Dermatology Book

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Furunculosis

Aka: Furunculosis, Furuncle, Carbuncle, Skin Abscess, Skin Boil
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  1. See Also
    1. Deep Folliculitis
    2. Incision and Drainage
    3. Perianal Abscess
    4. Paronychia
    5. Hidradenitis Suppurativa
  2. Pathophysiology
    1. Hair Follicle infection that spreads to deeper tissue
      1. Often begins as Folliculitis
    2. Walled-off Nodule of purulent infection
      1. Firm wall with inner fluctuant core
    3. Carbuncles involve a coalition of Furuncles
      1. Deeper, more extensive involvement
      2. Require greater degree of debridement
  3. Risk Factors
    1. Obesity
    2. Impaired Neutrophil function
    3. Corticosteroid use
    4. Diabetes Mellitus
  4. Causes
    1. Staphylococcus aureus (most common)
    2. Streptococcus species
    3. Mixed bacterial infection
  5. Signs
    1. Tender, erythematous skin mass
    2. Often spontaneously opens and drains to skin surface
    3. Distribution
      1. Occur most commonly in areas of increased friction
      2. Buttock
      3. Extremities
      4. Breast
        1. Lactating women: Associated with Mastitis
        2. Non-Lactating women: Usually subareolar
          1. Biopsy non-subareolar lesions
  6. Management: Acute Episode
    1. Trial of warm compresses for small abscesses
    2. Incision and Drainage
    3. Antibiotic
      1. Antibiotics usually not required once lesion opened
        1. Antibiotics do not shorten course of abscess
      2. Antibiotics indications (post-drainage)
        1. Cellulitis (see Cellulitis for antibiotic choices)
        2. Carbuncle
        3. Immunocompromised patients
  7. Management: Recurrent Episodes
    1. Optimize personal hygiene
    2. Mupirocin (Bactroban)
      1. Apply intranasally bid for 5 days
      2. Reduces nasal Staphylococcus aureus carriage
    3. Systemic antibiotic protocols (10 day course)
      1. Rifampin 600 mg PO qd and
      2. Dicloxacillin 500 qid or Septra DS bid
    4. Vitamin C 1 gram per day
      1. Effective in those with impaired Neutrophil function
  8. Complications
    1. Cellulitis
    2. Gangrene
    3. Necrotizing Fasciitis
    4. Hidradenitis Suppurativa
    5. Recurrent Furunculosis
  9. References
    1. Derksen in Pfenninger (1994) Procedures, p. 50-3
    2. Gilbert (2002) Sanford Guide, p. 36-37
    3. Carroll (1996) Postgrad Med 100(3):311-22
    4. Stulberg (2002) Am Fam Physician 66(1):119-24

carbuncle (C0007078)

Definition (MSH) An infection of cutaneous and subcutaneous tissue that consists of a cluster of boils. Commonly, the causative agent is STAPHYLOCOCCUS AUREUS. Carbuncles produce fever, leukocytosis, extreme pain, and prostration.
Concepts Disease or Syndrome (T047)
MSH D002270
SnomedCT 200602006, 41570003, 91374005, 156294007, 267826003, 416893007
English Carbuncle, Carbuncles, CARBUNCLE, Carbuncle of skin and subcutaneous tissue, NOS, Carbuncle NOS, carbuncles (physical finding), carbuncle (diagnosis), carbuncles, Carbuncle NOS (disorder), Carbuncle [Disease/Finding], nos carbuncle, Carbuncle (morphologic abnormality), Carbuncle of skin AND/OR subcutaneous tissue (disorder), Carbuncle of skin AND/OR subcutaneous tissue, Carbuncle (disorder), carbuncle
Italian Favo, Foruncolo
French Anthrax (infection cutanée), Anthrax, Anthrax (dermatose)
Japanese 癰, ﾖｳ
Swedish Böld
Czech karbunkl, Karbunkl
Spanish Carbuncle, Boil, carbunco de la piel Y/O del tejido celular subcutáneo, carbunco cutáneo y/o subcutáneo, carbunco de la piel Y/O del tejido celular subcutáneo (trastorno), ántrax (anomalía morfológica), ántrax cutáneo y/o subcutáneo, ántrax de la piel Y/O del tejido celular subcutáneo (trastorno), ántrax de la piel Y/O del tejido celular subcutáneo, ántrax, SAI (trastorno), ántrax, SAI, ántrax, ántrax (trastorno), Antrax, Ántrax, Forunculosis Multifocal, Forunculosis Multifocal por Staphylococcus aureus, Forunculosis por Staphylococcus aureus
Finnish Karbunkkeli
Russian KARBUNKUL, КАРБУНКУЛ
Polish Czyrak mnogi, Czyrak gromadny, Karbunkuł
Hungarian carbunculus
Dutch karbonkel, Carbunculus, Karbunkel
German Carbunculus, Karbunkel
Portuguese Carbúnculo, Furunculose Multifocal, Furunculose Multifocal por Staphylococcus aureus, Furunculose por Staphylococcus aureus
Sources
Derived from the NIH UMLS (Unified Medical Language System)


furuncle (C0242301)

Definition (CHV) hair follicle infection
Definition (CHV) hair follicle infection
Definition (CHV) hair follicle infection
Definition (CHV) hair follicle infection
Definition (CHV) hair follicle infection
Concepts Disease or Syndrome (T047)
MSH D005667
ICD10 L02.92
SnomedCT 200626008, 156303007, 267773002, 59843005, 111181004, 156294007, 267826003, 416675009
English Furuncles, BOIL, BOILS, FURUNCLE, FURUNCLES, Boil of skin and subcutaneous tissue, NOS, Furuncle of skin and subcutaneous tissue, NOS, Boil NOS, furuncle (diagnosis), Boils: [Recurrent] or [multiple sites] or [NOS] (disorder), Boil NOS (disorder), Furuncle, unspecified, boil, boils, furuncles, furunculus, Furuncle, Boil, Furunculus, Boil of skin AND/OR subcutaneous tissue, Furuncle (morphologic abnormality), Furuncle of skin AND/OR subcutaneous tissue (disorder), Furuncle of skin AND/OR subcutaneous tissue, Boil of skin AND/OR subcutaneous tissue, NOS, Boils: [Recurrent] or [multiple sites] or [NOS], Boils, Furuncle NOS, Furuncle (disorder), furuncle
Italian Furunculus, Bolla, Foruncoli
Dutch furunkel, furunkel op aangezicht, Steenpuisten
German Eiterbeule, Eiterbeulen, Furunkel
Japanese せつ, ｾﾂ
Portuguese Furúnculos, Furúnculo
Spanish Boil NOS, Boils of multiple sites, Furuncle, Recurrent boils, Boils: [Recurrent] or [multiple sites] or [NOS], Forunculos, Forúnculos, Forúnculo, divieso de la piel Y/O del tejido celular subcutáneo, forúnculo de la piel Y/O del tejido celular subcutáneo (trastorno), forúnculo de la piel Y/O del tejido celular subcutáneo, forúnculo, SAI (trastorno), forúnculo, SAI, furúnculo (anomalía morfológica), furúnculo de la piel Y/O del tejido celular subcutáneo, furúnculo, forúnculo, forúnculo (trastorno)
French Furoncles, Furoncle
Czech Furunkl
Hungarian kelés, furunculus
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Furunculosis (C0016867)

Definition (MSH) A persistent skin infection marked by the presence of furuncles, often chronic and recurrent. In humans, the causative agent is various species of STAPHYLOCOCCUS. In salmonid fish (SALMONIDS), the pathogen is AEROMONAS SALMONICIDA.
Concepts Disease or Syndrome (T047)
MSH D005667
ICD10 L02.92
SnomedCT 112650006
English Furunculoses, FURUNCULOSIS, FORUNCULOSIS, furunculosis (diagnosis), furunculosis, Forunculosis, Furunculosis NOS, Furunculosis [Disease/Finding], forunculosis, furunculosi, Furunculosis, Furunculosis (morphologic abnormality)
French FURONCULOSE, Furonculose
Portuguese FURUNCULOSE, Furunculose
Spanish FORUNCULOSIS, Furunculosis, forunculosis (anomalía morfológica), forunculosis, furunculosis, Forunculosis
German FURUNKULOSE, Furunkulose
Dutch furunculose, Furunculose
Swedish Furunkulos
Japanese ｾﾂｼｭｼｮｳ, せつ多発症, せつ腫症, せつ症, せつ, フルンケル症
Czech furunkulóza, Furunkulóza
Finnish Furunkuloosi
Russian GNOINIKI VOLOSIANYKH FOLLIKULOV, FURUNKULEZ, FURUNKULY, ГНОЙНИКИ ВОЛОСЯНЫХ ФОЛЛИКУЛОВ, ФУРУНКУЛЕЗ, ФУРУНКУЛЫ
Croatian FURUNKULOZA
Polish Czyraczność
Hungarian Furunkulózis, Furunculosis
Italian Foruncolosi
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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