Dermatology - diseases of the skin


Boil – an acute purulent-necrotic inflammation of the hair follicle (the root of the hair along with the root base) and surrounding sebaceous glands and surrounding connective tissue, caused by the introduction of pathogens, especially staphylococci.

Boils can occur on any area of the skin, but the skin of the palms and soles. Most often it is located on areas of skin exposed to prolonged irritation and contamination that can occur in a production environment. Such places are the skin on the face and neck, forearms and hands, lower back.

In men, the boils are identified in approximately 10 times more often than women.

Causes of boil

1. Contamination of the skin, primarily chemicals (cooling the mixture, lubricating oil and others) and dust particles of coal, lime, cement and other materials is a predisposing factor in the development of a single boil. This factor is of particular relevance in combination with a continuous friction exerted on the corresponding areas of the skin.

2. Contribute to the emergence of single also boils and microtrauma of the skin, including scratches, which can occur when skin diseases, causing itching, insect bites.
3. Sweating and sebum secretion contribute to the emergence of single boils.
4. Sensitization (increased sensitivity of the organism) to a staph infection.

Symptoms and causes of boilsCauses of boils – chronic, relapsing disease of the skin where there are multiple boils at different stages of its development:

1. Immunodeficiency conditions (disorders immunological reactivity of the organism).
2. Genetically determined enzymopathies (diseases or pathological conditions developing due to the absence or loss of activity of any enzymes).
3. The metabolic disease, primarily diabetes and hypovitaminosis (vitamin deficiency arising from the violation of the correspondence between the use of vitamins and their presence in the organism).

Symptoms of boils

In the course of the boil goes through three successive stages:
1) the stage of infiltration (the accumulation in the tissues of the cellular elements from blood and lymph);
2) the stage of formation and rejection of necrotic core;
3) stage of scarring.

Therefore symptoms when you boil undergo several successive changes of the respective stages.

In the first stage (infiltration) in the thickness of the skin appears slight painful nodule with redness of the skin over it is the centre of the hair. Approximately 24-48 hours in the area of the respective mouth of the hair follicle appears a little yellow abscess (pustule).

In the second stage (formation and rejection of necrotic core) the hair follicle and adjacent sebaceous gland undergo purulent fusion that is outwardly manifested by the expansion of the zone of redness and increase in the size of the infiltrate. Infiltrate as it begins to rise above the surface of the skin, taking the form of a cone with base diameter up to 0.5-1.5 cm, without a clear external boundaries. In the center of the cone of infiltration under thinned skin begin to Shine grayish-green mass of purulent-necrotic core. In this stage, usually appear and grow local pain and General symptoms: increased body temperature to subfebrile (of the order of 37.5°C), weakness and headache. However, a significant number of patients furuncle may not cause the total response. After melting the skin in the center of the cone-shaped infiltration of purulent-necrotic masses start be rejected. The take-off of the pus, which shines through the top of the necrotic core greenish color. Gradually together with pus and blood is separated and the rod, then in the center of infiltration appears rather deep wound, with moderate bleeding from her.

In the third stage (scarring) that 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 his clinical picture may be some features. When the boil is located on the skin of the upper lip, eyelid, brow bone, as a rule, pronounced swelling develops. In the case of the location of the boils on the scalp, neck, ear canal, on the dorsal surface of the fingers, a sharp pain boil.

What tests you have to pass

To recognize a boil may need one set of external signs, but in order not to miss possible complications, you may need lab tests:

General analysis blood (UAC): with the development of complications of boils (malignant boil, lymphangitis, meningitis) is characterized by leukocytosis (increased white blood cell count of more than 9 x 109/l) with increase in the content of stab neutrophils (over 5 %), increased ESR (erythrocyte sedimentation rate);
Biochemical analysis of blood: when you boil that developed on the background of diabetes characterized by increased content of glucose in the blood (hyperglycemia);
blood test for sterility: applies when you boil complicated by sepsis (spread of the pathogen from purulent focus in the blood stream). Determines the nature of the causative agent and define its sensitivity to antibiotics;
a Study of discharge from the channel of boil smear (examination under a microscope after special staining material) and bacteriology (isolation of a pure culture on nutrient media) methods also provides the ability to determine the nature of the causative agent and define its sensitivity to antibiotics;
the Study of the immune status laboratory tests to diagnose immunodeficieny States with abrasions.

Treatment of boils

Treatment boils can be General and local. Common treatments only applies when the location of the boils on the face, the presence of complications of boils, and also at occurrence of boils on the background of severe concomitant diseases (immunodeficiency disease, diabetes). Such patients are assigned antibacterial and anti-inflammatory drugs, use of ultraviolet blood irradiation.

Treatment of boilsLocal treatment. In uncomplicated furuncle shown only conservative treatment, which depends on the stage of the flow of the boil. In the process of infiltration shown skin treatment alcohol and cauterization of the fistula 5% solution of iodine. Perhaps the use of dry heat, a laser therapy appointment UHF-therapy. the Applying hot compresses is unacceptable due to the fact that they contribute to the loosening of skin and to create optimal conditions for the development of wound infection.

In the formation stage of purulent-necrotic core medical procedures should be directed to the acceleration of its origin. For that on the skin in the area of necrosis is placed crystals of salicylic acid, which a few hours dissolve thin skin and contribute to the discharge of the rod and around the skin treated with ointment (to protect her from the effects of salicylic acid), top-to-dry dressing is applied. As an alternative perhaps mechanical removal by doctor necrotic core with tweezers or thin grip after cleaning the skin with a disinfectant solution. This procedure doesn’t require anesthesia. After the start of discharge of purulent-necrotic masses to ensure their continuous outflow into the formed channel, the doctor inserts a thin strip of rubber (glove graduate). Hold daily dressings, and glove graduate removed, provided the disappearance of infiltration and the cessation of purulent discharge that usually occurs on the third day. After that you can overlay dry dressings or keeping the wound open way, where every day is treated with alcoholic solution of brilliant green (brilliant green).

When furunculosis is assigned to antibiotic therapy, conducted a comprehensive survey to identify and address related diseases, contributing to its development: the treatment of diabetes, correction of immune status, vitamin and the like.

Complications of boils

In some cases, when specific localization and some contributing factors furuncle may be complicated by the development of so-called malignant boil, limfangiita, lymphadenitis, thrombophlebitis of the facial vein, purulent meningitis, and even sepsis.

Attempts at squeezing the boil, the damage of his initial elements during shaving, as well as inadequate local treatment of the formation of the so-called malignant boil. It is characterized by a significant increase of inflammatory infiltration, edema, tension and thickening of the skin over it. Sometimes outside swelling palpated the affected veins in the form of dense strands (thrombophlebitis). At the same time, intense pain. As a General body reaction characterized by increased body temperature, and in General, the analysis of blood leukocytosis and increased ESR.

When the location of the boil on the limbs (usually on the skin of the back of the hand and fingers) it can be complicated limfangiitom (inflammation of lymphatic vessels) and lymphadenitis (swollen lymph nodes).

When the location of the boils on the skin, especially on the upper lip or in the nasolabial triangle, may develop the most serious complication of boils – suppurative thrombophlebitis (thrombosis with inflammation of the vein wall and thrombus formation which occludes the lumen) facial veins, which often subsequently leads to the development of purulent meningitis (inflammation of the membranes of the brain) and sepsis (blood poisoning). In sepsis can form multiple abscesses (purulent inflammation of the tissues with their melting and the formation of purulent cavity) in various organs and tissues, most often in the bones, muscles, perinephric tissue, the kidneys.

The effectiveness of treatment of boils

Complications and prevention of boilsThe prognosis is not complicated a single furuncle usually favorable and depends on its location. With the development of complications prognosis is determined by the adequacy and timeliness of treatment.

Prevention of boils

Prevention boils boils down to the observance of rules of personal hygiene and the protection of the skin from traumatic impacts, as well as its maceration (the softening and loosening of the skin due to prolonged exposure to liquids). In addition, sufficient attention must be given to the timely identification and treatment of diseases which contribute to the occurrence of boils.
For the purpose of prevention of complications of boils is unacceptable to squeeze the boil, cut the pustule with a razor and apply warm compresses.

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