What are folliculitis, furuncles, carbuncles, and abscesses?

Folliculitis occurs when a skin infection is confined to a hair follicle, However, when the infection spreads and involves the tissue around the hair follicle, it is called a furuncle. A carbuncle occurs when several furuncles connect.

Skin abscesses are the result of poor treatment of the above mentioned skin infections.
Folliculitis, furuncles and carbuncles are commonly caused by a bacterium (Staphylococcus aureus).

What are the signs and symptoms of these skin infections?

Folliculitis presents with an elevation of the skin (pustule) or reddish inflammation around a hair follicle.

Furuncles are acute localized reddish nodules, which are painful, and tend to occur in the neck area, the face, on breasts and buttocks. Often it starts as a pus blister (pustule), which then breaks open and discharges pus and necrotic tissue. If furuncles occur at the nose or the ears they are particularly painful.

Carbuncles are larger and deeper than furuncles, but otherwise are found in the same areas and also tend cheap oakleys to break open.

Abscesses present as tender, swollen areas of reddened skin, which are hot and tender to touch. There may be a fever. A brain abscess would be accompanied by signs of a stroke (hemiplegia, with half of the body paralyzed) and with abscesses in other organs.

How are these skin infections diagnosed?

The diagnosis is mostly a clinical one as the symptoms and the history will allow the physician to come to the diagnosis with high accuracy. In the case of skin abscesses blood tests, blood cultures and some other tests may be needed to help with the diagnosis. In deeper abscesses such tests as ultrasound, CT scan and Gallium bone scan might be indicated. Marked increased white blood cell counts (leukocytosis) is usually found in the case of an abscess.

How are these skin infections treated?

Folliculitis requires the daily application of an ointment (brandname: Bactroban ointment) to the affected area. This is best complemented by oral administration of cloxacillin or cephalexin for 7 to 10 days to interrupt the cycle of re-infection.

Furuncles and carbuncles are treated by incision and drainage. Isotretinoin (brand name: Accutane) is useful in severe acne cases where furuncles are frequently found. Oral antibiotics as for folliculitis are often also given, but for more prolonged periods of time.

A deep skin abscess requires an incision and drainage by a surgeon. In a large abscess gauze packing or a surgical drainage tube may have to be inserted to allow the wound to heal by “secondary” wound healing. Antibiotic coverage as above is given at the same time. Close monitoring of the blood tests and of the clinical condition for possible complications needs to be done.

IceWave patches from Lifewave are an FDA-approved non-drug method available to help control pain.

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