Treatment of Gram-Negative Folliculitis in Patients with Acne

Abstract

Gram-negative folliculitis may be the result of long-term antibacterial treatment in acne patients. It is caused by bacterial interference and replacement of the Gram-positive flora of the facial skin and the mucous membranes of the nose and infestation with Gram-negative bacteria. These Gram-negative bacteria include Escherischia coli, Pseudomonas aeruginosa, Serratia marescens, Klebsiella and Proteus mirabilis. The occurrence of Gram-negative folliculitis should be considered in acne patients in whom oral treatment with tetracyclines has not resulted in a significant improvement of acne lesions after 3–6 months’ treatment. The occurrence of Gram-negative folliculitis in acne patients is believed to be generally underestimated, since correct sampling and bacteriology is rarely performed by clinicians. Gram-negative folliculitis in acne and rosacea patients is best treated with isotretinoin (0.5–1 mg/kg daily for 4–5 months).

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Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Correspondence to Dr Roland Böni.

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Böni, R., Nehrhoff, B. Treatment of Gram-Negative Folliculitis in Patients with Acne. Am J Clin Dermatol 4, 273–276 (2003). https://doi.org/10.2165/00128071-200304040-00005

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Keywords

  • Acne
  • Isotretinoin
  • Rosacea
  • Antibacterial Treatment
  • Pyoderma