Treatment of gram-negative folliculitis in patients with acne.
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. The occurrence of Gram-negative folliculitis should be considered in acne patients in whom oral treatment with tetracyclines has not resulted in a significant improvement of acne lesions after 3-6 months' treatment. The occurrence of Gram-negative folliculitis in acne patients is believed to be generally underestimated, since correct sampling and bacteriology is rarely performed by clinicians. Gram-negative folliculitis in acne and rosacea patients is best treated with isotretinoin (0.5-1 mg/kg daily for 4-5 months).
Böni
Roland
R
Department of Dermatology, University Hospital, Zürich, Switzerland. rboeni@derm.unizh.ch
Nehrhoff
Brita
B
D003879:Dermatologic Agents / Q000627:therapeutic use*; D005499:Folliculitis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*
D003879:Dermatologic Agents; D015474:Isotretinoin