Differential Diagnosis for Skin Erosion and Pus Discharge during Hair Growth

• Single most likely diagnosis:
  • Folliculitis: This condition is an inflammation of the hair follicles, often caused by bacterial infection, which can lead to symptoms like skin erosion and pus discharge, especially during hair growth when the follicles are more susceptible to irritation and infection.
• Other Likely diagnoses:
  • Furuncle or Carbuncle: These are more severe forms of folliculitis that can cause deeper infections of the hair follicle, leading to more pronounced symptoms including significant pus discharge and skin erosion.
  • Ingrown Hair (Pseudofolliculitis Barbae): This condition occurs when hair grows back into the skin, causing inflammation, pus, and skin erosion, particularly in areas where hair is curly and prone to ingrowing.
  • Keratosis Pilaris: Although typically not associated with pus discharge, in severe cases or when secondarily infected, it could present with similar symptoms, including skin erosion, especially if the condition leads to follicular rupture.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Cellulitis: A bacterial skin infection that can spread rapidly and cause serious complications if not treated promptly. While it may not initially present with hair growth-related symptoms, it can lead to severe skin erosion and pus discharge.
  • Necrotizing Fasciitis: A rare but life-threatening infection that destroys the tissue under the skin, including fat and the tissue covering the muscles (fascia). Early signs can be similar to less severe skin infections, making it crucial not to miss.
• Rare diagnoses:
  • Erosive Pustular Dermatosis: A rare skin condition characterized by chronic erosion and pus-filled crusting, typically on the scalp, which could be exacerbated by hair growth.
  • Dissecting Cellulitis of the Scalp: A rare condition that involves inflammation of the scalp, leading to pus discharge and skin erosion, often associated with hair loss.