What is perforating folliculitis?

Perforating folliculitis is prone to occur on the head, causing hair loss or irregular color spots on the scalp. It can also cause patients to experience low fever, dry mouth, greasy tongue coating, or hair loss. Therefore, it is important to understand the symptoms and treat them accordingly.

1. Perforated abscess folliculitis and perifolliculitis, also known as folliculitis et perifolliculitis capitis abscedens et suffodiens in English, is a type of inflammatory disease of the hair follicles and surrounding areas. Perforated abscess folliculitis and perifolliculitis are caused by inflammation of the hair follicles gathering together to form abscesses. Most cases of perforated abscess folliculitis and perifolliculitis are caused by Staphylococcus aureus and Streptococcus.

2. Traditional Chinese medicine believes that perforated abscess folliculitis and perifolliculitis on the head are mostly caused by weak constitution, weak external defense, and rheumatism and heat evil, which accumulate in the muscles, turn into heat over time, and cause the flesh to rot and turn into pus. The pus flows and penetrates each other, causing perforated abscess folliculitis and perifolliculitis on the head.

3. Perforating abscess folliculitis and perifolliculitis of the head initially present as deep folliculitis limited to the scalp, followed by perifolliculitis, which gradually forms deep abscess cavities that are interconnected. The surface of the abscess appears as bean to walnut size. When the surface is pressed, pus can seep out of most pores (sieve-like pus discharge). Perforated abscess folliculitis and perifolliculitis are common in middle-aged men. The condition is stubborn, progresses slowly, and tends to relapse. The hair in the affected area is sparse, and after healing, atrophic scars and irregular depigmented spots are left.

4. The diagnostic basis of TCM for perforated abscess folliculitis and perifolliculitis on the head is that the lesions recur repeatedly, one after another, and are interconnected. Occasionally there is low fever, poor appetite, dry mouth, pale tongue, yellow and greasy tongue coating, and a wiry and slippery pulse. The syndrome is deficiency of vital energy and accumulation of heat and toxicity.

5. Perforated abscess folliculitis and perifolliculitis of the head can also be examined by laboratory methods. The early lesions are folliculitis and perifolliculitis, with extensive infiltration of neutrophils, lymphocytes and tissue cells, granulation tissue formation, and foreign body giant cells can sometimes be seen in the remnants of hair follicles.