Furuncle and furunculosis - description, causes, symptoms (signs), diagnosis, treatment.

FURUNCLE

(lat.
furunculus
) - acute purulent-necrotic inflammation of the hair follicle and surrounding connective tissue, caused by the introduction of pathogenic microorganisms, most often staphylococci.

The predisposing cause for the development of single F. is skin contamination, especially with chemicals (lubricating oils, cooling mixtures, etc.), dust particles (coal, lime, cement, etc.) in combination, as a rule, with prolonged friction of the corresponding areas of the skin. Microtraumas (see), in particular scratching, also play a certain role in the development of single F. (for example, in skin diseases accompanied by itching, F. often appear). Some F. may occur with increased sweating and sebum secretion. F.'s relapses are often caused by sensitization to staphylococcal infection (see). In some cases, in immunodeficiency states (see Immunological deficiency), genetically determined enzymopathies (see), metabolic diseases, for example, diabetes mellitus (see Diabetes mellitus), hypovitaminosis (see Vitamin deficiency), etc., furunculosis may occur - chronic . a recurrent skin disease characterized by the appearance of multiple F. at different stages of development.

With histol. The study reveals necrosis of the hair follicle (see Hair) and surrounding connective tissue, in the center of which a focus of accumulation of staphylococci is determined. Necrotic tissue is surrounded by a shaft of neutrophils and macrophages that penetrate the necrosis zone and partially phagocytize staphylococci. Around the shaft in the connective tissue of the dermis, swelling, dilation of blood and lymph vessels and an infiltrate consisting of neutrophils, lymphocytes, and a small number of plasma cells are noted.

Causes of furunculosis

The cause of furunculosis is staphylococcal bacteria, which are activated and provoke acute purulent and inflammatory processes under the influence of various conditions. If a person has a weak immune system, then bacteria only need external factors to cause inflammation, and then furunculosis. The disease can also be triggered by long-term infectious processes: diabetes mellitus, metabolic disorders, poor nutrition and chronic intoxication. Injured skin, its contamination and hypothermia can become an “entry gate” for infection of follicles with staphylococcal bacteria, which can subsequently cause localized furunculosis.

The causative agent of the disease

The appearance of suppuration of the boil occurs mainly due to the penetration of staphylococci into the hair follicle. Normally, they are present on the surface of the skin in normal microflora and do not pose a danger. If staphylococci penetrate the hair follicle, an inflammatory disease develops.

However, for a bacterium to cause harm, there must be a decrease in immune system activity. When the immune system cannot fully restrain the development and reproduction of pathogenic agents, they begin to rapidly increase in number, disrupt the normal microflora of the skin and penetrate the pores and hair follicles, causing the appearance of suppuration.

Furuncle symptoms and treatment are characteristic due to the main causative agent of suppuration.

Clinical manifestations of furunculosis

The initial stage of the disease is characterized by the formation of a small inflammatory infiltrate with a purulent substance, reminiscent of folliculitis. After a few days, the entire hair follicle participates in the inflammatory process. A distinctive feature of furunculosis from folliculitis is the damage not only to the follicles, but also to nearby sebaceous glands and connective tissues. Externally, the rashes associated with this disease resemble a reddened cone-shaped nodule, filled with infiltrate, rising above the general level of the skin. As skin inflammation develops and develops, the painful sensation, swelling intensifies and a throbbing or tugging pain appears. Extensive swelling around the formation is characteristic of furunculosis, affecting the neck and face. After 3-4 days, a rod is formed in the center of the infiltrate, when you press it, the movement of a purulent substance is felt in the follicle, and an inflammatory process is noted around the hair.

What does a boil on the leg look like and its characteristic symptoms?

A boil at the first stage of development looks like a red, dense pimple with a diameter of one to three centimeters. A distinctive feature is a hair in the middle of the formation. The skin swells, the abscess begins to tingle and itch.

Four days after the first symptoms appear, pus accumulates in the pustule, forming a yellow-greenish rod around the follicle, which is visible through the thin layer of epidermis on the leg.

The boil is formed from:

• sebum;
• inflammatory skin cells;
• desquamated epithelium;
• bacteria.

Boils are accompanied by increased body temperature, fatigue, weakness, and the affected leg begins to hurt. After two days, the abscess becomes covered with a “cap,” the thinned skin breaks through, the tip comes off, and the rod is rejected. The general condition of the body improves, the fever subsides.

After a boil, a crater appears on the skin, which quickly granulates. Large formations 4-5 cm in diameter leave scars on the leg.

In the groin, genitals, hands, face, boils can be regressed using physiotherapy or by treating the element with iodine or alcohol. When bathing, use antibacterial soap, lubricate adjacent skin fragments, wipe with antiseptic liquid and napkins.

To prevent the spread of suppuration to healthy areas on the leg, avoid baths and lotions as a method of treatment for boils. If the rod does not come out, you can use trypsin or chymotrypsin as prescribed by your doctor. Antibacterial drugs to eliminate complications are taken after consulting a specialist.

When does furunculosis open?

After opening the elements of furunculosis, a small amount of accumulated purulent fluid is released out, forming a small ulcer. At its bottom a greenish necrotic core is visible, the presence of which is a characteristic symptom of furunculosis. The core of the formation breaks through a few days later along with a small amount of blood mass and pus. After the process of rod rejection, the inflammatory signs of furunculosis begin to decrease. When touched, the skin element becomes less painful and tissue swelling subsides.

After the elements of furunculosis break through, an ulcer is formed with a depression in the center, outwardly resembling a crater, where the remains of necrotic and purulent masses are either rejected over time or develop chronic furunculosis. The ulcer is filled with new connective tissue, forming a retracted scar, the depth and size of which depend on the size of the lesion due to necrotic processes in the center of the boil.

Furunculosis does not have any favorite localization, but inflammatory elements often occur in problem areas of the skin that are prone to oiliness and the appearance of imperfections: the face, back of the neck, forearms, thighs and buttocks. If furunculosis manifestations are isolated, then the patient’s general well-being remains normal, body temperature does not increase, and patients lead the same normal lifestyle.

Symptoms of intoxication and headaches can occur with furunculosis, which affects the tissues of the nasolabial triangle and auricle, even with a single lesion. The skin of the face turns purple, swells sharply, becomes tense and painful.

Injury to furunculous elements during washing, shaving, working the facial muscles, or when trying to squeeze out the rod on your own favors the development of thrombophlebitis of the facial veins and the penetration of staphylococcal bacteria into connective tissues and internal organs.

Due to the characteristics of blood flow in the veins of the face, furunculous elements can cause meningoencephalitis or meningitis. One of the most severe complications of the disease is blood infection and the formation of purulent tissue inflammation in the internal organs. In the acute form of the disease, many furunculous elements are formed on the skin, having the same resolution in stage. If the acute form of furunculosis is not treated properly, the immune system is not strengthened, and personal hygiene rules are neglected, then the process becomes chronic. Chronic furunculosis is marked by the characteristic presence of inflammatory elements of varying degrees of resolution; on the skin, some manifestations may heal, and some may recur; this process can occur several times a year.

Localized furunculosis affects individual areas of the skin, and with extensive furunculosis the process spreads. Furunculosis of the extremities is complicated by regional lymphadenitis, especially if inflammatory processes occur near the joints. Sometimes, during furunculosis, kidney disease can worsen.

complications>

Medicinal plants against boils

Aloe vera juice has unique healing and anti-inflammatory properties. To make a boil on your leg go away as quickly as possible, cut a thick and juicy aloe leaf lengthwise and attach it to the sore spot. Repeat the procedure until the boil disappears completely. Kalanchoe leaves can be used for the same purpose. The leaves of this plant are not as succulent as aloe, so first crush them in a mortar. The resulting mush will draw out the boil and heal the wound.

You can lubricate the boil with the fresh juice of these plants several times a day until the abscess completely disappears, or you can tie it with a bandage and leave it for several hours.

Treatment of furunculosis

In order to timely identify furunculosis, the causes of its occurrence and undergo proper treatment, you should consult a dermatologist. Self-treatment with Vishnevsky ointment can cause the spread of infection and acute purulent inflammation, since the drug is used only after the purulent substance has broken through at the scarring stage. Self-extrusion of furunculous rods causes premature opening, which infects nearby healthy tissues with pathogenic microflora, and the rod remaining inside can lead to chronic furunculosis.

Complications of a boil

Often, with untimely treatment or its low effectiveness, the following pathologies are observed:

• lymphadenitis - inflammation of the nearest lymph nodes;
• inflammation of the lymphatic vessels;
• inflammation of the membranes and tissues of the brain;
• arthritis;
• kidney pathologies.

When a furuncle matures, it goes through three stages of development in 10 days. The disease may proceed atypically and skip some of the stages or become more complicated. Timely treatment is important to prevent the development of serious inflammation.

Limitations in the treatment of furunculosis

• during treatment of the disease, if possible, bathing should be limited or completely eliminated, however, in case of extensive furunculosis, taking a bath using potassium permanganate disinfects the skin;
• Hygiene must be strictly observed, healthy parts of the skin are treated with gentle antiseptics, and minor skin lesions are treated with a solution of brilliant green;
• Underwear and bed linen should be changed regularly;
• Limiting fatty and spicy foods and eating foods containing proteins and vitamins helps regenerate damaged tissue.

Treatment of furunculosis during the stage of maturation of the inflammatory element of the skin occurs with the help of treatment with antiseptic drugs, injecting with antibiotics, relieving pain and preventing the spread of pus. Electrophoresis with antimicrobial agents prevents furunculous complications: phlegmon and abscesses.

Bandages with salicylic acid are applied to the center of the furunculous elements, which accelerates the rejection of the rod.

Opening and removing purulent formations under local anesthesia is indicated for acute purulent form of furunculosis. After opening and removal, the wound is thoroughly washed with hydrogen peroxide and bandages are prescribed using the following agents:

• Erythromycin;
• Syntomycin ointment;
• Levomekol;
• During wound healing, Vishnevsky ointment is used.

UHF therapy and ultraviolet irradiation are used at all stages of the disease. Oral antibiotics are prescribed if the patient has chronic or abscessing furunculosis. If the patient’s body is exhausted and his immunity is weakened, then it is necessary to take antibiotics intramuscularly.

To increase the body's resistance to the disease, vitamin and immunotherapy, autohemotransfusion, restorative drugs and ultraviolet irradiation of blood are prescribed.

Medication therapy

How to treat boils at home? For this purpose, there are many different medicines that can be used to treat suppuration.

So, how to draw out pus from a boil:

• applications with Ichthyol ointment;
• compresses with Vishnevsky ointment;
• topical medications that contain antibiotics.

You can fight boils with Ichthyol ointment. As a rule, the medicine is applied to a washing napkin or gauze, an application is made, leaving the product for 10–12 hours. The procedure is repeated for several days until the abscess decreases in size.

It is allowed to make compresses with Vishnevsky ointment. The medicine is applied to the skin, the ointment is fixed on top using a sterile bandage. The compress is kept for several hours. You can apply a warm towel to the site of inflammation, this will help break through the abscess.

Levomekol is considered a pulling ointment, but the product contains the antibiotic Levomycetin. Syntomycin emulsion is considered one of the most effective medicines. It is applied directly to the boil, and a sterile bandage or napkin is applied on top. The bandage is fixed with adhesive tape.

Treatment of boils should be carried out using antiseptics:

1. You can remove or remove the abscess using hydrogen peroxide (a solution with a concentration of 3%).
2. Regular brilliant green (diamond green).
3. Among the traditional methods of treatment, one can note the use of Chlorhexidine and Boric alcohol.

Opening a boil at home, how to do it:

• on the 7th day from the moment of its appearance, the abscess should open on its own;
• The boil can be removed earlier, if it is ripe, the skin in the area of ​​​​the formation is treated with an antiseptic;
• using a sterile instrument or clean hands, remove the abscess;
• A sterile bandage with Ichthyol ointment or Levomekol is applied to the wound.

Do not treat instruments with vodka or alcohol. It is better to use specialized solutions; they will help “kill” pathogens and bacteria.

How to treat an internal boil:

1. Erythromycin ointment.
2. Levomekol.
3. Vishnevsky ointment.

Getting rid of chiria can be quite difficult. Therefore, you should not open it, it is advisable to show it to the doctor.

Prevention of furunculosis

Preventive measures for furunculosis include keeping the skin clean. Clean linen, clothes and daily showering allow the skin to breathe more and better, which undoubtedly improves its barrier function. A healthy lifestyle is of great importance. Therefore, daily rubbing with cold water, morning exercises, walks in the fresh air and dosed sunbathing will prevent furunculous disease.

Prevention of the disease also depends on the nature of the work. For example, the causes of furunculosis in metallurgists and workers associated with mechanical engineering have their own treatment characteristics. The disease appears as a result of infection of microtraumas and the ingress of oils there. To avoid various diseases, enterprises pay great attention to sanitary conditions: the workplace and tools are kept in order, oils are periodically cleaned of metal impurities that often get into them.

In the oil industry, the appearance of purulent skin diseases is facilitated by the penetration of oil into microtraumas. Preventive measures at such enterprises include the use of special masks and clothing by workers.

Prevention is mainly aimed at preventing skin injury. And if it occurs, you must immediately use an antiseptic.