Folliculitis occurs due to inflammation of the superficial hair follicle, resulting in follicularly centered papules and pustules.

The etiology of folliculitis can be variable, with bacterial, fungal (eg, candidiasis), viral, parasitic, and noninfectious causes reported. A detailed history of comorbid conditions, exposures, and medications, in conjunction with appropriate ancillary testing, can be helpful.

In infants in particular, infectious folliculitis should be considered. While Malassezia (Pityrosporum) folliculitis is commonly seen in adults and older children, it has been rarely reported in infants. Statistically, children in day care facilities are at higher risk for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, so suspicion should be high.

Noninfectious folliculitis may also be considered. Eosinophilic pustular folliculitis is a variant of Ofuji disease and is characterized by pruritic pustules on the scalp and peripheral leukocytosis with eosinophilia. Numerous cases of this arising during infancy have been reported.

Related topic: immunosuppression-associated eosinophilic folliculitis