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Gram-Negative Folliculitis

Signs & Symptoms

 Premenstrual acne flare up
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 215]
Inflammatory Pustules
Note: perinasal skin and the central face
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]
Inflammatory papules
Note: perinasal skin and the central face
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]
Inflammatory Nodules
Note: perinasal skin and the central face
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]

Physical Examination

 Premenstrual acne flare up
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 215]
Flesh-colored facial papules (negative symptom)
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]
Small follicular papules on the extensor surfaces of the upper arms (negative symptom)
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]

Lab / Serology

 Gram-negative organisms in culture of lesions
Note: Enterobacter, Klebsiella, Pseudomonas, Proteus, or Escherichia species
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]
Hyperandrogenism
Note: Include increase 5-alpha-dihydrotestosterone (DHT) _ testosterone
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 217]
Increase 5-alpha-dihydrotestosterone
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 217]

Imagin Study

Complication

 Gram-negative folliculitis
Note: due to long-term systemic antibiotics
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]
Solid facial edema
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]

Risk Factors

 Active Smoking
Ref: Hbif [ 215]
Age between 13 and 22
Ref: Hbif [ 229]
Tobacco
Ref: Hbif [ 215]

Cause

 Stress
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 223]
Familial history of Acne
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris] Hbif [ 223]
Acne-inducing drugs
Note: Glucocorticoids .Phenytoin ,Lithium ,Isoniazid Epidermal growth factor, receptor inhibitors,Iodides Bromides...
Ref: Uptodate [ Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris]

Other