Pityrosporum folliculitis: diagnosis and management in 6 female adolescents with acne vulgaris

Arch Pediatr Adolesc Med. 2005 Jan;159(1):64-7. doi: 10.1001/archpedi.159.1.64.


Background: Pityrosporum folliculitis is a common inflammatory skin disorder that may mimic acne vulgaris. Some adolescents with recalcitrant follicular pustules or papules may have acne and Pityrosporum folliculitis simultaneously. Clinical response is dependent on treating both conditions.

Objectives: To demonstrate the similarity in clinical manifestation between acne vulgaris and Pityrosporum folliculitis, the benefit of potassium hydroxide preparation, and the benefit of appropriate antifungal therapy.

Patients: We describe 6 female adolescents with concurrent Pityrosporum folliculitis infection and acne vulgaris.

Intervention: A potassium hydroxide examination was performed on all 6 patients from the exudate of follicular pustules exhibiting spores consistent with yeast. All patients were treated with oral antifungals, and 5 of the 6 patients were also treated with topical antifungals.

Results: Six of 6 patients improved with antifungal treatment. All patients also required some ongoing therapy for their acne.

Conclusions: These patients demonstrate that follicular papulopustular inflammation of the face, back, and chest may be due to a combination of acne vulgaris and Pityrosporum folliculitis, a common yet less frequently identified disorder. Symptoms often wax and wane depending on the patient's activities, time of the year, current treatment regimens, and other factors. Pityrosporum folliculitis will often worsen with traditional acne therapy and dramatically respond to antifungal therapy.

MeSH terms

  • Acne Vulgaris / complications
  • Acne Vulgaris / diagnosis
  • Adolescent
  • Antifungal Agents / therapeutic use
  • Dermatomycoses / diagnosis*
  • Dermatomycoses / drug therapy
  • Dermatomycoses / microbiology*
  • Diagnosis, Differential
  • Female
  • Folliculitis / complications
  • Folliculitis / diagnosis*
  • Folliculitis / drug therapy
  • Folliculitis / microbiology*
  • Humans
  • Hydroxides
  • Malassezia*
  • Potassium Compounds


  • Antifungal Agents
  • Hydroxides
  • Potassium Compounds
  • potassium hydroxide