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boil, boils on skin
A boil, also called a furuncle, is a deep folliculitis, infection of the hair follicle It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue1 Boils which are expanded are basically pus-filled nodules2verification needed Individual boils clustered together are called carbuncles3 Most human infections are caused by coagulase-positive S aureus strains, notable for the bacteria's ability to produce coagulase, an enzyme that can clot blood Almost any organ system can be infected by S aureus


  • 1 Signs and symptoms
  • 2 Causes
    • 21 Bacteria
    • 22 Family history
    • 23 Other
  • 3 Complications
  • 4 Treatment
  • 5 See also
  • 6 References
  • 7 External links

Signs and symptomsedit

Boils are bumpy, red, pus-filled lumps around a hair follicle that are tender, warm, and very painful They range from pea-sized to golf ball-sized A yellow or white point at the center of the lump can be seen when the boil is ready to drain or discharge pus In a severe infection, an individual may experience fever, swollen lymph nodes, and fatigue A recurring boil is called chronic furunculosis1456 Skin infections tend to be recurrent in many patients and often spread to other family members Systemic factors that lower resistance commonly are detectable, including: diabetes, obesity, and hematologic disorders7 Boils can be caused by other skin conditions that cause the person to scratch and damage the skin

Boils may appear on the buttocks or near the anus, the back, the neck, the stomach, the chest, the arms or legs, or even in the ear canal8 Boils may also appear around the eye, where they are called styes9 A boil on the gum is called intraoral dental sinus, or more commonly, a gumboil



Usually, the cause is bacteria such as staphylococci that are present on the skin Bacterial colonisation begins in the hair follicles and can cause local cellulitis and inflammation156 Myiasis caused by the tumbu fly in Africa usually presents with cutaneous furuncles10 Risk factors for furunculosis include bacterial carriage in the nostrils, diabetes mellitus, obesity, lymphoproliferative neoplasms, malnutrition, and use of immunosuppressive drugs11

Family historyedit

People with recurrent boils are as well more likely to have a positive family history, take antibiotics, and to have been hospitalised, anemic, or diabetic; they are also more likely to have associated skin diseases and multiple lesions12


Other causes include poor immune system function such as from HIV/AIDS, diabetes, malnutrition, or alcoholism13 Poor hygiene and obesity have also been linked13 It may occur following antibiotic use due to the development of resistance to the antibiotics used14 An associated skin disease favors recurrence This may be attributed to the persistent colonization of abnormal skin with S aureus strains, such as is the case in persons with atopic dermatitis14 Boils which recur under the arm, breast or in the groin area may be associated with hidradenitis suppurativa HS15


The most common complications of boils are scarring and infection or abscess of the skin, spinal cord, brain, kidneys, or other organs Infections may also spread to the bloodstream bacteremia and become life-threatening56 S aureus strains first infect the skin and its structures for example, sebaceous glands, hair follicles or invade damaged skin cuts, abrasions Sometimes the infections are relatively limited such as a stye, boil, furuncle, or carbuncle, but other times they may spread to other skin areas causing cellulitis, folliculitis, or impetigo Unfortunately, these bacteria can reach the bloodstream bacteremia and end up in many different body sites, causing infections wound infections, abscesses, osteomyelitis, endocarditis, pneumonia16 that may severely harm or kill the infected person S aureus strains also produce enzymes and exotoxins that likely cause or increase the severity of certain diseases Such diseases include food poisoning, septic shock, toxic shock syndrome, and scalded skin syndrome17 Almost any organ system can be infected by S aureus Squeezing or cutting boils and even smaller pimples in the danger triangle of the face can be particularly dangerous if done outside a medical setting, as blood vessels in this area drain into the brain and can carry serious infections there


A boil may clear up on its own without bursting, but more often it will need to be opened and drained This will usually happen spontaneously within two weeks Regular application of a warm moist compress, both before and after a boil opens, can help speed healing The area must be kept clean, hands washed after touching it, and any dressings disposed of carefully, in order to avoid spreading the bacteria A doctor may cut open or "lance" a boil to allow it to drain, but squeezing or cutting should not be attempted at home, as this may further spread the infection Antibiotic therapy may be recommended for large or recurrent boils or those that occur in sensitive areas such as the groin, breasts, armpits, around or in the nostrils, or in the ear1456 Antibiotics should not be used for longer than one month, with at least two months preferably longer between uses, otherwise it will lose its effectiveness18 If the patient has chronic more than two years boils, removal by plastic surgery may be indicated

Furuncles at risk of leading to serious complications should be incised and drained if antibiotics or steroid injections are not effective These include furuncles that are unusually large, last longer than two weeks, or occur in the middle of the face or near the spine16 Fever and chills are signs of sepsis and indicate immediate treatment is needed19

Staphylococcus aureus has the ability to acquire antimicrobial resistance easily, making treatment difficult Knowledge of the antimicrobial resistance of S aureus is important in the selection of antimicrobials for treatment20

See alsoedit

  • Nodule medicine
  • Cutaneous condition


  1. ^ a b c d e MedlinePlus Encyclopedia Furuncle
  2. ^ "Causes and Cures of Skin" Healthguidanceorg Retrieved 26 July 2014 
  3. ^ MedlinePlus Encyclopedia Carbuncle
  4. ^ a b Blume JE, Levine EG, Heymann WR 2003 "Bacterial diseases" In Bolognia JL, Jorizzo JL, Rapini RP Dermatology Mosby p 1126 ISBN 0-323-02409-2 
  5. ^ a b c d Habif, TP 2004 "Furuncles and carbuncles" Clinical Dermatology: A Color Guide to Diagnosis and Therapy 4th ed Philadelphia PA: Mosby 
  6. ^ a b c d e Wolf K; et al 2005 "Section 22 Bacterial infections involving the skin" Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology 5th ed McGraw-Hill 
  7. ^ Steele RW, Laner SA, Graves MH February 1980 "Recurrent staphylococcal infection in families" Arch Dermatol 116 2: 189–90 PMID 7356349 doi:101001/archderm1162189 permanent dead link
  8. ^ "Boils, Carbuncles and Furunculosis" Patientinfo Retrieved 26 July 2014 
  9. ^ "Boils, Kidshealth" http://wwwkidshealthorgnz Retrieved 26 July 2014  External link in |website= help
  10. ^ Tamir J, Haik J, Schwartz E 2003 "Myiasis with Lund's fly Cordylobia rodhaini in travellers" J Travel Med 10 5: 293–95 PMID 14531984 doi:102310/706020032732 
  11. ^ Scheinfeld NS 2007 "Furunculosis" Consultant 47
  12. ^ El-Gilany AH, Fathy H January 2009 "Risk factors of recurrent furunculosis" Dermatol Online J 15 1: 16 PMID 19281721 
  13. ^ a b Demos, M; McLeod, MP; Nouri, K Oct 2012 "Recurrent furunculosis: a review of the literature" The British Journal of Dermatology 167 4: 725–32 PMID 22803835 doi:101111/j1365-2133201211151x 
  14. ^ a b Laube S, Farrell M 2002 "Bacterial skin infection in the elderly: diagnosis and treatment" Drugs and Aging 19 5: 331–42 PMID 12093320 doi:102165/00002512-200219050-00002 
  15. ^ "What is this boil like abscess under your arm, breast or groin" The Hidradenitis Suppurativa Trust Retrieved 28 September 2015 
  16. ^ Lina G, Piémont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, Vandenesch F, Etienne J November 1999 "Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia" Clin Infect Dis 29 5: 1128–32 PMID 10524952 doi:101086/313461 
  17. ^ "Staph Infection Causes, Symptoms, Treatment – Staph Infection Diagnosis – eMedicineHealth" eMedicineHealth 
  18. ^ Mayo Clinic Archived 15 August 2012 at the Wayback Machine
  19. ^ ref="Archived copy" Archived from the original on 15 August 2012 Retrieved 2012-08-14 
  20. ^ Nagaraju U, Bhat G, Kuruvila M, Pai GS, Babu RP 2004 "Methicillin-resistant staphylococcus aureus in community-acquired pyoderma" Int J Dermatol 43 6: 412–14 PMID 15186220 doi:101111/j1365-4632200402138x 

External linksedit

  • DermAtlas 1817374494

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