Furunculosis

Multiple lesions of furuncles, which appear simultaneously or sequentially one after another in different parts of the body - is called furunculosis. When it lasts with little remissions for several years, it is chronic, relapsing.
In places deprived of hair (palms and palm surface of fingers, soles) boils do not develop. Most often observed in areas of the skin that are contaminated (forearm, rear of the hand) and friction (the back surface of the neck, lower back, gluteal region, thighs). Usually FURUNKUL does not cause significant disturbances of well-being. The pains are moderate, but when localized, for example, in the external auditory canal, in the nose - significant. In the face (lip, forehead), as well as on the scrotum, furuncles are accompanied by a significant edema of the surrounding tissues, which is explained by the friability of the subcutaneous tissue here.
Severe clinical course is often observed with furuncles of the upper lip, nasolabial fold, nose, suborbital (okolaglaznoy) area. Features of the development of the venous and lymphatic network on the face promotes the rapid spread of microbes. Thrombophlebitis of the veins with a furuncle of the face can spread over the anastomoses to the venous sinuses of the dura mater, which leads to their thrombosis, creating a threat of purulent basal meningitis. Rapidly swelling of the face, palpable dense painful veins, sharply worsens the overall condition of the patient, body temperature reaches a high level (40-41 ± С), stiff neck, visibility impairment (defeat of the chiasma) can be expressed.
To complications of furuncles should include lymphangitis and regional lymphadenitis.
Especially dangerous are rapidly progressive acute thrombophlebitis and sepsis. Acute thrombophlebitis usually develops in furuncles, located near large subcutaneous veins, and septicemia - with furunculahlitsa. They are often the result of attempts to squeeze out the contents of the boil, cut it during shaving, trauma in the massage. The prognosis for these complications is very serious.
Careful skin toilet around the focus of inflammation: rubbing 70% with alcohol, 2% with salicylic alcohol or lubrication with 1-3% alcohol solution of methyl-blue blue, brilliant green, etc. Hair around the infiltration is carefully cut. At the very beginning of the process, the abortive action is sometimes re-lubricated with a tincture of iodine. Ointments with various antiseptics are consumed only when the hearth is opened and emptied of pus. In the presence of necrotic masses, hypertonic solutions of sodium chloride are advisable.
It shows dry heat (hot-water bottle, salt, Minin lamp), as well as UHF, which has an analgesic effect.
Compresses should not be done, as they contribute to the formation of multiple infiltrates. For furuncles of the trunk, neck and extremities, stickers should be used that protect the skin in the area of ​​inflammation from friction. Sometimes in an early stage a furuncle is treated with an antibiotic with novocaine or electrophoresis, but many surgeons prefer intramuscular injections.
For boils, face bandages are usually not applied. It is strictly forbidden to extrude the contents of the boil and massage in the area of ​​the inflammation focus. At high temperature, a strict bed rest, liquid food is prescribed, the patient is forbidden to talk, chew. It is necessary to begin as early as possible vigorous treatment with antibiotics, and it is advisable to combine them with the methods inside sulfanilamide preparations. Surgery is rarely used. However, with the development of phlegmon, it is subject to immediate opening.
With recurrent furuncles, non-specific stimulating therapy is performed in the form of autohemotherapy (intramuscular injection of Augocra in 5-10 ml in 1-2 days, only 3-5 injections), do small doses of canned blood. In chronic furunculosis, immunization with staphylococcal anatoxin, the administration of hyperimmune serum, gamma globulin, and repeated transfusion of small doses of blood are effective.