Skin abscess – this is a limited purulent-inflammatory diseases of soft tissues, is a frequent complication of surgical hospital. It is a localized infection in the skin that begins as redness, over time, the area becomes more solid, in the end, the abscess softens and is formed inside the pus. Pus is a mixture of proteins, leukocytes and other cells, which main task is to isolate infection. Cutaneous abscesses occurs with equal frequency in men and women. As a rule, for the male is characterized by the location of abscesses in the neck and head, the limbs and perirectal zone. The female is characterized by axillary, vulvovaginal, and perirectal location.
Causes of abscess on the skin
As any purulent disease, cutaneous abscess occurs due to the violation of the integrity of protective barriers of the body and penetration of pathogenic agents (bacteria or viruses). The bacteria that cause melting of the skin tissue and the formation of a capsule filled with purulent masses, are part of us, but under certain conditions and to increase their number they can be activated. A large number of these organisms exist on our mucous membranes: mouth, nasal cavity, mucosa of the eyes, genitals, and part is in our intestines, as in thick and thin. To identify the pathogen abscess can be quite difficult, so it sometimes depends on the effectiveness of treatment. The variety of bacteria that cause purulent inflammation is very great, we shall consider those which are most frequently encountered in surgical practice.
- In the vast majority the cause of skin abscess is Staphylococcus aureus (Staphylococcus aureus). A recent study shows that Staphylococcus aureus is detected in 27.6% of cases of detection of cutaneous abscess, and almost always plated in pure culture, without concomitant flora. 47,4% abscesses identified in the upper half of the body (abscesses of the face, neck, armpits, and chest), mostly caused by Staphylococcus aureus. Some of the subgroups of staph is not sensitive to many antibiotics, making them difficult treatment.
- Proteus mirabilis is one of the many organisms that live in the large intestine and secreted by microscopy of stool. This microorganism is often the cause of abscesses of the lower half of the body, though not a permanent inhabitant of the skin.
- Quite often a cause of abscesses of the skin acts as Escherichia coli, this organism is a part of us and is part of the intestinal flora, but under certain conditions, and lower immunity can cause severe and sometimes fatal diseases.
- Some drugs may cause sterile abscesses that resemble cellulite skin.
- Some diseases can be complicated by the occurrence of abscesses (pharyngitis, ingrown toenail, abscess, Crohn’s disease, osteomyelitis, orhopedic, amoebiasis, donovans, phthirius…)
Symptoms of abscess of the skin
How did manifest a skin eruption. As mentioned above, skin abscesses may occur anywhere on the body. This most commonly occurs due to violation of the integrity of the protective barrier of the human skin epithelium, for injuries or cuts. Due to impaired barrier conditionally pathogenic flora that lives on human skin, begins to penetrate into the sterile field of the body and in favorable conditions begins to actively proliferate. The body tries to direct all their forces to suppress the inflammatory response and limits this section from healthy tissue by the shaft of inflammatory cells, and when this barrier is not enough, there is a capsule in which is formed an abscess.
Obstruction of the ducts of the sebaceous and sweat glands may also lead to abscess. Such abscesses are located mainly in areas with large concentrations of sebaceous and sweat glands — the face, neck, armpits and the area around the rectum. As in the period of puberty in adolescents these glands are the peak of his activity, in the same period there was the greatest number the formation of abscesses. In the rectal area are very frequent ingrown hairs, plus the accession of infection resulting in perirectal abscesses. Women abscesses in the genital area caused by obstruction of the Bartholin glands.
Patients with abscesses usually start complaining to local pain and swelling in the affected skin, most often noting that the disease started about 3-4 days ago. After some time, usually within 5 to 6 days in the affected area appears symptom fluctuation – oscillatory motion of the fluid inside the abscess cavity. In most patients, signs of intoxication may be absent, but occasionally you may experience moderate tachycardia, which is usually associated with patient anxiety and pain, as well as a direct toxic effect of infection, underlying inflammation.
From external symptoms may appear dense swelling of the skin around the abscess, cellulitis, due to inflammatory reaction and stagnation. Fever may appear later formation of the abscess, and not exceed the low-grade cifar. However, with further increase of temperature, it is possible to tell with confidence about the generalizability of infection, which is a very important factor which must be reported to your doctor.
Diagnosis of skin abscess
To identify the abscess is happy just because he has some very striking features, and physician surgeon, who is engaged in the treatment of this disease, is not difficult to diagnose. However, there are quite advanced cases, in which there is secondary infection joining and generalization process that may hinder the search for the primary focus of infection. The doctor, the surgeon will perform initial examination, you may need to take an impression smears from the abscess to identify the causative agent. General analysis of blood and urine will need to determine the total resistance of the organism and diagnostic comorbidity. The doctor will need to find out from the patient if he had any injuries, cuts or burns earlier. For the differential diagnosis will need to inform the doctor if you have diseases such as diabetes mellitus, vascular diseases, neoplastic tumors or diseases of the connective tissue. You must list all medications that you have recently been treated or are being treated at the moment, special attention should be paid to drugs corticosteroid series. Abscesses in the armpit are very reminiscent of lymphoproliferative diseases, so diagnosis abscesses this area should be conducted in collaboration with doctors hematologist.
Treatment of skin abscess
Treatment of abscesses in the home can be carried out only if the initial forms and formations of small size. Ideally, treatment should begin as soon as the inflammation is to avoid further complications. The main treatment of abscesses in the home is warm compresses. Heat increases circulation in the area of inflammation and allows the body to better fight infection by increasing the concentration of leukocytes in the area of infection. can’t hold a heat treatment in house conditions during the formation of a purulent process, you will immediately go to the doctor.
The main method of treatment of skin abscess without complications in the form of signs of intoxication – excision and drainage of the cavity with subsequent surgical treatment of the wound. When properly done surgery treatment with antibiotics is not required. In cases of doubt regarding the differential diagnosis between cellulitis and abscess may conduct diagnostic puncture of the affected area. Any number of aspirated pus is proof of abscess formed, which must be drained in an open way. If the pus is not received during a diagnostic manipulations, most likely, is cellulite a process in which not yet formed cavity. In such circumstances, the treatment of cellulite begin with the appointment of frequent, warm lotions and antibiotics that could fight varying flora as a cause of this pathology. Since cellulite, the process can proceed with the formation of cavities, the patient should be observed at the doctor surgeon, despite the use of antibiotics.
What to do when abscess
The majority of small abscesses form, such as furuncle, go away on their own. The forecast in relation abscesses treated stationary, is also favorable. Complications abscesses are quite rare and are more common with a suppressed immune system. Complications in this case includes the deterioration or the spread of inflammation to the neighbouring areas of skin tissue or soft tissue, which can lead to the formation of lymphangitis, lymphadenitis, arthritis, osteomyelitis and endocarditis; and very rarely, the infection spread through the blood to the development of sepsis. Recurrence of infection is another possible complication that may occur after a certain period of time.
Prevention of abscesses.
There are measures that can be taken to prevent the formation of abscesses:
Regular hygiene and the use of antibacterial Soaps can help to prevent the reproduction of pathogenic bacteria on the skin. This can reduce the chances of developing inflammatory process. In some cases your doctor may recommend a special antibacterial gels and ointments with enhanced effect, if you can’t find enough antibacterial soap. Proper and balanced diet, avoiding harmful habits will help to support your body and strengthen the immune system, which will be able to cope with any disease.