Furunculosis - a disease characterized by the formation of boils that develop due to necrotizing inflammation in the hair follicle and the tissues surrounding it.The reason for excitement necrotic infections considered staphylococci.If there are frequent relapses boils, then talk about it during chronic.Depending on the severity of the inflammatory process, there are several stages of boils.
Mild characterized by single boils boils, accompanied by a mild inflammatory reaction, repeated up to 2 times a year, with well-defined palpation lymph nodes in the affected area.
boils average degree is characterized by single or multiple boils, reaching impressive size;may occur with intense inflammatory reaction is repeated up to 3 times a year.In addition to the increase in regional lymph nodes, this step may be accompanied by lymphangitis, fever is not a long body and minor symptoms of intoxication.
Severe recurrent boils characterized by continuously disseminated, multiple small foci
main etiological factor of occurrence of boils is Staphylococcus aureus, which is detected in 80-95% of cases.Much less abrasions caused by microorganisms such as streptococci groups A and B, Staphylococcus epidermidis, and so forth.
importance in the development of boils are: violations of the barrier and the protective functions of the skin, gastrointestinal pathology and endocrine system, renal failure, chronic foci of infection of different localization.Often, there are pockets of chronic infection of upper respiratory tract: adenoids, pharyngitis, tonsillitis, sinusitis.Also, intestinal dysbiosis with a predominance of coccoid bacteria is considered one of the centers of a chronic infection.
immune response to bacterial pathogens include two similar components - the innate immune system, which is non-specific in nature, and adaptive immunity, which is characterized by high specificity for foreign antigens.Pathogens boils at penetration into the skin causes a "cascade" protective response.
Thus, when during the boils are usually identified violations of all parts of the immune system.
Low levels of serum iron can reduce the efficiency of oxidative activity of bacteria by neutrophils.When current is often boils decrease lymphocyte.More often revealed lower levels of IgM and IgG.The extent of violations of the laboratory performance is compared with the degree of clinical boils.
Diagnostics boils includes: clinical and / or biochemical analysis of blood (protein fractions, total bilirubin, creatinine, urea, AST, ALT), urinalysis, blood Wasserman blood for HIV, a blood test for hepatitis B andC glikemicheky profile analysis on helminth eggs, sowing throat flora, bacteriological analysis of feces.
additional methods of research are: measuring the level of sex hormones, measurement of thyroid hormone levels, urine culture tank, a tank crop of blood on sterility FBGSD stomach, abdominal ultrasound, thyroid, pelvic organs, electrocardiogram, fluoroscopy.
As seen from the above, it is considered to be an important full examination of the patient to identify chronic foci of infection and related chronic diseases.
At the beginning of the disease in the area of the hair follicle develops inflammatory infiltrate with purulent contents small size, which in its process is similar to the development of folliculitis.After several days, it is involved in the inflammation process and the hair follicle itself.When boils within the follicle is affected not only as in the follicles but the sebaceous gland and the surrounding connective tissue.Symptomatic lesions for abrasions are similar to tapered congested node, which rises above the surface of the skin.With the formation of the inflammatory focus increasing tenderness and swelling of the pulsating nature.
Furunculosis Facial accompanied by extensive infiltration in the affected area.On the third day in the middle zone of infiltration formed fluctuations.That is, palpation of the element boils can feel the undulating movement of the masses in the festering sore of the cavity and in the area of hair has a slight purulent melting hearth with tissues and the subsequent formation of a fistula.
After opening elements boils allocated a small amount of viscous pus that has accumulated on the surface of inflammatory element.Begins its formation a little sore.At the bottom of the rod is visible necrotic ulcers green character.The emergence of such a bar is considered to be a characteristic symptom in abrasions.After about 5 days, the rod torn away with a small admixture of blood and pus.After the rejection of stem pain and inflammation boils rapidly decrease.The affected area becomes less sensitive to palpation, swelling of the tissues takes place.
After opening elements boils remains deep ulcer with minor remnants of pus and necrotic masses that eventually or rejected, or give rise to the development of chronic furunculosis.Sores filled with granulation tissue then forms scar drawn shapes.The size and depth of the scar depend on the p-ra areas of necrosis in the central portion of the boil.
Often elements boils appear on the face, arms, buttocks and thighs, back of the neck.When the elements boils have a single character - the overall health of the patient does not suffer, the body temperature normal.If abrasions on the face, especially the localization of its elements in the nasolabial triangle, the area of the external auditory canal there is an increase in body temperature, joined manifestations of intoxication and headache.Skin on the face becomes purple in color, with pronounced swelling and soreness.High risk elements in the traumatic abrasions on his face while washing and shaving, or attempt to oust the independent elements, may lead to the occurrence of thrombophlebitis of veins on the face.It may also be dissemination staphylococcal infection in the tissue and the internal organs.
time has not cured acute abrasions and reduced immunity could lead to the development of chronic process boils.Chronic process boils manifested by the presence of its units of varying severity.
main reason leading to the development of boils in children is considered to be the introduction of skin bacterial infections.This well help to microtrauma of the skin, poor hygiene child care, frequent colds, and lowered immunity.Children can develop abrasions after suffering: bronchitis, sore throat, inflammation of the lungs.The causative agent of furunculosis children also acts Staphylococcus aureus (in most cases).In second place is streptococcus.
Furunculosis children can develop anywhere on the skin.But often boils units are located in the neck, buttocks, chest and face.Rarely appears in the nose abrasions in the genital area, in the ear.
boils development occurs in stages.For the first stage boils considered characteristic of itching on the skin at the site of furunkuleznyh units.It may also feel tingling or numbness.Duration of the stage is about 3 days.
Further inflammatory process associated with the development of inflammation in the skin of small-sized formation.At the touch of this formation of dense, very painful on palpation.This period also takes about 3 days.Further, the unit boils increase in size, joined by swelling of the skin in the affected area.
about 4-5 days after the onset of the inflammatory process at the top of the unit furunkuleznoy visually determined the white point, or abscess.
After opening the abscess drained a significant amount of pus and rod furunkuleznoy units (necrotic tissue character).After emptying the area affected by inflammation child's condition improves dramatically, the body temperature is lowered.
Children may be the consequences in the form of boils complications of chronic boils (prone to relapse inflammatory process with the formation of furunkuleznyh units);lymphangitis (inflammation of regional lymph vessels);lymphadenitis (inflammation of regional lymph nodes);thrombophlebitis (inflammation of veins);cellulitis (acute inflammation of the surrounding adipose tissue);abscess (the process of inflammation surrounding tissue is melted to form a cavity filled with purulent contents).
Furunculosis on the face of the children considered the most dangerous location abrasions among children.Development boils in the nasolabial triangle zone is very dangerous subsequent complications.Thrombophlebitis veins on the face may cause penetration of the inflammatory process in the cranial cavity.In this case, more likely to develop meningitis, which is fraught with fatal consequences.
boils treatment in children eliminates domestic methods.An urgent need to show the child's surgeon.In no case can not be opened independently furunkuleznye unit.
Antibiotics for abrasions appointed specialist.They can be cut away is brewing area.You can apply ichthyol ointment.It is applied twice a day.After opening the inflammatory process furatsilinom unit produced and hydrogen peroxide.
boils therapy should be performed by the surgeon and dermatologist.Do not be amiss to visit immunologist.Wisniewski ointment therapy may lead to the spread of inflammation in the surrounding tissue and complications such as cellulitis.Because Vishnevsky ointment is used only after emptying the contents of the capsule with purulent granulation step.Samovydavlivanie rods for abrasions or using cans leads to early opening of the unit boils when the surrounding healthy skin tissue enriched with pathogenic microflora, and part of the rod can remain in what will eventually lead to chronic course with recurrent boils.
boils During therapy is recommended, if possible, to limit water treatments.But if there is a generalized abrasions, then a warm bath with a weak solution of potassium permanganate contribute to disinfect the skin.Hygienic procedures embody wiping healthy skin antiseptic solutions, for example, salicylic alcohol or p-rum furatsilina.
hygiene procedures should be given special attention, minor scratches and cuts should be treated p-rum green diamond.Also recommended for frequent change of bed clothes.It is important to eliminate from the diet spicy and fatty food.Compliance rational diet with high fiber content promotes good bowel movement and thus the prevention of dysbiosis, which is highly desirable for abrasions.
At maturation furunkuleznyh units skin around them is treated with antiseptic preparations produce obkalyvanie affected area p-rum novocaine with antibiotics.This procedure is well relieves pain, while preventing the spread and development of purulent process on the surrounding tissue.Physiotherapy in the form of electrophoresis with antimicrobial drugs to prevent complications in the form of boils abscesses and abscesses.
Once determined fluctuation zone, the center furunkuleznyh elements applied salicylic crystalline sodium and make it dry bandage fixation.These applications contribute to accelerated rejection furunkuleznogo rod.
At current boils to form abscesses, surgical dissection element.Produced procedure under local anesthesia with removal of necrotic masses.Once opened, the wound should be washed as a 3% hydrogen peroxide and bandages prescribed drugs with proteolytic group - levomikol, erythromycin, sintomitsinovoy ointment.These dressings changed every other day, and when the process will move into a stage of granulation, then apply a bandage with ointment Vishnevsky ointment or ichthyol for better healing.UHF and MSS as an anti-inflammatory therapies are applied at all stages of boils.
Antibiotics for abrasions prescribed in cases of chronic course of boils and abscesses in the transition elements.If the patient has other chronic diseases, or had been reduced immune status, the recommended antibiotic in the form of i / m injection.
to enhance immunity apply ozone therapy and gamma globulin, vitamin, UBI, autotransfusion and restorative drugs.
When treating patients with chronic recurrent furunculosis identify immunological disorders, stage of the disease, possible comorbidities.During exacerbation boils require a topical treatment in the form of processing elements furunkuleznyh antiseptic agents, antibacterial ointments;in the case of the elements in the head and neck - carrying antibacterial treatment based on sensitivity to the pathogen.At any stage boils recommended correction of comorbidities (sanitation chronic infectious foci treatment of gastrointestinal diseases, endocrine diseases, and so on. D.).
If chronic abrasions are in the acute stage, the treatment is carried out with the purpose of certain immunomodulators.If there are changes in phagocytic immune response, it is advisable Polyoxidonium appointment of 6-12 mg / m within 14 days.
By lowering the affinity of the immunoglobulin Galavit administered 100 mg / m for a period of 14 days.
By lowering the level of B-lymphocytes and abuse CD4 / CD8 ratio downward Myelopid recommended the use of 3 mg for a week / m.
By lowering the IgG level against the background of intense aggravation of boils, the clinical application of ineffectiveness Galavita prescribe drugs immunoglobulin / in (Octagam, Intraglobin, Gabriglobin).
In remission boils available immunomodulatory therapy.
Seram seems a synthetic analog of an endogenous immunoregulatory peptide nature - MYELOPEPTIDE-3 (IP-3).This drug is used in the complex therapy of patients with boils all stages of 5 mg / m for five days.After therapy Seramilom observed indicators of normal B-lymphocytes, as well as lowering the levels of CD8-lymphocytes.There is also a significant increase in terms of remission boils (up to 1 year, a third of patients).
Neogen represented as synthetic tripeptide consisting of L-amino acid residue glutamine and tryptophan izoletsitina.Neogen is used in the complex therapy, which is performed in patients with chronic furunculosis.Intramuscular injections Neogene conducted on 1 ml of 0.01% solution 1 times a day for 10 days.
Application Neogene in the complex therapy of patients with chronic furunculosis is the acute stage of the disease proves confident normalization initially changed parameters of immunological response and increased rates of spontaneous CL and anti-DAO antibodies affinity, the number of HLA-DR + lymphocytes, which significantly extends the remission rateboils.
So, from the above it is clear that chronic abrasions passes under the influence of a complex set of pathogenetic and etiologic factors and in any case can not be seen only as an inflammation of a local nature.