Dermatological Enigma

I am 34 and never had any issues with my skin until I was 29ish. It started as just breakouts on my forehead.  I have gone to several dermatologists and have been on a laundry list of antibiotics and tropical’s, none of which did anything to cure or resolve the problem.  (if I was to list the antibiotics/tropical’s I have tried it would consume this entire post)

As a result of being on all the antibiotics a biopsy confirmed I developed Pityrosporum Folliculitis on my arms. I took oral ketaconazole as well as the topical but neither worked.

From the outset I was recommended to go on accutane and within the last year I reluctantly agreed out of frustration after nothing has worked over the last four plus years.

I am now off accutane about 2 months and am starting to get the break outs (just on the forehead) again.

The Pityrosporum Folliculitis seems to be getting better but the issue of the breakouts JUST on my forehead seems to continue.

I was curious if there is somewhere I can go that could properly diagnose and treat this? I have been to several dermatologists in my area and I have had no resolve!!

Any help or guidance would be GREATLY appreciated.

[Bhupinder Kaur, MD]

Hello,
Pityrosporum folliculitis presents as pruritic, follicular papulopustular eruption on the upper trunk. Both topical and oral antifungals are effective agents in the treatment of Pityrosporum folliculitis. Other topicals that are used to treat Pityrosporum folliculitis are ciclopirox olamine cream, econazole cream, alcohol and salicylic acid solution. Retinoids are not very effective. I suggest you to consult a dermatologist and discuss these treatment options with him.


I sincerely hope it helps. Take care and please do keep us posted on how you are doing. Warm regards.

[jason12676]

The Pityrosporum folliculitis has seemed to subside which was only present on my arms. However the bumps on my forehead which are not Pityrosporum folliculitis seem to still be an issue.

Several of the dermatologist seem to think its some type of folliculitis but if this is the case shouldn't they have cleared after accutane, several oral medications both antibiotic/anti-fungal and topicals?

Since the bumps on the forehead haven't reacted to accutane and several other topical and oral medications, do you have any suggestions as of a route to take?

I seen a new dermatologist yesterday which suggested I may have a staff infection and put me on Doxy as well as Bactroban Ointment swabbed in the nose 2X/day. He advised to wash the area with Hibbiclens and apply clindamycin as well.

Does the new course of treatment make sense?