Furunculosis. Chronic furunculosis Chronic furunculosis treatment

What is furunculosis? This is an inflammation of the sebaceous gland and hair follicle. Consider the main causes and treatment of this common dermatological ailment.

What causes a boil to appear? The causative agent of the disease is staphylococcus aureus. He is everywhere. But only under certain conditions does the inflammatory process begin. Furunculosis occurs when:

chronic mechanical trauma to the skin. Ulcers often occur in the collar zone of the neck in men and women;
with metabolic pathologies, overweight or dystrophy. In all these cases, the local immunity of the skin falls sharply, and staphylococcus actively multiplies, which is an important cause of furunculosis in adults;
diseases of the gastrointestinal tract. With gastritis, duodenitis, ulcers, there is a high probability of getting an inflammatory process of the sebaceous gland and hair follicle;
overheating or hypothermia. If you have been in a draft for a long time, then there is a high probability of encountering an abscess. Also, lovers of baths, saunas or sun tanning often suffer from inflammatory processes. And all because high temperatures and ultraviolet destroy the natural water-fat protective ball of the skin;
a long course of antibiotics, hormonal drugs or an increase in the daily dose, instead of a therapeutic effect, this will bring patients a dermatological problem.

Outwardly, it looks like a cone-shaped swelling, ranging in size from a pea to a chicken egg.

Symptoms of the disease

We found out the causes of the disease, what causes the inflammatory process of the sebaceous gland and hair follicle. Now consider the symptoms of a chronic and common dermatological disease.

The onset of the disease is accompanied by:

swelling and swelling of the sebaceous gland. At the initial stage, it looks like a small cone. Real photos can be viewed online. Over time, the symptom spreads to the depth of the subcutaneous tissue, the patient observes redness of the affected area of the skin;
the causes of furunculosis in children and adults are different, but dermatologists always observe an active accumulation of purulent infiltrate. It has a conical shape. 3-4 days after the first appearance of alarming symptoms in patients, a purulent core is visible;
throbbing pain. Everyone who has at least once encountered inflammation of the sebaceous glands knows how strong the sensations are. Patients with ulcers in the area of the face, nose, neck and buttocks are especially affected. The reason is the very thin skin in these parts of the body. The discomfort is so strong that the patient cannot sleep normally, and simple movements are given with great difficulty. The general condition is complicated by psychosomatics. And often against the background of boils, especially on the face, patients develop depression, decreased performance;

Most often, furunculosis occurs and worsens in spring and autumn.

neglected or chronic furunculosis is often accompanied by intoxication. A person has a fever, fever and severe weakness.

These are classic symptoms. Based on them, a scheme is drawn up for the treatment of a dermatological disease.

stages

How to get rid of the purulent-inflammatory process, what treatment should be used? First, let's look at its stages:

We talked about the stages of the disease, now we will talk about how to treat furunculosis.

Traditional medicine methods

How to treat furunculosis effectively and without complications? Just trust the drugs and the reliable hands of a dermatologist. For the treatment of a person's condition, apply:

Vishnevsky ointment, Levomekol, Synthomycin and other similar drugs will have an antimicrobial effect and accelerate wound healing

injections of novocaine and anti-inflammatory drugs. Medicines are injected directly into the area of the inflammatory process. After manipulation, an infiltrate is quickly released, a purulent core is formed. This not only accelerates healing, but also relieves pain in the patient's abscess area;
antibiotics. If the disease has affected a solid area of \u200b\u200bthe body or does not go away for a long time, then antibiotic therapy is connected. How to cure furunculosis once and for all? Get a course of antibiotic injections. Due to the weakening of the immune system, oral administration will not give a quick result;
multivitamin preparations. Without them, the treatment of furunculosis is impossible. A balanced composition and daily intake for inflammation of the sebaceous gland guarantees patients a positive result. No wonder there are so many positive reviews about them;
stretching ointment. In the inflammatory process, it is important that the purulent infiltrate completely leaves the sebaceous gland and subcutaneous tissue forever. Therefore, for the treatment of patients, dermatologists use erythromycin, synthomycin ointment, Vishnevsky balm. It is enough to do compresses on the affected areas with them daily. And the boil will quickly disappear;
if the boil does not break through for a long time, then the patients will not do without surgical intervention. The dermatologist opens the boil, drains the pus and removes the rod. Then he puts a bandage with an antiseptic on the boil. Manipulation can not be carried out by patients on their own at home. Otherwise, a banal boil can develop into sepsis or another complication.

When it comes to multiple recurrent abscesses that characterize furunculosis, antibiotic treatment is mandatory.

Treatment with folk methods

After making a diagnosis, patients do not know exactly how to treat dermatological inflammation and what to do in the first place. Some prefer only pharmacological drugs. Others combine folk methods and medicines from the pharmacy chain at home. You should not completely rely on the healing power of plants and other unconventional methods. But you can skillfully combine funds at home.

Dermatologists say that decoctions and homemade ointments give a pronounced positive effect only on single pustules. With group boils, it is better to rely on conventional medicines.

With a purulent-inflammatory process of the skin, try treatment with folk remedies:

Complications

We talked about the causes of the disease. Now it remains to find out what happens with advanced forms of furunculosis.

A complication occurs when a person neglects the purulent-inflammatory process or is treated on his own and squeezes out the rod in violation of the principles of asepsis and antisepsis at home. In this case, pus quickly spreads throughout the body through the blood and lymphatic vessels. And inflammation easily captures vast areas.

Furunculosis and improper treatment can cause:

thrombophlebitis. Inflammation of varicose veins after an abscess can occur anywhere on the body. The affected vessel increases in size several times, swelling and convulsions occur. The reason is that the infection from the boil got to the inner ball of the veins and provoked inflammation there;
meningitis. With inflammation of the meninges, jokes are bad. The disease is not only accompanied by serious symptoms, but there is also an immediate threat to life. The chance of getting meningitis after a banal boil is high in those who have an abscess located on the forehead, scalp, nose or neck;
chronic stage ailments or gangrene. Constantly inflamed and swollen areas have reduced immunity. Therefore, with advanced furunculosis in adults or children, there is a high probability of necrosis or gangrene.

You should immediately consult a doctor for timely treatment if a person has:

high fever and severe intoxication;
soreness of the lymphatic or blood vessels in the area of the inflammatory process;
severe pain in the occipital region;
a sharp deterioration in well-being.

These symptoms may be harbingers of sepsis. And then the patient will be worried, not what to treat, but how to survive. Therefore, we advise you to be attentive even to a small abscess.

Acute purulent inflammation of the hair follicle, capturing the soft tissues surrounding it and the adjacent sebaceous gland. The furuncle begins with the formation of a dense infiltrate, in the center of which a necrotic rod is formed, ending in a pustule. Then there is an opening of the pustule, the discharge of the rod along with purulent contents and the healing of the boil, after which a scar remains on the skin. Diagnosis of a boil includes dermatoscopy, culture of discharge, blood test, examination of the immune system, identification of concomitant diseases and complications. Treatment is carried out locally in accordance with the stages of development of the boil. According to the indications, antibiotic therapy, immunocorrection, and treatment of complications are prescribed.

General information

The popular name of the boil is widespread - "boil". This disease is more common in adults, and in men more often than in women. The increase in the incidence of boils occurs in autumn and spring.

Causes of a boil

The main cause of the appearance of a boil is a staphylococcal infection. In the course of numerous studies that dermatology constantly conducts, it has been proven that staphylococci are normally present on the surface of human skin. However, only 10% of the total number of staphylococci are pathogenic microorganisms. In patients with boils, this ratio is changed and the number of pathogenic staphylococci often reaches 90%. Such a violation of the microflora of the skin can develop as a result of skin contamination, its additional infection, or with a decrease in the reactivity of the immune system.

Reduced immunity, in turn, may be due to chronic diseases and infectious processes in the body (tuberculosis, chronic pyelonephritis, bronchitis, hepatitis, sinusitis, tonsillitis, etc.); metabolic disorders (diabetes mellitus, endocrine obesity); long-term therapy with glucocorticosteroids; the use of cytostatics and other medications aimed at suppressing the immune system (in patients with lymphoma, gastric cancer, kidney adenocarcinoma, breast cancer, uterine sarcoma and other oncological diseases).

The penetration of staphylococci into the hair follicle with the formation of a furuncle can be facilitated by skin maceration with increased sweating and its microtrauma: scratching in dermatological diseases with severe itching (eczema, atopic dermatitis, scabies, inguinal epidermophytosis, pruritus), scratches, cuts and scuffs. Furuncles in the nose and auricle can develop as a result of constant exposure to the skin of mucopurulent discharge from the nose or ear in chronic rhinitis, adenoids, sinusitis, otitis media.

Furuncle symptoms

The appearance of a boil is possible almost anywhere on the human skin. It most often occurs where rubbing, sweating, or soiling of the skin occurs. This is the face, neck, axillary and inguinal regions, thighs, buttocks, lower back, chest. In its development, the boil goes through 3 stages: infiltration, suppuration and necrosis, healing. The whole process of its development usually takes no more than 10 days.

Infiltration stage the furuncle begins with the appearance of a bright red infiltration around the mouth of the hair follicle. The infiltrate increases in size (up to 1-3 cm in diameter), thickens, becomes more and more painful, accompanied by swelling of the surrounding tissues and a tingling sensation. The most pronounced puffiness is observed when the boil is located on the face: in the region of the eyelids, lips, cheeks.

Stage of suppuration and necrosis the furuncle occurs 3-4 days later from the moment of its appearance. It is characterized by the formation of a purulent-necrotic rod typical of a boil, which emerges on the surface of the skin in the form of a pustule. During this period, there is a rise in body temperature to 38 ° C and a pronounced pain in the area of the boil. General symptoms of intoxication are possible: malaise, weakness, headache, loss of appetite. At the peak of the clinical picture of the boil, its tire is opened. Through the hole formed, pus is poured out and a necrotic rod comes out. After that, infiltration, swelling, soreness and general symptoms quickly pass, the healing process begins.

Healing stage the boil proceeds with the formation of granulation tissue in the crater left after its opening. Within 3-4 days, a scar forms at the site of the boil. At first, it has a noticeable red-blue coloration, but gradually fades and can become almost invisible.

In some cases, the course of a boil may be erased and not be accompanied by the formation of a necrotic rod. With the formation of a boil in the auricle, intense pain in the ear, radiating to the temporal region and jaw, joins its symptoms. Sometimes there is a diffuse headache. A furuncle can block the ear canal, which is accompanied by hearing loss.

Complications of a boil

Despite the apparent simplicity of the disease, even a single boil can cause serious complications. The furuncles located in the region of the nasolabial triangle and on the mucous membrane of the vestibule of the nose are most often complicated. The development of complications is often facilitated by attempts to extrude the boil, its inadequate local treatment, and injury during shaving.

According to the localization of the process, all complications of the boil are divided into local (abscess, carbuncle, erysipelas, phlegmon), remote (lymphadenitis, lymphangitis, phlebitis) and general (furunculosis, brain lesions, abscesses in the internal organs, sepsis).

Local complications arise due to the fact that the discharge of the boil contains pathogenic staphylococci and can cause infection of other areas of the skin. The fusion of several boils leads to more extensive purulent skin lesions, such as carbuncle, abscess, soft tissue phlegmon. The multiple nature of boils is regarded as furunculosis.

The transition of the infection from the boil to the lymphatic vessels and veins causes the development of lymphangitis, lymphadenitis, phlebitis and thrombophlebitis. The most dangerous is the spread of staphylococcal infection through arterial vessels with the development of metastatic abscesses, pyelonephritis, sepsis. Furuncles localized on the face can be complicated by arachnoiditis, meningitis, brain abscess.

Diagnosis of a boil

If signs of skin inflammation are found, the patient should consult a dermatologist. The doctor will make a diagnosis based on the examination and dermatoscopy of the affected area. To determine the etiology of the pathogen, bacteriological culture of the separated furuncle is performed. Recurrent and multiple boils are an indication for a general examination of the patient with a clinical blood and urine test, a blood sugar test, urine culture, pharyngo- and rhinoscopy, radiography of the paranasal sinuses, fluorography, abdominal ultrasound and UHF therapy. After opening it, dressings are applied with a hypertonic solution of sodium chloride, turunda with an ointment containing chloramphenicol in combination with methyluracil. With difficult discharge of the necrotic rod, proteolytic enzymes are indicated: trypsin, chymotrypsin. Treatment in the stage of healing of the boil is carried out with antibacterial and healing agents.

With multiple and recurrent boils, treatment should include therapy aimed at increasing immunity. For this purpose, autohemotherapy, laser and ultraviolet blood irradiation (ILBI and UBI), the introduction of gamma globulin, staphylococcal toxoid or vaccine are used. Medical immunomodulatory therapy is prescribed in accordance with the results of the immunogram. Systemic antibiotic therapy is carried out in the case of a large, recurrent or complicated boil, as well as when it is localized on the face. Simultaneously with the treatment of the boil, the correction of concomitant diseases and the relief of complications are carried out.

Prevention of the appearance of boils

Preventive measures aimed at preventing the appearance of a boil include: skin hygiene, appropriate skin care for hyperhidrosis and increased sebum secretion, treatment of skin lesions with antiseptics, timely and adequate treatment of superficial forms of pyoderma, correction of metabolic disorders and treatment of chronic diseases, a healthy lifestyle to maintain high immunity.

Prevention of complications is primarily to prevent injury to the boil and the spread of infection. Self-medication is not recommended. It is necessary to timely contact a dermatologist and follow his appointments.

Furunculosis is a contact disease of a purulent-necrotic nature, affecting the hair follicle and nearby connective tissue. As a rule, pus forms around the follicle, and the involvement of neighboring tissues in the pathological process occurs due to the spread of infection. The appearance of subcutaneous acne is caused by bacteria, most often staphylococcus aureus, less often streptococcus. In size, pimples can be both small (3-5 mm in diameter) and huge (up to 2-3 cm).

Local furunculosis affects only one area of the body (buttocks, shoulders, legs), and common - several areas of the skin. The disease manifests itself against the background of weakened immunity and, in the event of a transition to a chronic form, can disturb its carrier for many years. To understand how to treat furunculosis, you need to know why it appears.

The main causes of the disease are the presence of staphylococcus aureus in humans. On healthy skin, the infection does not manifest itself, and with an injured epidermis (for example, a cut or abrasion), good conditions are created for the start of the inflammation process. Provoking factors in the development of the disease can be:

Chronic infections of the body.
Intoxication.
Non-observance of cleanliness of the body.
Hormonal disorders (diabetes mellitus, overactive adrenal glands)
Excess weight.
Some medicines.
Weak immunity (a decrease in immunity occurs due to various past diseases, hypothermia or overheating of the body, poor nutrition).
Increased sweating when the protective functions of the skin are violated.
Depletion of the body.
Diseases of the intestines, teeth, tonsils.
Low levels of iron in the body.
Pathology of the urinary system.

The causes of furunculosis are caused by a number of the above factors with a simultaneous violation of the protective function of the skin. The degree of infectiousness of bacteria (their virulence) affects the development and course of the disease. It can affect both a previously healthy area of \u200b\u200bthe skin, and skin affected by staphyloderma.

To identify the cause in each case, it is necessary to conduct a complete examination of the body: blood, urine, feces, sowing from the pharynx on the flora, determining the level of sex hormones, abdominal ultrasound, electrocardiogram and other procedures at the discretion of the attending physician.

Furunculosis occurs more often in adults than in children. Men suffer from the disease more than women. In the spring and autumn periods, outbreaks of the disease become more frequent. Increased nervousness, irritability and anger lead to a constant release of the stress hormone, which depletes the adrenal glands and lowers the immune system.

To understand what furunculosis is and how it proceeds, it is necessary to have an idea about some stages of its development.

Staphylococci are common everywhere: on the street, indoors, at work, in homes, on human skin, in places where hair comes out of the skin, in the sebaceous glands and in the nasopharyngeal mucosa. They can be infected, but the presence of staphylococci in itself does not cause furunculosis, since the microorganisms are in a non-pathogenic form.

When staphylococcus is exposed to the complex effects of several factors (external, internal, psychological), the development of the disease begins. Unfavorable internal factors weaken the human immunity, and at this time the microorganism enters the epidermis through its damage. The immune system is unable to resist foreign organisms, so they begin to actively develop, leading to inflammation.

The ability of microbes to secrete coagulase (an enzyme that affects blood clotting) leads to blockade of adjacent lymphatic vessels. As a result, a purulent core is formed, which does not extend along the sides, but deep into the skin.

Medicine distinguishes two forms of the course of the disease: acute and chronic furunculosis. The acute form is characterized by a one-time appearance of acne with a white, dense top. After a while, they open up, releasing pus outward, after which the skin at the site of the pathology acquires a bluish tint. Lasts from 14 to 60 days. The chronic form is characterized by the undulating appearance of acne. They can disappear and reappear for a long time. In both cases, there is an increase in body temperature, weakness, pain in the place, nausea, swollen lymph nodes.

First, a characteristic appears on the body in certain places: on the face, neck, buttocks, hips, shoulders. There are no such acne only on the palms and soles of the feet, since they do not contain hair follicles.

During acute furunculosis, the pimple site becomes dense and painful (aching or twitching pain). A bright red lump with indistinct borders expands and tingles. Nearby tissues swell. After about 3 days, the spot reaches a diameter of 3 mm, a rod of dead cells appears in its center. The formation causes severe inflammation, which is accompanied by the death of immune cells.

The pimple turns red, rising above the surface of the skin, and on the third day, in the center of the red spot, the skin softens, tenses and turns purple. Pus is formed there, consisting of leukocytes, dead microorganisms, destroyed follicle tissue. At the surface of the pus becomes more and more and the skin bursts. A hole appears, inside which you can see a greenish rod. He comes out in a week. After that, the pain begins to subside, the swelling disappears. A sore appears in place with uneven edges and a loose bottom. It contains remnants of dead tissue and pus. Over time, the ulcer begins to fill with connective tissue, forming a blue-red scar.

On any part of the body, furunculosis symptoms are always the same. But the most dangerous are neoplasms on the face, in the nose and lips. These pimples cannot be squeezed out on their own and cannot be treated. The proximity of the veins going into the cranial cavity is dangerous because particles of pus get into them. Only a doctor should treat furunculosis on the face.

With chronic furunculosis, acne on the body appears constantly. Some of them are just starting to grow, others are already healing. The general condition may not change much, but the lymph nodes are enlarged.

Complications of the disease

The face area becomes the most dangerous area on the human body when affected by furunculosis. There are a lot of blood vessels located close to the surface of the skin. One bad action to pop a pimple and bacteria can get into the bloodstream.

The situation can lead to inflammation of the veins on the face and a more terrible disease - meningitis. This will be evidenced by:

Elevated temperature.
Thickening of the veins.
Decreased visual acuity.
Swelling of the face.
General deterioration.

The presence of such symptoms should be immediately reported to the doctor in order to prevent lymphadenitis or sepsis.

Treatment of furunculosis begins with a trip to the clinic. First you need to make an appointment with a dermatologist. If necessary, he will give a referral to the surgeon. The specialist will conduct a visual examination and manual examination of the pathology. Then he will give directions for tests and necessary procedures. The treatment does not use one method, since complex therapy is the best way to avoid relapse and complications. Treatment methods include:

Dieting.
Antimicrobial therapy.
local therapy.
Surgical impact.
Immunity boost.

When drawing up a proper diet, you should include as many proteins and fiber as possible in it. Do not eat sweets and foods that cause allergies (chocolate, oranges, seafood, etc.). Avoid salty, spicy, fried foods. Food should be simple and well digestible. It can be cereals, steam cutlets, baked vegetables, fresh cottage cheese, kefir.

Despite the fact that body hygiene is violated during furunculosis, during the illness you can not go to the bathhouse and lie in the bathroom so as not to spread the infection throughout the body. At home, you need to carefully cut off all the hair around the sore, wipe it with a solution of potassium permanganate, apply ichthyol and tie it with a bandage. Repeat in the morning and before bed. When removing the old bandage, the skin should be wiped with warm water and a solution of boric acid. In the initial stages, lubrication of the rash with iodine or brilliant green helps. During the formation of a purulent core, the boil can be lubricated with salicylic acid. If the abscess has already opened, make compresses with a solution of furacilin twice a day. After the sore becomes clean, you can apply Vishnevsky ointment.

During treatments, the application of ointments and lotions is not fixed with circular bandages. Treatment of a boil on the face is carried out only in a hospital with bed rest. The patient is forbidden to eat solid food and strain the facial muscles.

The appropriateness of the use of antibiotics for each patient is determined by the doctor. He decides on the duration of treatment and the drugs taken. It can be: Amoxiclav, Cefalexin, Lincomycin and others. You can not cancel the treatment yourself, and you also need to take into account that microorganisms can develop resistance to the drug.

An increase in immunity is achieved by taking vitamins of groups: A, PP, C, E. Sometimes immunostimulation is carried out with non-specific drugs or ultraviolet blood irradiation.

If an abscess appears on the face, sometimes it is decided to remove it surgically.

Features of children's furunculosis

Having studied furunculosis, causes and treatment in adults, we will find out the features of the disease that affects the children's body.

A child can become infected with staphylococcus while communicating with a carrier of the disease, especially when that person has an acute stage of the disease.

In order not to infect a small family member, everyone living in the house needs to undergo decolonization of bacteria on the surface of the skin and mucous membranes.

Children's furunculosis at any age is always accompanied by weak immunity. Adults need to be extremely careful when acne appears on the face of a child. A complication may be the development of meningitis or a decrease in visual acuity. If there are no complications, the disease disappears in 10 days. At the same time, the baby:

Body temperature rises to 38 degrees.
Affected skin turns red and sore.
Inflammatory processes appear and lymph nodes increase.
Lost appetite and desire to play.

Furuncles in a child are opened without outside interference, but healing will take a long time, the sores will not heal right away.

Prevention of the disease includes a number of measures aimed at avoiding provoking factors:

Always wear personal protective equipment while working.
Wear comfortable clothing that doesn't irritate your skin.
Maintain body hygiene.
Do not start dermatological diseases.
Monitor blood sugar levels.
Do not drink alcoholic beverages.
Maintain the optimal temperature regime of the environment (do not cool or overheat the premises).

With proper and constant observance of all preventive measures, furunculosis can be avoided. A healthy lifestyle will maintain immunity at the proper level, and safety measures during work and personal hygiene will prevent microorganisms from penetrating deep into the epidermis.

Good day, dear readers!

Today we will consider such an unpleasant phenomenon on the skin as a boil, as well as everything connected with them. So…

What is a furuncle?

Furuncle (boil)- pustular, characterized by acute purulent-necrotic inflammation of the hair follicle and its surrounding connective tissues.

The main cause of the boil is mainly Staphylococcus aureus, less often white.

Furunculosis- massive, repetitive, chronic formation of boils.

The place of appearance of the boil can be anywhere except the soles of the feet and palms, but most often, the boil is formed on the back of the head, forearms, lower back, buttocks, abdomen, lower extremities. The most painful is the furuncle in the ear, nose, face and genitals.

The prognosis for a boil is positive, but there are still complications with this disease - thrombosis, lymphadenitis, sepsis, due to which the formation of a boil is considered a rather serious disease.

Boils have a certain seasonality - most often they form in autumn and spring. In addition, doctors note that most often, boils appear in men, and in children this is generally rare.

Furuncle development

The development of a boil can occur primarily on healthy skin and secondarily, when development occurs against the background of other pathological conditions and diseases of the body, for example, staphyloderma.

The development of a boil occurs in 3 stages, the duration of which, in the absence of complications, is up to 10 days:

Furuncle stage 1 (beginning)- characterized by inflammation of the follicle, in which a solid infiltrate (seal) of bright red color with fuzzy boundaries appears in this place. In the place of the inflamed follicle, soreness and tingling are felt. As the boil grows, the seal increases in size, expands, and the surrounding tissues swell.

Furuncle stage 2 (3-4 days)- is characterized by the expansion of the boil up to 3 cm in diameter, while in the center of the seal a purulent-necrotic rod with a pustule on the surface is formed. In the process of suppuration, not only the hair follicle is involved, but also the sweat gland with the surrounding connective tissue, while the vessels around it expand, collagen edema is observed. The shape of the boil begins to acquire a cone-shaped, like a growing mountain, shape. Inside the "mountain" elastic and collagen fibers are destroyed. Collagenized fiber bundles form a thick protective ring inside the boil, which prevents the infectious purulent formation from entering the body and its further infection, therefore it is very important not to squeeze out the boil without understanding the consequences of this process. The opening of the boil must be correct.

Further, the skin at the site of inflammation becomes smooth, bluish in color, and the pain intensifies. In case of extensive damage to the body by infection (in the case of a large number of boils), a person may experience symptoms of intoxication, which are expressed by general malaise, nausea, lack of appetite, headaches and fever up to 38 ° C.

The 2nd stage of the development of the boil ends with spontaneous or artificial opening of the pustule and the release of its contents to the outside. The content of the pustule is a yellow-green necrotic rod with a purulent formation, sometimes with the addition of blood.

Furuncle 3 stages- characterized by the appearance at the site of the opening of the abscess "crater", which at the beginning is filled with granulations, and after 2-3 days, scarring occurs in this place. The scar at the beginning of healing is red, but as it heals, it turns white and becomes almost invisible.

The entire flow cycle may have an erased character, for example, the entire process sometimes takes place only with the formation of an infiltrate, i.e. without pus and necrosis. In other cases, a boil against a background of weakened immunity and other diseases acquires an abscessed or phlegmonous form.

Furuncle - ICD

ICD-10: L02;
ICD-9: 680.9.

The main cause of the boil- an infection of a bacterial nature, predominantly golden, less often white.

This infection is present on the surface of the skin of almost every person, but due to strong immunity, the normal functioning of all other organs and systems, and the absence of violations of the integrity of the skin, staphylococcus does not harm health in any way. By the way, a weakened immune system is one of the main reasons for the development of many.

The furuncle gets its development under a combination of 2 conditions - the presence of an infection and a pathological factor, which can be external (exogenous) or internal (endogenous).

External causes of the appearance of a boil:

skin contamination;
Injury to the skin - microtrauma, cracks, cuts (especially when shaving), scratching with nails, rubbing the skin with uncomfortable clothes or shoes;
Poor quality food;
or its overheating;
Permanent .

Internal causes of the appearance of a boil;

Reduced immunity;
Increased sweating and sebum secretion;
Violation of metabolic processes - metabolism;
, smoking;
The presence of diseases such as staphyloderma, as well as others, and systems of infectious etiology.

Furuncle - symptoms

The main symptom of a boil- formation in the area of the inflamed follicle of a red seal (infiltrate), up to 3 cm in diameter, on the surface of which a pustule forms over time. Inside the boil there is a purulent-necrotic core and a purulent formation, sometimes with an admixture of blood. In some cases, the furuncle manages only with the formation of a reddened infiltrate.

Other symptoms of a boil include soreness and a tingling sensation in the inflamed area, as well as swelling of the surrounding tissues.

Against the background of weakened immunity and the spread of infection within the body, there may be general malaise, fatigue, drowsiness, loss of appetite, and.

After rejection of necrotic tissue, healing occurs by scarring. Most often, a boil occurs on the skin of the neck, neck, face, back, and thighs. The appearance of boils in different stages of development is called furunculosis, and purulent-necrotic inflammation of the skin and subcutaneous tissue around a group of hair follicles and sebaceous glands is called carbuncle. When a boil is found on the face, severe complications (purulent meningitis, sepsis) are possible.

Complications of a boil

A complication of a boil can be:

Arachnoiditis;
Phlebitis;
erysipelas;
upper lip or nose;
sinus thrombosis;
Lymphangitis;
Lymphadenitis;

Types of boil

The classification of the boil is as follows ...

With the flow:

Acute boil - the classic development of boils;
Chronic boil (furunculosis) - characterized by a large number of boils at different stages of development, for a long time.

Origin:

Primary - development occurs when the integrity of the skin is violated and infection penetrates into this place.
Secondary - development occurs against the background of already existing skin diseases - eczema, staphyloderma and others.

Furuncle - diagnosis

Diagnosis of a boil includes:

visual inspection;
Anamnesis;
Dermatoscopy;
Bakposev contents of the boil.

Additional diagnostic methods can be:

General urine analysis;
Urine culture;
pharyngoscopy;
Rhinoscopy;
sinuses;
brain.

Furuncle - treatment

How to treat a boil? Treatment of a boil primarily depends on the stage of the inflammatory process.

At the first stage of the boil (infiltration period) ultraviolet irradiation is used.

At the second stage (maturing period) to stop the infection and anesthesia, a blockade is placed - the boil is cut around the circumference with solutions of antibacterial drugs and novocaine. Injections are carried out in the surgical department.

The antibiotic is selected based on diagnosis and resistance (resistance) to infection.

Among the most used antibiotics for the treatment of a boil are:"Amoxicillin", "Methicillin", "Oxacillin", "", "".

Along with antibiotic therapy, sulfonamides are often prescribed.

To avoid allergic processes in the body from the use of antibiotics, antihistamines are used: Diphenhydramine, Pipolfen, "".

The effectiveness of the blockade in the "classic" course of the boil is characterized by a quick recovery. In other cases, it leads to a more rapid course of the disease - activation of the inflammatory process, its delimitation and rapid healing.

In order not to damage the inflamed area, which causes pain and the risk of rupture of the internal protective "ring" in which the purulent contents are located, a removable plaster splint is applied to the boil.

If the blockade is not effective, and the inflammatory process intensifies with pain, it is repeated every other day or every day until the boil opens and the purulent-necrotic rod comes out. At the same time, a bandage with a 1% solution of silver nitrate is applied to the inflamed area, which must be changed daily.

Ichthyol is an effective remedy for pain relief, disinfection and removal of the inflammatory process. The hair is removed from the center of the boil, after which, “Ichthyol ointment” is applied with a thick layer on the boil, on which loosened cotton wool must be applied. When dried, cotton wool forms the so-called "ichthyol cake", which is easily washed off with warm water. Such dressings should be done 1-2 times a day. However, remember that such “cakes” cannot be made on an opened boil, as they will prevent the purulent contents and the rod from leaving it normally.

After the furuncle is opened, its cavity is washed with a 3% hydrogen peroxide solution and bandages are applied with a hypertonic sodium chloride solution, which is intended to cleanse it of necrotic masses. The purulent-necrotic core of the boil can be removed only after it is completely separated from the surrounding tissues.

Important! In no case should a boil be opened by squeezing, since there is a high probability of a breakthrough of the internal protective ring, after which the infection can spread throughout the body, causing a number of serious and life-threatening complications!

In the third stage (healing period), after extracting the contents of the boil, the skin around the boil is treated with alcohol, brilliant green (brilliant green) or methylene blue.

In place of the boil, bandages are applied with Vishnevsky ointment or Levomekol, changing them every 2-3 days. In the case of granulations, indifferent fatty dressings are applied, which are based on fish oil, sterile vaseline oil, synthomycin emulsion, and others.

Surgical treatment is used for complications of the boil - phlegmon, neglected forms of carbuncle or abscessing boils. Surgical treatment of a boil involves making an incision in the boil and extracting its contents, after which the usual treatment regimen is applied. Sometimes a complete excision of the boil is performed with suturing.

Treatment of boils is carried out until the infiltrate (seal) is completely resorbed, otherwise various complications of the boil may appear.

Complicated boils are treated only in a hospital setting. With furunculosis, as well as with various additional complications, concomitant diseases are treated.

Additional treatments for a boil sometimes become:

physiotherapy methods - ultraviolet irradiation, infrared irradiation (sollux), UHF;
diet - includes restriction of spicy and fatty foods, spices, alcoholic beverages;
additional reception and - which is aimed at strengthening the immune system and other systems, normalizing metabolic processes and the fastest recovery of the patient;
autohemotherapy often becomes an effective remedy for furunculosis.

What can not be done with a boil?

Squeeze out the boil, especially during its maturation;
Massage the site of inflammation;
Apply warm compresses, poultices, and other wet treatments.

Important! Before using folk remedies for treating a boil at home, be sure to consult your doctor!

Ointment from boils from turmeric. The following ointment has a pulling property. To prepare it, you need to mix 1 teaspoon of turmeric powder with half a teaspoon of ginger, 1 tbsp. a spoonful of honey and a pinch of salt. Mix everything thoroughly, and wrapping the mixture in gauze, attach to the boil. To increase efficiency, wrap the top of the bandage with cling film and fix it on top with a handkerchief or bandage.

Ointment from boils from wax. Melt good butter in a bowl, then add beeswax shavings to it, in a ratio of 4: 1. Simmering the mixture over low heat, stir it until the wax is completely dissolved, but do not bring to a boil. It is necessary to apply wax ointment against a boil in a warm form, as a compress, for 2 days without a change.

Honey. Mix 1 tbsp. a spoonful of flour, bringing the mixture to the consistency of clay, then attach this cake to the boil, apply a bandage and hold until the abscess opens.

Aloe. Take a large leaf of an adult, wash it, remove the thorns and remove the top layer of the peel with a knife, from the flat side. Attach the sheet to the boil with the cut side and fix it on top with a bandage. Change the leaf 2 times a day until the boil is ripe and bursts.

Plantain. Wash and fold several leaves in several layers, fixing them with a bandage. Change the bandage every 1-2 hours until the abscess opens up.

Treat an opened boil with silver water, alcohol, hydrogen peroxide or Chlorgescidin to clear the infection from the “crater” and the surrounding tissues.

Prevention of the appearance of a boil includes the following recommendations:

Follow the rules of household and industrial hygiene, do not use other people's hygiene items for personal use;
Try to eat foods enriched with vitamins and minerals;
If the skin surface is injured, treat the wound;

It is an inflammatory-purulent lesion of the skin, in which the purulent-inflammatory process affects the deep layers of the epidermis and, as a result, scars form.

A characteristic feature of the disease is the formation of multiple abscesses.

This pathology has a long and sluggish course.

Exogenous causes

The following external factors contribute to the development of furunculosis:

minor injuries of the skin, which open the way for the spread of pathological microflora into the deep layers of the skin;
chronic damage to the skin by clothing, which contributes to the transition of conditionally pathogenic microorganisms into a pathological form;
the formation of scratching of the epidermis, which is observed with concomitant dermatological diseases (eczema, neurodermatitis and scabies).

Endogenous causes

Systemic decrease in immunity is considered the main predisposing factor for chronic furunculosis. A sharp loss of the body's protective abilities is observed in such cases:

hypovitaminosis and beriberi;
diseases of the organs of internal secretion (diabetes mellitus and obesity), anemia, pathologies of the gastrointestinal and nervous systems;
chronic alcoholism;
frequent recurring hypothermia or overheating of the body.

Signs of the disease

The main pathological element of the disease is the boil. Recurrent furunculosis is characterized by the re-formation of an abscess after the previous one has healed.

Depending on the severity of the pathology, chronic recurrent furunculosis is manifested by the following symptoms:

Easy degree. The patient has solitary boils and slight reddening of the skin. The recurrence of the disease occurs once every six months.
Average degree. The doctor diagnoses multiple purulent foci with a pronounced inflammatory reaction of nearby soft tissues. The frequency of relapses is 1-2 times every six months.
Severe degree. The patient complains of multiple and continuously formed boils. Regional lymph nodes are enlarged and painful on palpation. The disease is accompanied by hyperthermia, general weakness and malaise.

Photo of furunculosis

The rash is possible on any part of the body: on the face, in the nose, on the neck, on the torso, arms, legs and genitals.

Diagnosis of the disease

Chronic recurrent furunculosis is diagnosed by a surgeon. After clarifying the history of the disease, he conducts a visual examination of the pathological area and palpation of the regional lymph nodes.

These measures are usually sufficient to establish a preliminary diagnosis.

For the final diagnosis, the patient undergoes the following set of measures:

laboratory analysis of blood, urine and feces;
gastroscopy - a visual examination of the organs of the gastrointestinal tract;
ultrasound examination of the abdominal organs, thyroid gland and reproductive system;
electrocardiogram;
radiography of the lungs and nasal sinuses.

In addition, the patient is consulted by a surgeon, endocrinologist, ENT doctor and urologist.

Basic Treatments

Therapy of the chronic form of furunculosis requires an integrated approach to solving this problem. Treatment of recurrent abscesses is carried out in the following areas:

Immunotherapy. Activation of immunity is considered the basis for the treatment of recurrent forms of furunculosis. Preparations are selected individually for each patient, depending on the severity and stage of the disease. Stimulation of the specific protective abilities of the organism is often carried out with the help of the introduction of a staphylococcal vaccine and toxoids. These funds contribute to the production of antibodies to combat pathological microflora.
Correction of daily diet. The patient's diet should be rich in proteins and vegetable fiber. During this period, doctors recommend eliminating fats and carbohydrates from the diet. It will be very useful for patients to eat more vegetables and fruits, which include an increased amount of vitamins and trace elements.
Local treatment. Purulent foci at the stage of infiltration should be treated with agents that stimulate the formation and opening of the boil. To do this, the skin is lubricated with antiseptics (70% ethyl alcohol, brilliant green and iodine). After disinfection, a layer of Vishnevsky ointment or ichthyol is applied to the abscess.

At the stage of suppuration and necrosis, antiseptic treatment and local antibiotic therapy are considered the main methods of treatment.

The healing stage is characterized by the restoration of the skin and requires the use of agents that stimulate the growth and reproduction of epithelial tissues.

Systemic use of antibiotics

In such cases, the patient is mainly prescribed antibiotic tablets, less often intravenous and intramuscular injections. Antimicrobial agents should have a wide spectrum of action. These can be penicillins, cephalosporins, macrolides and lincosamides, such as Amoxiclav (Amoxicar, Augmentin, Flemoklav); Ceftriaxone (Rocefin, Cefaxone); Azithromycin (Sumamed, AzitRus, Zitrolid); Vancomycin; Zinnat.

Self-medication with antibiotics is one of the causes of the chronic form of the disease, which is why in the case of chronic furunculosis it is so important that the doctor conducts the treatment.

The duration of the antibiotic, as a rule, is 7-10 days. Premature discontinuation of the drug causes a relapse of the disease or the formation of insensitivity of microorganisms to the antibiotic.

vitamin therapy

Vitamin preparations with a recurrent form of furunculosis should be constantly taken. During this period, the body needs an increased amount of vitamins C, A, E, PP.

Surgical intervention

Before the manipulation, the pathological area is anesthetized with a local anesthetic (2% novocaine or lidocaine).

The doctor opens the cavity of abscesses with a scalpel. Then the skin is washed with an antiseptic solution. Drainage is installed in the postoperative wound. It can be a rubber strip or a tube.

Postoperative care for an open abscess consists in daily washing of the opened boils and replacing the sterile dressing. Drainage is removed for 4-5 days.

Complications of the disease

The negative consequences of furunculosis are observed after the untimely provision of surgical care. In this case, the following complications are observed:

cosmetic discomfort. In some people, the disease ends with the formation of colloidal scars. Such patients require subsequent laser resurfacing of skin seals.
Spread of infection to nearby soft tissues. In such cases, the patient may form an abscess (limiting the focus of suppuration) or phlegmon (diffuse purulent-inflammatory lesions).
Purulent meningitis, which is a consequence of the penetration of pathological microorganisms into the lymphatic and blood vessels of the face and neck.
Thrombophlebitis is an infectious inflammation of the wall of a blood vessel.
Sepsis, which is the systemic spread of pathogenic staphylococcus through the blood supply. This complication often ends in death.

Signs of the development of complications of furunculosis are a sharp increase in body temperature, a sudden deterioration in well-being, an increase in soft tissue edema and general weakness.

Disease prevention

It is possible to prevent the development of purulent-inflammatory processes in the skin with the help of such measures:

use of personal protective equipment in production;
avoid wearing tight and uncomfortable clothing;
strict observance of the rules of personal hygiene;
timely treatment of skin and venereal diseases;
control of the course of severe systemic diseases;
refusal to smoke and abuse of strong alcoholic beverages;
complete and balanced diet.

Disease prognosis

The disease has a relatively favorable prognosis. Timely complex impact on the patient's body ensures complete recovery of the patient.

The only negative consequence in this case may be the formation of colloidal scars, which are eliminated with the help of minimally invasive plastic surgery.

Complications of the disease and rare deaths are associated with self-medication and untimely treatment of the patient for medical help.

The recurrent form of furunculosis requires a person to be under dispensary control. Comprehensive medical supervision provides control over the course of staphylococcal infection.

1 comment

Please advise a competent dermatologist in Minsk. Son is 33 years old. He repeatedly underwent treatment for progressive furunculosis. Initially, the abscesses were on the neck, now on the head. The disease lasted more than 10 years. It fades away, then it gets worse. I drank the strongest antibiotics, visited an immunologist, and so on. There is no desired result. Sincerely, Ludmila

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! An accurate diagnosis can only be made by a doctor.