Sycosis - Treatment of sycosis barbae

What is Sycosis?

It simply means chronic folliculitis due to staphylococci affecting the hairy regions of the body. In order of frequency, the beard region, neck, scalp, legs, arms and pubic region are most often involved. Characteristically, this condition is seen as small, superficial, follicular pustules; some rupture to discharge beads of pus, the rest dry up to form crusts.

Folliculitis develops rapidly, involving more and more follicles. Soon the infection becomes chronic; the skin looks congested, swollen and infiltrated. Usually no pain is present; itching and burning are the only symptoms. The eruption looks unsightly and is ann6ying. In the beard region (Sycosis barbae), the chin and upper lip are most affected; the\eruption later spreads to other parts.

SYCOSIS LUPOIDES is a rare, chronic and progressive folliculitis of the beard region and scalp. It is seen as a small, smooth, atrophic patch of alopecia, surrounded at the periphery by small follicular papules. It is presumably caused by staphylococcus or virus. The prognosis is bad. X-ray therapy, local hydrocortisone injections and broad-spectrum antibiotics (systemically or locally) are worth trying.

Fatigue and emotional stress often appear to precipitate relapses but their significance is hard to evaluate. Many patients are seborrhoeic, with a greasy complexion and chronic belpharitis.

Causes of Sycosis

The most common causative organism of sycosis is Staphylococcus aureus; less commonly, other staphylococci. Discharges from the nose, throat and teeth are the source of these organisms. They may enter the skin through slight injuries or abrasions caused by shaving.

Use of unhygienic shaving kit, blunt razors, fine shaving by stretching the skin and shaving against the grain of hair tend to cause sycosis. Foliiculitis has a tendency to occur amongst people working in dusty and dirty environments, e.g., miners, building workers and sweepers.

Treatment of Sycosis

Treatment of sycosis consists of:

• Removing the causes, viz., eliminating the septic focus from the nose, throat, teeth etc.; change from dusty environments; improving the general health with tonics and exercises.
• Avoiding trauma to the affected parts, viz., by shaving in one direction; by keeping away from the use of strong soaps and irritating oils like mustard oil; by using sharp razor blades to prevent repeated shavings; by keeping the hair short, and by refraining from fine shaving which would necessitate stretching of the skin. In resistant cases, shaving should be avoided.
• Medicaments. The ones usually employed are: Vioform cream (P), Cetavlex cream (P), topical antibiotic ointments like bacitracin, and soframycin (P) etc. These are applied three times a day. Gentian violet I per cent, ammoniated mercury paste and 5-10 p.c. tannic acid lotion are useful for resistant patients. The latter is very useful in tanning (hardening) the integument and increasing its resistance to infection and trauma.

Prevention inlcudes correction of precipitating factors - Systemic e.g. diabetes mellitus and local e.g. irritations, discharges, etc.

Complications include abscess formation and cavernous sinus thrombosis if upper lip, nose or eyes are affected. SB has to be differentiated from acne, vulgaris, pustular miliaria, impetigo and fungal skin infections

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