Folliculitis, Nodular Acne....

Since my late 20's, I have seen a variety of dermatologists for painful boil-like eruptions on my butt, that are 1-3 CM in diameter. I am now 39, and they seem to be getting worse! I feel like I'm not getting anywhere. I am currently using a benzoil wash, and in the past have used such topicals as tretinoin (some success), clindomycin, evoclin, desonide, and oral antibiotics; minocyline and now solydyn. Lately the only thing these boils respond to are steroid shots, which happen to work really well, but that would mean I see the dermatologist roughly every 4 weeks.

So my question: what is this?! it's making me nuts. I have had one doctor refer to it as folliculitis, and another as nodular acne, which ultimately would lead to Accutane. But given the area affected, and from what little I have gleaned looking online is confusing as to whether this would be nodular acne.

Any suggestions welcome.

[Alan Rockoff, MD]

Most of the time, pimples and boils below the waist are bacterial folliculitis and not acne.  I usually treat them with oral antibiotics, antibacterial cleansers, and the application of an antibiotic ointment in the nostrils to suppress growth of staph germs that live there and cause no problems in the nose but seed the body and cause boils elsewhere.  You might want to ask your skin doctor whether he or she would consider that approach.

Best.

Dr. Rockoff

[texanconcerns]

It would appear from my reading that staph could be tested for-is this correct?

[NEBelle]

Check out www.hs-usa.org.  It may be helpful.