Pseudomonas aeruginosa gram-negative folliculitis

Area of Science:

• Dermatology
• Microbiology
• Infectious Diseases

Background:

• Acne vulgaris exacerbations can sometimes be linked to bacterial infections beyond typical Propionibacterium acnes.
• Gram-negative folliculitis is a recognized but less common cause of severe acne-like eruptions.

Observation:

• Three patients presented with severe, unmanageable acne vulgaris.
• These patients were diagnosed with Gram-negative folliculitis caused by Pseudomonas aeruginosa.

Findings:

• The source of Pseudomonas aeruginosa in these cases was identified as co-existing otitis externa (external ear infection).
• Unlike previous reports, anterior nares colonization was not observed in these patients.
• Treatment involving acetic acid compresses and topical antibiotics for both otitis externa and folliculitis resulted in rapid improvement.

Implications:

• Highlights otitis externa as a potential, overlooked source of Pseudomonas aeruginosa in Gram-negative folliculitis.
• Suggests a revised diagnostic approach for recalcitrant folliculitis, considering ear canal infections.
• Demonstrates the efficacy of targeted antibiotic and acetic acid therapy for this specific condition.