Furunkulez – it is purulent - a necrotic disease of a hair follicle and okolofollikulyarny connecting fabric. Primary inflammatory element is the inflammatory knot which is formed around a hair follicle. Staphylococcal infections are the main reason for a furunkulez. The typical dermatological picture, inflammation signs in clinical blood test and results of the bacteriological crops separated skin elements allow to diagnose without special difficulties . Patients with furunkulezy undergo treatment at the dermatologist.
Furunkulez – it is purulent - a necrotic disease of a hair follicle and okolofollikulyarny connecting fabric. Primary inflammatory element is the inflammatory knot which is formed around a hair follicle. Staphylococcal infections are the main reason for a furunkulez.
Reasons of a furunkulez
Staphylococcal microflora which under the influence of various factors becomes more active is the reason of a furunkulez and provokes pyoinflammatory process. In the presence of immunodeficiencies of short-term influence of exogenous factors it is enough for development of a furunkulez. Existence of the centers of a chronic infection, diabetes, hypovitaminoses, errors in a diet, chronic intoxications both independently, and in total can provoke . At the localized furunkulez the skin travmatization, local overcooling and its pollution are the main reasons for introduction of stafilokokk in a follicle.
Clinical manifestations of a furunkulez
At the initial stage of a disease around a hair sack pyoinflammatory infiltrate of the small size which reminds is formed follikulit. In several days all hair follicle is involved in inflammatory process. At a furunkuleza unlike a follikulit not only the follicle, but also an adjacent sebaceous gland, and surrounding connecting fabric is surprised. Clinically elements of rashes at a furunkuleza remind the cone-shaped stagnant and hyperemic knot towering over the surface of skin. In process of formation of the center of an inflammation morbidity, puffiness and pains of the pulsing or pulling character increases.
If furunkulezy follicles of the person and neck are surprised, then process is followed by extensive hypostasis around infiltrate. For the 3rd, 4th days in the center of infiltrate the fluctuation zone begins to be formed – when pressing such element of a furunkulez the elastic movement of purulent masses in a follicle cavity is felt, and around a hair the small center of purulent fusion of fabrics and formation of fistula is noted.
After elements of a furunkulez are opened, the insignificant amount of dense pus which accumulated on a surface is distinguished and the small ulcer is formed. At the bottom of an ulcer it is possible to see a necrotic core of greenish color, existence of such core is a diagnostic symptom at a furunkuleza. In several days the core is torn away together with insignificant amount of blood and purulent masses. After rejection of a core the inflammatory phenomena of a furunkulez begin to decrease. The affected area becomes less painful at a touch, puffiness of fabrics falls down.
After permission of elements of a furunkulez the deep crateriform ulcer from the remains of pus and necrotic masses which are gradually torn away is formed or form chronic . The ulcer is filled with granulyatsionny fabric and the involved hem is formed, depth and the size of a hem depend on the necrosis zone size in the center of a furuncle.
The furunkulez has no favourite localizations, but more often elements of an inflammation arise on forearms, a face, the back surface of a neck, buttocks and hips that is where sites of problem skin, inclined to fat content, are located. If elements of a furunkulez have single character, then the general health of the patient does not suffer, body temperature remains normal, patients lead a former life.
At defeat furunkulezy zones of a nasolabial triangle, wings of a nose, the field of external acoustical pass even at single rashes body temperature increases, symptoms of intoxication and headaches are observed. Face skin becomes crimson, intense, puffiness and morbidity is sharply expressed. Work of mimic muscles, high risk of a travmatizatsa of elements of furunkulez during shaving and washing, attempt to squeeze out them independently can lead to developing of thrombophlebitis of veins of the person and to a dissemination of a staphylococcal infection in internals and fabrics.
Because of features of a venous krovoottok on a face in certain cases leads faces to meningitis and an encephalomeningitis. Sepsis with formation of multiple abscesses in internals is one of the heaviest complications of a furunkulez.
At a sharp current of a furunkulez at skin there are set of furuncles identical on a permission stage. Uncured sharp , existence of immunodeficiencies and neglect rules of personal hygiene lead to process synchronization. The chronic current of a furunkulez is characterized by existence of furuncles of different degree of permission, at the same time on skin there are granulyatsionny changes of elements and recurrent furuncles in which process becomes more active several times a year or more often.
At the localized furunkulez certain sites of skin whereas at disseminirovanny process accepts widespread character are surprised. Furunkulez of extremities, especially at an arrangement of elements near joints is complicated by regionarny lymphadenitis. Sometimes at a furunkuleza complications in the form of a glomerulonefrit are possible.
Diagnostics of a furunkulez
Clinical manifestations, existence of a zone of fluctuation, existence of signs of infectious process allow to make the diagnosis. In clinical blood test increase in speed of subsidence of erythrocytes, shift of a leykotsitarny formula to the left and expressed is noticeable. Cultural diagnostics confirms the staphylococcal nature of a disease. Together with cultural diagnostics carry out definition of sensitivity of a microorganism to antibiotics. Exact definition of the activator helps to reveal also the center of an infection, for example, often intrahospital infection is shown in the form of piodermiya and furunkulez.
Treatment of a furunkulez
Treatment of a furunkulez has to be carried out by the dermatologist. Self-treatment by Vishnevsky's ointment can lead to distribution of process and to phlegmon as Vishnevsky's ointment will be applied only after resolution of the purulent capsule at a granulation stage. Expression of cores at a furunkuleza hands or by means of vacuum cans leads to premature opening when nearby sites of healthy skin obsemenyatsya by pathogenic microflora, and a part of a core remains inside and by that leads to process synchronization.
During treatment of a furunkulez it is necessary to limit whenever possible or to completely exclude water procedures, but at an extensive furunkulez slightly heat baths with permanganate of potassium disinfect skin. As hygienic procedures resort to wiping of healthy skin nonaggressive antiseptic solutions – salicylic alcohol or solution of Furacilin.
Much attention has to be paid to personal hygiene, insignificant scratches and cuts are processed by solution of diamond greens, frequent change of next-to-skin and bed linen is obligatory. The exception of a diet of greasy, spicy food and presence of food at it vitamin-rich and protein help to improve regeneration of fabrics.
At a maturing stage leather around elements is processed antiseptics, obkalyvany zones of defeat by novocaine solution with antibiotics remove a pain syndrome and does not allow distribution of purulent process on healthy fabrics. With antimicrobic medicines complications of a furunkulez in the form of abscesses and phlegmons help to prevent an electrophoresis.
After the fluctuation zone was outlined, in the center of elements of a furunkulez impose crystal salicylic sodium and fix it a dry bandage. Such applications have keratolitichesky effect and promote the accelerated rejection of a core.
At an abstsediruyushchy current of a furunkulez opening of a furuncle under local anesthesia is shown and removal is purulent - necrotic masses. After independent or compulsory opening the wound is carefully washed out by 3% peroxide of hydrogen and appoint bandages with proteolytic medicines, sintomitsinovy and eritromitsinovy ointments. Bandages change every other day, and after transition of process to a granulation stage apply Vishnevsky's liniment and ointments on the basis of Ichthyol to the best healing.
Ultra-violet radiation and UVCh-terpiya it is applied it is dosed at all stages of a furunkulez. Resort to internal reception of antibiotics in cases of a chronic furunkulez and at an abstsedirovaniye of elements. In the presence of the general diseases, exhaustion of the patient and the lowered immune status appoint antibiotics in the form of intramuscular injections. Gamma globulin and an ozonoterapiya are applied to increase in resilience of an organism, vitamin therapy, autogemotransfuziya, UFOK and the all-strengthening medicines is appointed.
Prevention of a furunkulez consists in respect for personal hygiene, timely treatment of pustulous diseases, in treatment of system diseases and under the authority of a healthy lifestyle.