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Facial Hair (go to hirsutism) | Fifth disease | Flushing | Folliculitis | Fox Fordyce disease | Freckles (go to ephelides) | Fungal infections | Furuncles and carbuncles

FIFTH DISEASE

Fifth disease is also known as erythema infectiosum. It is quite a common infection in young children.

    Cause
  • Parvovirus B19.

    Symptoms

  • Bright red cheeks as if slapped ("slapped cheek" appearance).
  • A red, lace or net-like rash on the limbs and trunk a few days later.
  • The child is usually well although some may have a slight fever, headache or gastrointestinal symptoms.
  • The rash fades within a week.
     
    Complications
  • Anaemia may sometimes develop.
     
    What you can do
  • You should consult a doctor.
  • Apply cold compresses to the cheeks.
     
    What the doctor may do
  • Confirm the diagnosis.
  • Do blood tests.
  • Treat the symptoms. The rash usually clears on its own within one week.

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FLUSHING

Flushing occurs when the blood vessels in the skin dilate. It has many causes.

    Causes

  • Food induced
    • Alcohol.
    • Food additives, eg., monosodium glutamate.
    • Hot beverages.
    • Spicy foods such as chills and curries.
     
  • Neurologically induced.
    • Anxiety.
    • Blushing.
    • During a migraine attack.
     
  • Drugs induced.
    • Vasodilators (drugs that dilate the blood vessels).
    • Systemic steroids.

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FOLLICULITIS

The term folliculitis refers to superficial inflammation of the hair follicles. Furuncles or boils and carbuncles are deep infections involving one or several follicles, respectively. Folliculitis usually affects the scalp and hairy areas. Furuncles most commonly affects the neck and upper back. Carbuncles usually affect the back of the neck and buttocks.

    Causes
  • Infection.
    • Staphylococcal bacterial infection is usually the cause.
    • Pseudomonas aeroginosa - infection by this bacteria has been reported in people using hot tubs and jacuzzis.
    • Pityrosporon orbiculare, a yeastlike fungus may cause pityrosporon folliculitis.
     
  • Irritation
    • Mineral oils (oil exploration and refinery workers and mechanics)., cutting oils (metal industry) and other chemicals.
    • Tar (road workers and psoriasis patients treated with tar products).
    • Ingrown hairs. This is more common in dark-skin individuals with curly hairs and usually affects the back of the neck. It causes lumpy scars or keloids and is known as folliculitis keloidalis.

    Symptoms

  • Red papules (pimply bumps) and pustules (pusheads) centred around the hair follicles (skin pores). Occupational folliculitis usually affects the forearms and thighs).
  • On the scalp, folliculitis may result in patchy alopecia (hairloss). This form is called folliculitis decalvans.
  • On bearded areas, folliculitis may result a chronic infection called sycosis barbae.
  • Itching, pain or neither.
  • Pityrosporon folliculitis cause an itchy, acne-like eruption on the upper trunk.
      Folliculitis.
    Click on image for larger view    		   Sycosis barbae.
    Click on image for larger view 
    Complications
  • Folliculitis decalvans of the scalp may cause scarring and permanent hairloss.
  • Folliculitis keloidalis affecting the back of the neck may cause scarring and permanent hairloss.

      Folliculitis keloidalis.
    Click on image for larger view

    What you can do

  • You should consult a doctor.
  • Clean the area with an antiseptic solution if infection is the cause.
  • Use antibacterial or deodorant soaps if the problem is recurrent. Remember not to use ordinary soaps afterwards as these will wash away traces of antibacterial chemicals that remain on the skin and keep bacteria at bay.
  • If folliculitis is due to contact with with oils and tars, wear protective clothings.

    What the doctor may do

  • Determine and treat the cause.
  • Prescribe oral and/or topical antibiotics.
  • Take a culture to help choose the best antibiotic to use.

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FOX FORDYCE DISEASE

This is a chronic disorder of the special sweat glands found in the armpits, pubic and nipple regions known as apocrine glands. It appears after puberty and usually affects women.

    Cause

  • Blockage of the apocrine glands.
     
    Symptoms
  • Skin coloured or greyish papules (bumps) around the hair follicles.
  • The hairs are often lost.
  • Itching.
  • The skin is often thickened and darkened as a result of repeated scratching.
  • It usually affects the axillae, pubic or nipple regions.
     
      Fox Fordyce disease.
    Click on image for larger view 
    What you can do
  • You should consult a doctor.
  • Take oral antihistamines to relieve itching.
     
    What the doctor may do
  • Perform a skin biopsy to confirm the diagnosis.
  • Prescribe topical steroids or tretinoin cream.
  • Prescribe birth control pills in women.
  • Excise the affected skin.
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FUNGAL INFECTIONS
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FURUNCLES AND CARBUNCLES

Furuncles (boils) and carbuncles are deep bacterial infections causing abscesses in the skin. A furuncle develops when folliculitis spreads deeper into the skin. A carbuncle is a group of interconnecting furuncles. Furuncles and carbuncles occur more commonly on the face, scalp or at sites that are subjected to friction and maceration such as back of the neck, armpits and buttocks.

    Causes
  • Bacterial infection, usually caused by the staphylococcal bacteria.
     
    Predisposing factors
  • Diabetes, especially in patients with carbuncles.
  • Carriage of staphylococcal bacteria in the nostrils or perineum of the individual or family members.
  • Friction from skin surfaces rubbing together eg., armpits and buttocks or from collars.
  • Poor hygiene.
  • Old age and debility.
  • Obesity.
  • Immunological defects (eg., in rare disorders such a chronic granulomatosis, hyper-IgE syndrome).
     
    Symptoms
  • Furuncle
    • Painful, red, hot swelling of 1 - 5 cm in size.
    • Softens after a few days and ulcerates, usually through one opening.
     
  • Carbuncle
    • Painful, large red, hot swelling of 3 - 10 cm in size.
    • Softens and ulcerates through several openings.
    • Fever.
    • Malaise (feeling of illness).
     
      Furuncle.
    Click on image for larger view     		   Carbuncle.
    Click on image for larger view 
    Complications
  • Scarring.
  • Septicaemia (blood poisoning), especially if furuncles or carbuncles around the lips or nose are squeezed.
  • Recurrences may occur in people with diabetes, immunological defects or if there is carriage of the staphylococcal bacteria by the person or his family members.
     
    What you can do
  • You should consult a doctor.
  • Apply warm compresses for about 10 minutes twice a day. This helps the swelling to point and discharge pus, thus aiding healing.
  • Keep the area clean, cover with a gauze dressing and change the soiled dressing regularly.
  • Do not squeeze as this may force infection into the blood, leading to septicaemia.
  • Observe careful hygiene. Wash the hands regularly.
  • Do not share towels, sheets and personal items.
  • Avoid activities that cause excessive sweating if boils recur on places that are subjected to sweating and friction such as the armpits, groins, between the buttocks.
  • Have your family members screened if you suffer from recurrent furuncles.
  • Use antiseptic soaps if you suffer from recurrent furuncles.
     
    What the doctor may do
  • Take a culture to determine the best antibiotic to use. Cultures may be taken from other sites as well such as the nostrils, armpits between the buttocks and legs which may harbour the bacteria and from other family members who may be carriers.
  • Prescribe topical and oral antibiotics.
  • Drain abscesses and remove infected tissue.
  • Detect aggravating causes and treat.
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