Folliculitis, boils, and carbuncles are a group of diseases that affect hair follicles and the area surrounding them. They are common skin diseases in clinical practice, with the head and neck being the most common sites, and the vulva also being affected.
Etiology
Most of the diseases in this group are caused by Staphylococcus aureus infection. Because the vulva has a lot of hair and is relatively prone to friction, it is more susceptible to folliculitis and boils. If not treated promptly or properly, these can easily develop into carbuncles. Other predisposing factors for these diseases include high temperatures, poor hygiene, wearing tight clothing, weakened immunity, taking immunosuppressive drugs, and diabetes.
Clinical features
Folliculitis is a superficial infection of the hair follicle opening, manifesting as follicular papules or pustules; a boil is a purulent infection of the deep hair follicle and surrounding tissue, initially presenting as an inflammatory papule, later developing into a nodule, with pustules on the surface, surrounded by redness and swelling, and may feel fluctuant and tender to the touch; a carbuncle is a deep skin infection formed by the fusion of inflammation of multiple hair follicles and surrounding tissues, manifesting as a poorly defined plaque. Folliculitis, boils, and carbuncles most commonly occur on the mons pubis, but can also occur on the labia majora and minora.
Pathological features
Folliculitis manifests as superficial pustules at the hair follicle opening and an inflammatory reaction around the hair follicle; boils and carbuncles manifest as abscesses in the entire hair follicle and surrounding area, with varying degrees of damage to the hair follicle.
Diagnosis and differential diagnosis
This group of diseases has obvious clinical features and is easy to diagnose, generally requiring no differentiation from other diseases. However, when multiple folliculitis or boils appear on the vulva and the clinical features are not obvious, it is necessary to differentiate it from genital herpes.
treat
For this group of diseases, squeezing and friction should be avoided first. Folliculitis and boils are mainly treated with topical antibiotics, including erythromycin ointment, neomycin ointment, mupirocin ointment, fusidic acid cream, etc. Carbuncles and more severe folliculitis and boils require oral antibiotics, such as cephalosporins, macrolides, and quinolones. Depending on the condition of the skin lesions, surgical incision and drainage may be considered.
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