triamcinolone acetonide, topical anti-infective agents, and oral
antibiotics). There were 76 patients from 2016-2019 identified
as meeting the criteria required for consideration in the study.
No patient reported fever or systemic symptoms. Culture
results were identified and sectioned based on the type of
bacteria cultured. Courses of treatment were broken down
by whether they were antibiotic or non-antibiotic, topical,
systemic, intralesional, or surgical (incision and drainage and/
or excision), along with whether they were coupled with other
therapies at the time of prescription.
RESULTS
As reflected in Table 1, of the 76 patients with cultures taken of their EIC contents, 36 patients had normal cultures (47%), of whom 19 (25%) had no growth and 17 had growth of normal flora (22%).2 41 positive cultures were identified, including 10 (13%) that grew methicillin-sensitive S. Aureus (MSSA), 6 (8%) that grew methicillin-resistant S. Aureus (MRSA), and 4 (5%) that grew S. Lugdunensis. Finegoldia magna was the most prevalent anaerobic organism found, comprising 3 (4%) of 76 cases. Three (4%) patients were culture positive for Cutibacterium acnes and 1 (1%) for Peptostreptococcus, as would be noted in acne and hidradenitis suppurativa lesions.
As shown in Table 2, treatments prescribed included oral antibiotics: doxycycline (n=25), minocycline (n=13), cephalexin (n=7), amoxicillin-clavulanate (n=2), clindamycin (n=1), and cefdinir (n=1). Twenty-six patients were not initially treated with antibiotics (n=26); eight of these cases turned out to be culture positive lesions- 2 Staphylococcus aureus light/ scant growth, 2 Peptostreptococcus, 1 Staphylococcus aureus with heavy growth, 1 Staphylococcus capitis, 1 Proteus mirabilis, and 1 Strep viridans), by using intralesional triamcinolone acetonide (n=4), incision and drainage (n=6), mupirocin (n=5), and clorhexidine wash (n=1). Four patients required the addition of an oral antibiotic (4 of 41; 10%) based on the bacterial isolates, ie, 50% of the untreated culture positive (4 of 8 cases). Five cases had recurrent symptoms after treatment and 4 were referred for excision. Overall, 16 patients received intralesional triamcinolone acetonide, 25 patients had incision and drainage, 30 received topical therapy (mupirocin, retapamulin or chlorhexidine wash). In the group of 76, only two cases resolved by themselves without prescription or therapies. EIC locations included intertriginous locations (n=19; groin,
As shown in Table 2, treatments prescribed included oral antibiotics: doxycycline (n=25), minocycline (n=13), cephalexin (n=7), amoxicillin-clavulanate (n=2), clindamycin (n=1), and cefdinir (n=1). Twenty-six patients were not initially treated with antibiotics (n=26); eight of these cases turned out to be culture positive lesions- 2 Staphylococcus aureus light/ scant growth, 2 Peptostreptococcus, 1 Staphylococcus aureus with heavy growth, 1 Staphylococcus capitis, 1 Proteus mirabilis, and 1 Strep viridans), by using intralesional triamcinolone acetonide (n=4), incision and drainage (n=6), mupirocin (n=5), and clorhexidine wash (n=1). Four patients required the addition of an oral antibiotic (4 of 41; 10%) based on the bacterial isolates, ie, 50% of the untreated culture positive (4 of 8 cases). Five cases had recurrent symptoms after treatment and 4 were referred for excision. Overall, 16 patients received intralesional triamcinolone acetonide, 25 patients had incision and drainage, 30 received topical therapy (mupirocin, retapamulin or chlorhexidine wash). In the group of 76, only two cases resolved by themselves without prescription or therapies. EIC locations included intertriginous locations (n=19; groin,
