Perioral pseudomonas folliculitis may be associated with chronic use of antibiotics for acne vulgaris. The ubiquitous bacterial organism, Pseudomonas aeruginosa , found in soil and fresh water, gains entry through hair follicles or via breaks in the skin. Minor trauma from wax depilation or vigorous rubbing with sponges may facilitate the entry of organisms into the skin. There are no known race differences in incidence. There are no known sex differences in incidence.
Lesions begin as pruritic, erythematous macules that progress to papules and pustules.
Rash usually clears spontaneously in 2-10 days, rarely recurs, and heals without scarring, but may cause desquamation or leave hyperpigmented macules. Pseudomonas folliculitis is characterized by follicular papules, vesicles, and pustules, which may be crusted. Lesions involve exposed skin, but usually spare the face, neck, soles, and palms. Lesions progress to erythematous papulopustules that range in size from 2-10 mm, with a pinpoint central pustule. Rash is not unique in appearance and is most often confused with insect bites.