Three patients with sudden, unmanageable exacerbation of acne vulgaris were shown to have Gram-negative folliculitis due to Pseudomonas aeruginosa. In each patient, the source of the Pseudomonas proved to be an otitis externa infection. In contrast to previous cases of Gram-negative folliculitis due to Proteus, Escherichia coli, or Klebsiella, the anterior nares were not colonized. Treatment of the otitis externa and the Gram-negative folliculitis with acetic acid compresses and topical antibiotics led to prompt resolution without recurrence.
(Arch Dermatol 115:1203-1204, 1979)
Leyden JJ, McGinley KJ, Mills OH. Gram-Negative Folliculitis. Arch Dermatol. 1979;115(10):1203-1204. doi:10.1001/archderm.1979.04010100023009