Dermatovenerologist
Khasanova
Alina Rashidovna
9 years experience
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If staphylococcal bacteria enter the hair follicle of the skin, it can cause serious inflammation. An accumulation of pus with tissue necrosis that has captured the affected area along with the sebaceous glands and tissue is called a boil, and the disease itself is called furunculosis. Its appearance is quite painful, and its development is relatively fleeting. To avoid infection of the skin and the spread of the inflammatory process to healthy tissues, at the first signs of pathology you should seek medical help.
Description of the disease
Boils can occur in both young children and adolescents. Today they are the most common purulent skin lesion. Inflammation can affect any area where there are hair follicles. Most often, boils appear on the child’s head and neck, less often on the body (in the groin, on the back or stomach, under the armpit), on the legs and arms. The main feature of the course of this pathology in children is the high risk of inflammation spreading to neighboring tissues and structures, as well as its spread through the bloodstream, leading to the development of dangerous complications.
Causes of boils in children
Most often, inflammation develops due to tissue damage by Staphylococcus aureus, less often the causative agent is other groups of staphylococci or streptococci. All of them are on the skin almost constantly, but in a normal state of immunity they cannot cause disease. The pathological process starts when exposed to certain unfavorable factors:
- wounds, scratches on the skin;
- skin diseases (eczema, atopic dermatitis);
- decreased immunity due to acute respiratory viral infections, operations, injuries, exacerbation of chronic diseases);
- congenital immunodeficiency conditions;
- diabetes mellitus and metabolic disorders (often cause the constant appearance of boils in a child);
- chronic infections: tuberculosis, pyelonephritis, sinusitis, etc.
Let's talk in more detail about what contributes to the occurrence of this disease?
We have already mentioned that the immediate cause of a boil is an infection, namely staphylococcal.
We can also include damage to the skin - abrasions, cuts, scratches, scratches, abrasions - which contribute to the penetration of infection. We will also include lack of personal hygiene here.
Decreased immune status of the body due to hypothermia, or associated with vitamin deficiency, stress, diets, chronic diseases (diabetes mellitus, obesity, gastrointestinal diseases), taking certain medications, hormonal disorders.
Pathogenesis and stages of development
During the development process, the boil goes through three successive stages:
- initial (infiltration): the inflammatory process begins at the mouth of the follicle and gradually spreads;
- necrotic (maturation): inflammation engulfs the entire cavity of the follicle, causing necrosis and purulent melting of tissue; the process lasts from several days to 2 weeks and ends with a rupture of the skin over the center of the boil;
- healing stage: after the pus has drained and the cavity of the lesion has been cleaned, it gradually scars with the formation of a scar.
How does acne develop?66
Problematic skin is most often characterized by increased oiliness. The skin texture becomes uneven, roughness appears, and the mouths of the follicles expand. Staphylococci and propionibacteria located on the surface of the skin produce endogenous lipase, which breaks down triglycerides of sebum (sebum) into free fatty acids. They irritate the skin, causing the appearance of comedones.
If treatment is not started at this stage, the number of comedones will increase, the inflammatory reaction will worsen, and acne will take an indurative form. It is characterized by the appearance of large inflammatory infiltrates.
As a rule, it takes a few more weeks for the infiltrate to soften, the acne elements to open and cavities filled with purulent content to form. After such a rash heals, noticeable scars often remain.
With severe acne, acne conglobata may appear. These are large nodes on the face, back, chest, which are located in the deep layers of the skin, sometimes affecting the upper sections of the subcutaneous fatty tissue. The nodes, the size of which can be 1.5-2 cm, are painful; they cause patients not only aesthetic, but also physical discomfort.
When nodes merge, conglomerates are formed, and abscesses sometimes develop. After opening them, ulcers appear that do not heal for a long time. Over time, rough scars with fistula tracts remain in their place.
When inflammatory nodes immersed in the deep layers of the skin merge, sinus acne can develop. This form is characterized by the formation of epithelial sinus tracts.
Symptoms of a boil in a child
The main symptoms of a boil in a one-year-old child, preschool and school-age children are the same and depend on the stage of development of the disease.
At the initial stage, an area of redness appears on the skin, which gradually increases, but practically does not cause discomfort. As the pathology progresses, a purulent area appears in the center of the lesion, and the area of inflammation increases in size and becomes sharply painful. Then a necrotic rod is formed inside the cavity, which from the outside looks like a dark dot in the very center of the boil. After a few days, the abscess breaks through, its contents come out, after which the healing process begins. A small boil, especially if it is located on a child's hand, foot or finger, rarely causes general symptoms. With multiple inflammatory foci, as well as when localized in an area with a large number of blood and lymphatic vessels (face, neck, groin, armpits), the baby may have a fever, weakness, malaise and other signs of general intoxication.
Treatment
The main method of treating furunculosis is the use of external topical agents that relieve inflammation and pain. The course is based on the sequential use of antibiotics, antiseptic and painkillers. If there is a possibility of developing an abscess, it is possible to surgically open the boil, extract its contents and treat the site of inflammation. It is possible to use UHF therapy, which demonstrates high efficiency at any stage of the disease.
Please note: it is strictly unacceptable to self-medicate, or try to open a boil yourself to extract its contents. In addition, it is important to change clothes and bedding more often, strictly observe personal hygiene rules, but limit exposure to raw water on the affected area.
Diagnosis of boils in children
Diagnosis and treatment of boils in children is carried out by a dermatologist, often requiring the help of a surgeon and/or otolaryngologist. Making a diagnosis is not difficult, since the formation is clearly visible during a routine examination. If boils appear in a child too often and/or in large numbers, a more detailed examination is required to clarify the cause of this condition. Depending on the situation, the following is prescribed:
- microscopy and bacterial culture of the abscess contents;
- general and biochemical blood test;
- glucose tolerance test for suspected diabetes mellitus;
- study of the state of immunity;
- Ultrasound of internal organs, examination of the nasal cavity and sinuses, chest x-ray and other studies aimed at searching for chronic foci of inflammation.
Pediatric doctors of other specialties often join the examination: endocrinologists, pulmonologists, gastroenterologists and immunologists.
In addition, if you suspect the development of a boil, it is imperative to involve a pediatric surgeon in the diagnosis. His intervention will help to promptly notice the formation of an abscess and take the necessary measures (opening the abscess, washing the cavity, bandaging).
Ulcers* on the face: treatment
If you have acne, it is important to consult a dermatologist in a timely manner. If you notice that you often have a rash, even in the form of comedones, you need to visit a doctor. Acne is a chronic disease prone to recurrence18, do not allow it to worsen, do not wait until pustules appear next to the comedones.
Topical antibiotics can be used to treat mild to moderate acne. One of them is Clindovit®18.6 gel. It must be applied twice a day to dry, previously cleansed skin6.
Due to the presence of clindamycin, Clindovit® gel exhibits antibacterial activity against Propionibacterium acnes6. The drug reduces the level of free fatty acids6.
Clindovit® gel is recommended to be used together with azelaic acid (for example, Azelik® gel) or benzoyl peroxide, which helps reduce the risk of developing antibiotic resistance28.
*acne
Treatment of boils in children
If the child’s boil is small in size and is not located on the face, neck or knee, treatment at home is allowed. In case of extensive lesions or multiple purulent foci, hospitalization is required.
With a relatively mild course of the disease, conservative treatment is sufficient, which depends on the stage of development of the disease:
- at the initial stage, alcohol solutions and dry heat are used to accelerate ripening;
- at the necrotic stage, antibacterial agents, proteolytic drugs and regular wound washing are necessary;
- at the healing stage, agents are used that accelerate regeneration in combination with antibacterial treatment.
In more severe cases, local treatment is supplemented with systemic drugs: antibiotics, anti-inflammatory drugs, immunostimulants, etc. If the infection spreads to adjacent tissues with the development of abscesses or phlegmons, surgical assistance is required: opening and draining the abscess.
Causes
The inflammatory process and tissue suppuration are promoted by:
- non-compliance with personal hygiene requirements or its inadequate quality;
- constant friction of clothing on the skin;
- abrasions and injuries that provide access to the subcutaneous layer for bacteria;
- intensive work of the sebaceous and sweat glands;
- hypovitaminosis;
- metabolic disorders.
Most boils form on areas of the skin with hair follicles. They often appear on the neck, face, back of the hands, and in the lumbar region. At the initial stage, inflammation makes itself felt by the appearance of a characteristic red bump that rises above the surface of the skin. After 3-4 days, a purulent head appears. Later, the boil breaks out under the influence of an increase in the volume of purulent secretion or mechanical impact. At the site of the skin break, a core is visible - the so-called necrotic tissue. 2-3 days after the rupture, the rod, along with the remainder of the purulent contents, is rejected, and the wound begins to heal.
Are you experiencing symptoms of boils and furunculosis?
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Prognosis and prevention
Single boils that occur without complications completely disappear within 2-3 weeks.
With relatively frequent relapses (exacerbations once a year or more often), the likelihood of complications is much higher. In this case, regular monitoring, immunostimulating procedures, and treatment of underlying diseases are required. Prevention of the development of boils in children includes careful skin care, regular hardening and strengthening of the immune system, timely treatment of acute and chronic diseases.
A boil is not just a pimple. An abscess can cause severe complications, including sepsis and meningitis, which is why any such formation on the body of a child or teenager requires careful monitoring. The specialists of the SM-Doctor clinic will select the optimal method of treating and preventing this problem.
