presentation:-
-المريض بيجي يشتكي من حبوب حمراء أو جواها صديد بعد الحلاقة بالموس بتفضل فترة وبعد كدة بتروح لوحدها وبتتكرر بشكل مستمر.
-treatment:-
1-الحلاقة بإستخدام ماكينة حلاقة كهرباء بلاش أمواس
2-الحلاقة تكون في نفس اتجاه بصيلات الشعر مش في عكس اتجاهها
3-كريم مضاد حيوي + كورتيزون
Ex:-fucicort cream contains"fucidic acid 2%+betamethasone 1%"
دهان على مكان الحبوب صباحا ومساءا لمدة 3 ايام.
4- الانتظام فى حلاقة الذقن كل يوم أو يومين، لأن أهم الأخطاء الشائعة بين الشباب، وجود حبوب بالذقن يتم إهمالها وتترك الذقن لينمو بها الشعر، مما يؤدى ذلك إلى زيادة الحبوب فى الوجه.
what is the pseudo foliculitis???
-Pseudofolliculitis barbae (PFB) or shaving bumps is a foreign body inflammatory reaction involving papules and pustules.
-It primarily affects curly haired males who shave. Pseudofolliculitis barbae can also affect some white men and hirsute black women.
- Pseudofolliculitis pubis is a similar condition occurring after pubic hair is shaved.
**Pathophysiology
-Two mechanisms are involved in the pathogenesis of pseudofolliculitis barbae: -
1- extrafollicular penetration occurs when a curly hair reenters the skin, and
2-transfollicular penetration occurs when the sharp tip of a growing hair pierces the follicle wall.
*Black men who shave are predisposed to this condition because of their tightly curved hair.
* The sharp pointed hair from a recent shave briefly surfaces from the skin and reenters a short distance away.
Several methods of close shaving result in a hair cut below the surface.
-These methods include :-
1-pulling the skin taut while shaving,
2-shaving against the grain,
3-plucking hairs with tweezers,
4-removing hairs with electrolysis
5- using double- or triple-bladed razors.
The close shave results in a sharp tip below the skin surface, which is then more likely to pierce the follicular wall, causing pseudofolliculitis barbae with transfollicular penetration.
management of pseudo foliculitis:-
1-Chemical depilatories
-Chemical depilatories work by breaking the disulfide bonds in hair,
-which results in the hair being broken off bluntly at the follicular opening.
Ex:-
a-Barium sulfide powder depilatories of about 2% strength can be made into a paste with water and applied to the beard area.
-This paste is removed after 3-5 minutes.
B-Calcium thioglycolate preparations come as powder, lotions, creams, and pastes.
-The mercaptan odor is often masked with fragrance. In rare cases,
-this fragrance can cause an allergic reaction.
-Calcium thioglycolate preparations take longer to work and are left on 10-15 minutes;
- chemical burns result if left on too long.
**Chemical depilatories should not be used every day because they cause skin irritation.
-Every second or third day is an acceptable regimen.
- Irritation can be countered by using hydrocortisone cream.
-A lower pH or concentration, or a different brand, may also prove less irritating.
-Several products are available; therefore, trying a different product is encouraged if one depilatory proves to be unacceptable.
2-Topical medications
Ex:-
a-Topically applied tretinoin (Retin-A) has shown promise for some patients.
-When used nightly, it alleviates hyperkeratosis. It may remove the thin covering of epidermis that the hair becomes embedded in upon emerging from the follicle.
B-Topical combination cream (tretinoin 0.05%, fluocinolone acetonide 0.01%, and hydroquinone 4%) (Triluma) has been shown to provide some benefit by targeting the hyperkeratosis (tretinoin), -inflammation (fluocinolone),
- postinflammatory hyperpigmentation (hydroquinone).
C-Mild topical corticosteroid creams reduce inflammation of papular lesions.
D-Topical eflornithine HCL 13.9% cream (Vaniqa) has been used for excessive facial hair and in patients with pseudofolliculitis barbae.
-It is also used as a combination with laser therapy for hirsute women and pseudofolliculitis barbae patients.
- It decreases the rate of hair growth. In addition, the treated hair may become finer and lighter.
3-Antibiotics
-For severe cases of pseudofolliculitis barbae with pustules and abscess formation, topical and oral antibiotics may be indicated.
-Topical antibiotics may successfully reduce skin bacteria and treat secondary infection.
These topicals include
*erythromycin or
clindamycin or
*combination clindamycin/benzoyl peroxide (Benzaclin, Duac) and erythromycin/benzoyl peroxide (Benzamycin) agents.
-Applying one of these agents once or twice per day is effective.
-Benzoyl peroxide applied topically once a day is also effective in reducing bacterial populations. It should be used sparingly and may be irritating to sensitive skin. It is a good first-line topical agent for persons with oily skin.
-Benzamycin is a combination of erythromycin and benzoyl peroxide. A once daily application has the benefits of both agents.
**If pustules or abscess formation is evident, an oral antibiotic is indicated.
-Tetracycline is a common choice for a systemic antibiotic. Similar to a standard acne regimen, a -dose:-
500 mg twice a day used initially for 1-3 months is often effective.
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