Furuncle ( boil ) - Causes, Symptoms and Treatment .MF .
Furuncle - acute purulent-necrotic inflammation of the hair follicle (the root of the hair together with the surrounding root sheath) and surrounding the sebaceous gland and the surrounding connective tissue, caused by the introduction of pathogens, especially staphylococci.
Furuncle may form on any part of the skin, in addition to the skin of the palms and soles.Most often it is placed on the areas of skin exposed to prolonged irritation and contamination that can occur in a production environment.These places are Kazha face and neck, forearms and wrists, waist.
Men boils identified about 10 times more often than women.
Causes single furuncle:
1. Skin contamination, primarily in chemicals (cooling mixture of lubricating oil and others), and dust particles of coal, lime, cement and other materials is a predisposing factor for the development of a single boil.This factor is particularly relevant in combination with long friction exerted on the relevant areas of the skin.
2. Contribute to the emergence of single boils and skin and microtrauma, including raschёsy that can be observed in skin diseases accompanied by itching, insect bites.
3. Increased sweating and sebaceous excretions contribute to the emergence of single boils.
4. sensitization (hypersensitivity) to a staph infection.
Causes furunculosis - chronic recurrent skin disease in which there are multiple boils that are in various stages of development:
1. Immunodeficiency states (disorders of immunological reactivity of the organism).
2. Genetically caused enzimopatii (diseases or pathological conditions that develop due to lack of activity or violations of any enzymes).
3. Metabolic diseases in the first place - diabetes, hypovitaminosis (vitamin deficiency that occurs in violation of the correspondence between expenditure and vitamins entering the body).
In his current boil passes through three successive stages:
1) infiltration stage (accumulation in the tissues of the cellular elements mixed with blood and lymph);
2) the stage of formation and rejection pyonecrotic rod;
3) the stage of scarring.
Therefore symptoms boils undergo several successive changes, the respective stages.
In the first stage (infiltration) in the skin appears a little bundle of painful reddening of the skin over it, it is in the center of the hair.After about 24-48 hours in the mouth of the corresponding hair follicle appears small yellow abscess (pustule).
In the second step (the formation and rejection pyonecrotic rod) the hair follicle and sebaceous gland adjoins exposed purulent fusion that outwardly manifested extension redness zone and increase the size of the infiltrate.Infiltrate as it begins to rise above the skin surface, taking the form of a cone with a base diameter of up to 0.5-1.5 cm, with no clear outer boundaries.In the center of a cone-shaped infiltrate istonchёnnoy skin begin to show through gray-green mass of purulent necrotic core.At this stage, as a rule, appear and grow local pain, and general symptoms: fever to subfebrile (about 37.5 ° C), weakness and headache.However, a significant number of patients can not produce boil overall reaction.After melting the skin in the center of the cone-shaped infiltrate necrotic masses begin to be rejected.First departs pus, then the tip of the rod necrotizing greenish color becomes visible.Gradually, with pus and blood separated himself rod, then in the center of infiltration appears fairly deep wound with moderate bleeding from it.
In the third stage (scarring), the resulting tissue defect is filled with connective tissue and epithelialized, leaving 2-3 days a small scar drawn.
Depending on the location of the boil in its clinical picture may be some features.When boils, located on the skin of the upper lip, eyelids, brow and scrotum, as a rule, develops pronounced edema.In case of boil locations on the scalp, back of the head, in the outer ear canal, on the dorsum of the fingers marked sharp pain boil.
What tests need to take
"Learn" boil can be on one external features, but not to miss possible complications may need laboratory tests:
• Complete blood count (OAK): the development of boils complications (malignant boil,lymphangitis, meningitis) is characterized by leukocytosis (increased white blood cell count of more than 9 x 109 / l) with increasing content of band forms of neutrophils (over 5%), increased ESR (erythrocyte sedimentation rate);
• Biochemical analysis of blood: when boils develop on the background of diabetes is characterized by elevated levels of blood glucose (hyperglycemia);
• Blood tests for sterility: used for boils, complicated by sepsis (in the propagation of the infectious agent of purulent focus in the bloodstream).It allows you to determine the nature of the pathogen and determine its sensitivity to antibiotics;
• study separated from the channel boil smear microscopy (microscopic examination after special staining material) and bacteriological (isolation of a pure culture on nutrient media) methods and makes it possible to establish the nature of the pathogen and determine its sensitivity to antibiotics;
• study the immune status of laboratory tests to diagnose immuodefitsitnyh states with abrasions.
boils treatment can be general and local.General treatment applies only at the location of boils on the face, the presence of complications boils, as well as in case of boils on the background of severe concomitant diseases (immunodeficiency diseases, diabetes).Such patients are assigned antibacterial and anti-inflammatory drugs, used ultraviolet blood irradiation.
Local treatment.When uncomplicated furuncle show only conservative treatment, which depends on the current stage of the boil.In the stage of infiltration of the skin is shown and moxibustion treatment of alcohol fistula 5% iodine solution.Perhaps the use of dry heat, laser designation and UHF-therapy.Application warming compresses unacceptable inasmuch as they contribute to the loosening of the skin and create the optimum conditions for the development of wound infection.
being formed pyonecrotic rod medical procedures should be directed to the discharge of its acceleration.To do this, the skin in the area of necrosis placed crystals of salicylic acid, which is dissolved in a few hours, thin skin and contribute to the discharge of the rod, and around the skin is treated with ointment (to protect it from the effects of salicylic acid), applied on top of a dry bandage.Alternatively, perhaps the mechanical removal of the doctor pyonecrotic rod clamp tweezers or thin skin after treatment with disinfecting solution.This manipulation does not require anesthesia.After the beginning of a discharge of necrotic masses to ensure their continuous outflow channel formed in the doctor inserts a thin strip of rubber (glove graduate).Carry out daily dressings, and a graduate of the glove is removed, provided infiltrate disappearance and cessation of purulent discharge, which usually takes place on the third day.After that, dry bandages may be imposed, or keeping the wound open way in which it is treated with a daily alcoholic solution of brilliant green (green paint).
When abrasions assigned antibiotic therapy, carried out a comprehensive survey to identify and eliminate concomitant diseases, contributing to its development: is the treatment of diabetes, correction of immune status, vitamin and the like.
In some cases, a given locale and some of the factors contributing to a boil may be complicated by the development of so-called malignant boil, limfangiita, lymphadenitis, thrombophlebitis facial veins, purulent meningitis and even sepsis.
When trying squeezing a boil, damaged its initial elements during shaving, as well as inadequate local treatment, the formation of the so-called malignant boil .It is characterized by a significant increase in inflammatory infiltration, edema, tension and seal the skin over it.Sometimes edema palpated outside the affected veins in the form of dense strands (thrombophlebitis).At the same time there are intense pain.As a general reaction of the body is characterized by fever, and in the general analysis of blood - leukocytosis and increased ESR.
When placing boil on the extremities (usually on the skin and the rear brush of fingers), it can be complicated limfangiitom (inflammation of the lymphatic vessels) and lymphadenitis (swollen lymph nodes).
When placing boils on the face, especially on the upper lip or nasolabial triangle, can develop the most severe complications boil - suppurative thrombophlebitis (venous thrombosis with inflammation of the vein wall and thrombus formation, closing its gap) facial vein, which is often subsequently leads to the development ofpurulent meningitis (inflammation of the membranes of the brain), and even sepsis (blood poisoning).When sepsis can form multiple abscesses (purulent inflammation of tissue with their melting and the formation of purulent cavity) in various organs and tissues, most often in the bones, muscles, perirenal fat, kidneys.
nasolabial triangle - a dangerous position boils area
Weather Forecast in uncomplicated single boils, usually beneficial, depending on its location.With the development of complications prognosis is adequate and timely treatment.
Prevention boil comes to observing personal hygiene and prevention of skin from the traumatic effects, as well as from its maceration (softening and loosening of the skin as a result of prolonged exposure to it liquid).In addition, sufficient attention must be paid to the timely detection and treatment of diseases that contribute to the appearance of the boil.
In order to prevent complications boil unacceptable squeeze a boil, cut the pustule with a razor and apply a hot compress.
Surgeon Kletkin ME