Boil

Furuncle is a purulent-necrotic inflammation of the hair follicle and surrounding tissues. The localization of furuncles is varied, it cannot be only in the area of the palms and soles, since there are no hair follicles there. Favorite localizations are: forearms: shins, neck, face, gluteal areas. The diagnosis is simple - based on examination and palpation.

Causes furuncle

The etiology is varied, mainly determined by staphylococcus or mixed microflora. The reasons for the introduction of infection are: rubbing the skin, irritation with chemicals, increased function of sweat and sebaceous glands, microtrauma, metabolic diseases.

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Stages

Furuncles go through several stages of development. The process begins with ostiofolliculitis: a small, painful nodule (follicle) forms in the thickness of the dermis, and a small pustule (pustule) forms in the mouth of the hair. The inflammation can be stopped conservatively.

When squeezed out, the process deepens, spreading to the hair follicle and surrounding tissues. The infiltration stage develops. The pustule opens, the hair falls out. Edema and hyperemia with blurred edges appear; an infiltrate forms in the center, which rises conically above the skin - it is purple-red above it, thinned. The size of the furuncle varies from 1 to 2 cm, reactive inflammation of the surrounding tissues can be more extensive.

On the 3rd-4th day, the abscess stage develops: the infiltrate softens, the skin above it breaks through with the release of a small amount of purulent contents and the top of the purulent-necrotic core is exposed. It can be rejected with independent healing. Pronounced edema and hyperemia around the furuncle, the core intimately fused with the tissues, localization on the face - indicate a "malignant" course of the furuncle and possible complications. The patient should be sent to the hospital. Furuncles localized in the middle part of the face (from the eyebrows to the corners of the mouth) are especially dangerous.

Venous blood from this area flows through the angular veins of the face (vena oftalmiha) directly into the cavernous sinuses of the skull, which can lead to the development of purulent meningitis. Furuncles of the face are often complicated by submandibular abscesses, as a result of lymphadenitis.

Furuncles of other localizations, although rare, can cause other complications: lymphangitis and lymphadenitis, more often when localized on the extremities; osteomyelitis, especially when localized on the anterior surface of the shin, with the transition of purulent inflammation to the periosteum; sepsis, when trying to squeeze out the rod or scrape out granulations, the spread of suppuration by the type of phlegmonous process with the transition to a carbuncle, the development of phlebitis, thrombophlebitis, in cases of involvement of veins in the inflammatory process.

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Diagnostics furuncle

The diagnosis is formed according to the following principles: the diagnosis is indicated - "furuncle"; localization only by body segment, without clarification; stage of the process.

For example: "furuncle of the right shin, infiltration stage"; "furuncle of the face, abscess formation stage". If there are several furuncles in one anatomical area, the diagnosis indicates: "multiple furuncles", the name of the anatomical area and the stage of the process; for example, "multiple furuncles of the trunk in the infiltration stage".

In case of multiple furuncles all over the body, usually in equal stages of development, which indicates the systemic nature of the disease, the diagnosis is: "Furunculosis". These patients are referred to a dermatologist.

Treatment furuncle

It is necessary to treat foci of chronic infection and follow a diet with limited carbohydrates.

In case of a single furuncle, only local therapy is possible - pure ichthyol, dry heat, UHF, on an opened furuncle - levomekol, levosin, etc. In case of dangerous localization of a single furuncle (area of the nasolabial triangle, nose, lips), antibiotics are prescribed as for multiple furuncles and furunculosis (cloxacillin 500 mg 4 times a day, cephalosporins, syspres 500 mg 2 times a day, rifampin 600 mg / day once for 7-10 days, clindamycin 150 mg / day, etc.). In case of recurrent chronic course of the process, specific (staphylococcal anatoxin, aptifagin, vaccine) and non-specific immunotherapy, vitamins (A, C, group B) are also used. In case of a large furuncle and extensive necrosis, surgical intervention is used. Various antiseptics and antibacterial ointments are used externally. In case of poor rejection of the necrotic core, proteolytic enzymes are used (1% trypsin, chymopsyp, etc.).

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