002 Jul;66(1):119-24

Utah Valley Family Practice Residency, Provo 84604, USA.

Family physicians frequently treat bacterial skin infections in the office and in the hospital. Common skin infections include cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles. Cellulitis is an infection of the dermis and subcutaneous tissue that has poorly demarcated borders and is usually caused by Streptococcus or Staphylococcus species. Read More

Cutis 2002 May;69(5):393-4

Department of Dermatology, Hospital Universitario de Canarias, University of La Laguna, Tenerife, Canary Islands, Spain.

Gram-negative folliculitis, an uncommon condition, is most often seen in older patients who have acne and who either have received prolonged courses of antibiotic therapy or have used antibacterial cleansers that selectively inhibit gram-positive organisms. Citrobacter infections are uncommon, and dermatologists seldom encounter them. In the past, these infections occurred in hospitals, particularly in neonatal intensive care units. Read More

J Investig Dermatol Symp Proc 2001 Dec;6(3):170-4

Department of Dermatology, University of California at San Francisco, USA.

The skin is a milieu for controlled bacterial growth. Skin supports the growth of commensal bacteria, which protect the host from pathogenic bacteria. Environmental and local factors, host immunity, and organism adherence and virulence are intricately related to cutaneous infection. Read More

Arch Dermatol 2000 Jun;136(6):803

Praxis (Bern 1994) 2000 Mar;89(14):566-70

Dermatologische Klinik, UniversitätsSpital Zürich.

Diseases of seborrhoic origin include rosacea, acne, gram-negative folliculitis, demodex-folliculorum, perioral dermatitis as well as seborrhoic dermatitis. An important prerequisite for adequate therapy is the knowledge of these different diseases. Unfortunately, topic steroids are often applied, resulting in well known corticosteroid side-effects like skin atrophy and teleangiectasias. Read More

Int J Dermatol 1999 Apr;38(4):270-4

Department of Dermatology, Ludwig-Maximilians-University, Munich, Germany.

Background: Gram-negative folliculitis is an infection with gram-negative rods that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne and rosacea.

Methods: The bacteriologic and immunologic findings are reported in 46 patients, 39 men and 7 women, aged 16-79 (median, 28) years, with gram-negative folliculitis. Hypersensitivity reactions to various microbial recall antigens as well as granulocyte functions were evaluated. Read More

Singapore Med J 1998 Aug;39(8):353-6

National Skin Centre, Singapore.

Background: Bacterial skin infections are common clinical problems encountered in most fields of clinical medicine. Staphylococcus aureus and group A streptococci are common invaders of eczematous, traumatised or immunocompromised skin. Advances in pharmacology have introduced a wide array of new antibiotics into the physician's armamentarium, but the rising incidence of bacterial resistance continues to be a problem. Read More

Dermatology 1998 ;196(1):102-7

Department of Dermatology, Ludwig Maximilians University of Munich, Germany.

Acneiform dermatoses are follicular eruptions. The initial lesion is inflammatory, usually a papule or pustule. Comedones are later secondary lesions, a sequel to encapsulation and healing of the primary abscess. Read More

Fortschr Med 1997 Feb;115(4):42-4

Klinik und Poliklinik der Univ., Klinikum Innenstadt, München.

Fortschr Med 1997 Jan;115(3):37-8

Klinik und Poliklinik der Univ, Klinikum Innenstadt, München.

Dermatology 1997 ;195 Suppl 1:34-7; discussion 38-40

Service de Dermatologie, Hôpital de l'Archet, Nice, France.

A consensus meeting was held in Brussels in 1995 to review current oral isotretinoin (Roaccutane/Accutane) treatment policies among internationally renowned experts and to improve service to needy patients by proposing treatment guidelines based upon a review of 1,000 acne patients who received this therapy. The group agreed that acne conditions warranting oral isotretinoin treatment include severe acne and poorly responsive acne which improves less than 50% after 6 months of therapy with combined oral and topical antibiotics. Furthermore, acne which relapses, scars or induces consequential psychological distress should be treated with oral isotretinoin. Read More

Am Fam Physician 1995 Feb;51(3):625-30

Mount Sinai Medical Center, New York, New York.

In recent years, especially with the advent of acquired immunodeficiency syndrome, new skin disorders associated with systemic disease have been described in the literature. Eosinophilic folliculitis and pruritic papules of human immunodeficiency virus (HIV) infection are clinically similar lesions that respond to phototherapy. Bacillary angiomatosis, another HIV-related skin disease that is caused by a pleomorphic gram-negative organism, resembles Kaposi's sarcoma clinically but is curable if treated early with antibiotics. Read More

J Clin Microbiol 1994 Feb;32(2):469-72

Clinical Microbiology Laboratories, Mount Sinai Hospital, New York, New York 10029.

Loofah sponges are natural products used as exfoliative beauty aids. As a consequence of tracing a case of Pseudomonas aeruginosa folliculitis to a contaminated loofah sponge, we assessed the role of loofah sponges in supporting the growth of a wide variety of bacterial species. Our data show growth enhancement of sterile loofah fragments for numerous gram-negative (Pseudomonas, Xanthomonas, and Klebsiella) and gram-positive (Enterococcus and group B Streptococcus) species of human and environmental origin. Read More

Ann Dermatol Venereol 1994 ;121 Suppl 1:1-155

In 1994 acne should be a very treatable disorder. However there are a significant number of patients who do not respond as well to therapy as they ought. Compliance is an important reason for poor response. Read More

Semin Dermatol 1993 Dec;12(4):336-41

Department of Microbial Diseases, St. John's Institute of Dermatology, St Thomas's Hospital, London, UK.

The gram-negative bacilli are a very diverse group of organisms with varied antimicrobial resistance patterns and degrees of pathogenicity. In consequence, it is difficult to make confident statements on appropriate therapies. Here the most common types of infections, or infecting organisms, are described together with reported successful therapies. Read More

Harefuah 1993 Feb;124(4):200-1, 247

Dermatology Dept., Soroka Medical Center of Kupat Holim, Beer Sheba.

Gram-negative folliculitis is one of the complications of antibiotic treatment of acne. Isotretinoin is recognized as extremely effective for this condition. We describe 2 patients with gram-negative folliculitis following antibiotic treatment for acne who improved after 3-months of treatment with isotretinoin. Read More

JAMA 1993 Jan;269(4):502-4

Student Health Center, University of Washington, Seattle.

Objective: To investigate an outbreak of gram-negative folliculitis in relation to a common exposure, mud wrestling, and identify risk factors for dermatitis among those who mud wrestled.

Design: Case-control study.

Setting: University of Washington, Seattle. Read More

MMWR CDC Surveill Summ 1991 Dec;40(3):1-21

For the 2-year period 1989-1990, 16 states reported 26 outbreaks due to water intended for drinking; an estimated total of 4,288 persons became ill in these outbreaks. Giardia lamblia was implicated as the etiologic agent for seven of the 12 outbreaks in which an agent was identified. The outbreaks of giardiasis were all associated with ingestion of unfiltered surface water or surface-influenced groundwater. Read More

Bol Asoc Med P R 1991 Apr;83(4):160-3

Infections Disease Program, University of Puerto Rico School of Medicine, San Juan Department of Veterans Affairs 00927-5800.

Pseudomonas aeruginosa is an opportunistic, gram negative bacillus that causes serious hospital acquired infections. However, it also causes infections with unusual presentations which are acquired in a non-hospital environment. This report will discuss the pathogenesis, clinical manifestations, and therapy of this uncommon infection, such as: 1) Pseudomonas folliculitis: a superficial or deep bacterial infection associated with the use of public hot tubs, whirlpools and swimming pools. Read More