Gram-positive folliculitis. The lesions of gram-positive folliculitis are tender and erythematous. Diabetes and obesity may predispose to this infection. Staphylococcal folliculitis is gram-positive but resembles gram-negative folliculitis and needs to be differentiated by culture. Treatment with cephalosporin antibiotics is generally effective.
Gram-negative folliculitis. Pseudomonas folliculitis, or “hot tub” folliculitis, produces painful pustules that typically affect the trunk. This infection is usually self-limited and often clears in 2 to 10 days. Treatment is not necessary in most cases. For patients with persistent infection and for those who are immunosuppressed, treatment with an oral fluoroquinolone is recommended.
On the following pages, you will find images of both types.