Summary
The clinical and bacteriological findings are reported in 13 patients with gram-negative folliculitis before, during, and after treatment with isotretinoin (13-cis-retinoic acid). Patients were treated for 14–36 weeks with a daily dose of 0.5–1.5 mg isotretinoin/kg body weight. Inflammatory lesions were counted before and during weeks 2, 4, 8, 12, 16, 20, 24, 28, and 30 of therapy and again up to 172 weeks after cessation of treatment. In all patients there was an impressive improvement in clinical symptoms, especially a decrease in seborrhea and inflammatory lesions. Simultaneously, the gram-negative bacteria disappeared from the facial skin. Full clinical bacteriological remission was achieved in 9 patients within a period of up to 43 months, with minor recurrences of the disease in the remaining 4 patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fulton JE, McGinley K, Leyden JJ, Marples R (1968) Gram-negative folliculitis in acne vulgaris. Arch Dermatol 98:349–353
Hallmann L, Burkhardt F (1974) Klinische Mikrobiologie, 4. Aufl. Thieme, Stuttgart
Hersle K, Mobacken H, Möller A (1979) Chronic nonscarring folliculitis of the scalp. Acta Derm Venereol (Stockh) 59:249–253
James WO, Leyden JJ (1983) Gram-negative folliculitis —recognition and treatment. J Am Acad Dermatol 9:165–166
Jones DH, Cunliff WJ, King K (1983) Treatment of gramnegative folliculitis with 13-cis-retinoic acid. Br J Dermatol 108:252–253
King K, Jones DH, Daltrey DC, Cunliffe WJ (1982) A double-blind study of the effects of 13-cis-retinoic acid on acne, sebum excretion rate and microbial population. Br J Dermatol 107:583–590
Landthaler M, Kummermehr J, Wagner A, Plewig G (1980) Inhibitory effects of 13-cis-retinoic acid on human sebaceous glands. Arch Dermatol Res 269:297–309
Leyden JJ, Marples RR, Mills OH, Kligman AM (1973) Gram-negative folliculitis — a complication of antibiotic therapy in acne vulgaris. Br J Dermatol 88:533–538
Leyden, JJ, McGinley KJ (1982) Effects of 13-cis-retinoic acid on sebum production and Propionibacterium acnes in severe nodulocystic acne. Arch Dermatol Res 272:331–337
Maibach HI (1967) Scalp pustules due to corynebacterium acnes. Arch Dermatol 96:453–455
Neubert U (1983) Immunabweichungen bei sogenannter Gram-negativer Follikulitis. Hautarzt [Suppl VI] 34:277–278
Neubert U, Plewig G (1981) Gram-negative Follikulitis: Verlaufsbeobachtungen und therapeutische Möglichkeiten. Hautarzt 32:294–295
Nikolowski J, Plewig G (1981) Orale Behandlung der Rosacea mit 13-cis-Retinsäure. Hautarzt 32:575–584
Nikolowski, J., Plewig G, Hofmann C (1982) In-vivo-Tests zum Nachweis der antiinflammatorischen Wirkung der 13-cis-Retinsäure. Dermatol Monatsschr 168:173–181
Pigatto PD, Fioroni A, Riva F, Brugo MA, Morandotti A, Altomare GF, Finzi AF (1983) Effects of isotretinoin on the neutrophil chemotaxis in cystic acne. Dermatologica 167:16–18
Plewig G, Braun-Falco O (1974) Gram-negative folliculitis. Hautarzt 25:541–546
Plewig G, Gollnick H, Meigel W, Wokalek H (1981) 13-cis-Retinsäure zur oralen Behandlung der Acne conglobata. Ergebnisse einer multizentrischen Studie. Hautarzt 32:634–646
Plewig G, Nikolowski J, Wolff HH (1982) Action of isotretinoin in acne, rosacea and gram-negative folliculitis. J Am Acad Dermatol 6:766–785
Plewig G, Wagner A, Braun-Falco O (1980) Orale Behandlung schwerster Akneformen mit 13-cis Retinsäure. Münch Med Wochenschr 122:1287–1293
Strauss JS, Stranieri AM, Farrell LN, Downing DT (1980) The effect of marked inhibition of sebum production with 13-cis-retinoic acid on skin surface lipid composition. J Invest Dermatol 74:66–76
Wagner A, Plewig G (1980) 13-cis-Retinsäure. Pharmakologische und toxikologische Untersuchungen bei der Behandlung schwerster Akneformen. Münch Med Wochenschr 122:1294–1300
Weissmann A, Wagner A, Plewig G (1981) Reduction of bacterial skin flora during oral treatment of severe acne with 13-cis-retinoic acid. Arch Dermatol Res 270:179–183
Williamson PE, Kligman AM (1965) A new method for the quantitative investigation of cutaneous bacteria. J Invest Dermatol 45:498–503
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Neubert, U., Plewig, G. & Ruhfus, A. Treatment of gram-negative folliculitis with isotretinoin. Arch Dermatol Res 278, 307–313 (1986). https://doi.org/10.1007/BF00407743
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00407743