title: Phage typing in dermatitis cruris pustulosa et atrophicans: does staphylococcal carrier status have a role?
abstract: BACKGROUND
  Dermatitis cruris pustulosa et atrophicans (DCPA) is a form of chronic folliculitis of the legs with a multifactorial etiopathogenesis, seen primarily in tropical countries. Staphylococcus aureus has been isolated from the pustules in earlier studies, although the organisms isolated have not been further characterized.
  
  
  METHODS
  Patients with DCPA, who attended the Dermatology outpatient clinic at JIPMER, Pondicherry, India, during the study period (December 2006-June 2008) were included. Pus from the lesions as well as swabs from carrier sites (nares, axillae, and gluteal fold) were cultured. Staphylococcus aureus isolates were subjected to phage typing at the National Staphylococcal Phage Typing Center, Department of Microbiology, Maulana Azad Medical College, New Delhi, India.
  
  
  RESULTS
  Thirty-seven patients were included in the study. Pus from the folliculitic lesions grew S. aureus in 32 (86.49%) patients. Based on the comparison of antibiotic sensitivity patterns, isolates from pus and carrier sites were found to be similar in 15 patients. Phage typing established the organism to be identical in five of these patients.
  
  
  CONCLUSIONS
  Characterization of S. aureus in DCPA shows that there is no specific phage type that is uniformly responsible for the lesions in most patients. However, in view of the unclear etiology of this condition, the pathogenicity of a staphylococcal carrier state in individual patients needs to be addressed.
authors.affiliation: Department of Dermatology and STD (Former), Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Kaimal
authors.forename: Mariette
authors.initials: M
authors.lastname: D'Souza
authors.forename: Sujatha
authors.initials: S
authors.lastname: Sistla
authors.forename: Subhash C
authors.initials: SC
authors.lastname: Parija
mesh_terms: D001434:Bacteriophage Typing; D002353:Carrier State; D002908:Chronic Disease; D005260:Female; D005499:Folliculitis / Q000382:microbiology*; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000302:isolation & purification*