The cluster boil, or carbuncle

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Carbuncle, or cluster boil, is a cluster of boils located next to each other, usually on the nape or on the back. The inflammatory surface reaches a considerable size and then often tissue necrosis occurs over a large area. For example, diabetes predisposes to the formation of cluster boils, therefore tests must be performed.

What is a cluster boil (carbuncle)?

A gromanda boil, otherwise known as a carbuncle, is an unsightly bloom on the skin of the face or other hairy parts of the body, which is a cluster of many boils located close to each other. These changes combine to form one larger bloom. Carbuncle is found equally often in children and the elderly, and in men and women. The cause of cluster boils is a bacterial skin infection caused by staphylococcus aureus (Staphylococcus aureus). The area around the hair follicle is inflamed, accompanied by purulent discharge and the formation of necrotic plugs (dying of infected tissues). In most people, the plug ruptures spontaneously, there is a discharge, and the lesion itself leaves a scar after healing.

Types of boils

1. single boil,
2. cluster boils (lesions merging into one larger eruption),
3. furunculosis (multiple lumps some distance apart).

The most common locations of the boil are: face, head, leg, buttocks, groin, inner nose, inner ear, back, labia. Changes always occur in the area of ​​the scalp, which is why they cannot be found on the hands or soles of the feet.

What are the causes of a cluster boil?

Carbuncle in most cases is caused by an infection with golden staphylococcus, which is normally found on the surface of the skin and in the nasopharynx. However, it can spread to neighboring parts of the body due to certain factors:

1. inadequate personal hygiene,
2. vitamin deficiencies in the body,
3. old age,
4. alcohol abuse,
5. the use of preparations with immunosuppressive effects – e.g. glucocorticosteroids: Encorton, Dexaven,
6. skin diseases damaging the protective layer of the epidermis,
7. overweight or obesity,
8. temporary decline in immunity / impaired immunity,
9. systemic diseases,
10. diabetes (untreated or poorly treated),
11. chronic kidney disease
12. HIV and AIDS – the function of T lymphocytes, which are the main element of the immune system of every human being, is impaired,
13. liver failure
14. cancer, such as that of the colon, lung, or pancreas; which causes long-term disturbances in the absorption of nutrients and exhaustion of the body,
15. shared use of towels, clothes, bedding (in places such as military barracks or dormitories),
16. sometimes: skin irritation due to shaving, wearing too tight clothing, insect bites (especially in places where the skin has the greatest number of sweat glands).

Classical boil (carbuncle) – symptoms

Carbuncle is most often found around the nape and the back of the neck, much less often on the buttocks or thighs. At first, the boil is a red and very painful lump that fills with pus over time (small, usually up to 1 cm). It contains all kinds of dead tissues, bacteria and neutrophilic granulocytes, which causes pimples to spill side by side on a small area of ​​the skin. They then merge together into one larger pus-filled shift.

If left untreated, the lesions burst spontaneously over time and their contents (pus, yellow or cream) are empty. After removing the purulent and necrotic content, the lesion heals, leaving a scar, its size depends on the size of the boil. Skin lesions that are more superficial, and those that have many holes on the surface of the skin, usually do not leave scars. In addition to the occurrence of eruptions, patients complain of accompanying symptoms in the form of:

1. general feeling of tiredness
2. high temperature,
3. weakness,
4. sometimes enlargement of the surrounding lymph nodes.

Cluster boil – diagnosis

The presence of symptoms suggesting the formation of a boil should prompt you to visit your GP. In the case of more severe symptoms, when further boils develop in the area of ​​a single boil, a visit to a dermatologist is necessary. The basis for the diagnosis of the disease is a medical interview with the patient, which includes questions about:

1. smoking cigarettes,
2. localization of the observed skin changes,
3. the frequency of changes (is it the first time in your life?),
4. enlarging or reducing nodules and accompanying pain
5. medications currently taken,
6. possible allergies,
7. chronic diseases, e.g. cancer, diabetes.

Then a physical examination of the patient is performed. Every part of the body should be assessed, not just the carbuncle. A medical history and physical examination are usually sufficient to make a proper diagnosis.

Note:

If there are doubts as to whether a specific skin lesion is a boil, additional tests are performed, such as:

1. blood counts (ESR, CRP),
2. bacteriological smear (allows for quick detection of the golden staphylococcus in the body in microscopic examination and assessment of its growth).

Class boil and complications

Keep in mind that the carbuncle is caused by strains of staphylococcus that require treatment with strong antibiotics. Serious complications must be taken into account, because in some (rare) cases, bacteria may enter the blood and cause, for example, sepsis or infection foci in other parts of the body (e.g. internal organs, lungs, heart or central nervous system). Then the patient develops chills, high temperature, increased heart rate and a feeling of serious illness. Also in routine examinations (ESR, CRP, morphology) – irregularities are revealed.

Treatment of a cluster boil (carbuncle)

Single skin lesions can be treated with a special ichthyol ointment, which has bacteriostatic and anti-inflammatory properties. The growth and multiplication of the bacterial cells will be inhibited. In addition, the necrotic suppository can be incised and removed. However, in more severe cases, patients with impaired immunity who additionally suffer from diabetes or other systemic ailments develop multiple boils. In such people, treatment includes:

1. the use of topical antibiotics (creams with mupirocin, neomycin or fusidic acid),
2. use of systemic antibiotics (erythromycin, clarithromycin or dicloxacillin – taken for about a week),
3. surgical resection (this does not apply to boils localized around the face!).

Treatment is usually done at home, of course, this includes taking antibiotics and applying ointments and creams. Visits to the hospital require surgery and incision of the lesion to remove purulent discharge.

Massive boil – prophylaxis

Single lesions are usually not a problem because proper treatment completely eliminates the symptoms. The situation is different in the case of frequent occurrence of lesions and carbuncle. Then, appropriate prophylaxis and control in predisposed people allows you to avoid them.

1. Immunocompromised people should protect themselves against infections.
2. It is important to systematically control the course of diabetes and to use antidiabetic preparations.
3. The diet should be adjusted to the needs of the patient’s organism.
4. You should monitor kidney functions and include low-protein products in your menu. Take medications systematically.
5. People addicted to alcohol or drugs, as well as with anorexia and bulimia – should seek help in specialist clinics.

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