CARBUNCLE

DEFINITION:

• It is red swollen painful cluster of boils that are connected to each other under the skin.
• Boil-Infection of a hair follicle that has small collection of pus.
• It is an infective gangrene of the sub cutaneous tissue and skin .
• The word meaning CARBUNCLE is CHARCOAL.
COMMON SITE

• Nape of neck and back is the most common site.

• It is common in males, diabetics and 40 years of age.
• Cheek
• Dorsum of hand
• Buttocks, thighs.
• Armpits
• Groins
 CAUSES

• Bacterial infection-Staphylococcus, Streptococcus pyogens mainly methicillin resistant

staphylococcus aureus
• People with dermatitis, diabetes and week immune system are at greater risk.
• Sometimes poor hygiene and a cut from clothing or shaving.
• Infection spreads from one part to other parts of the person’s body or from one person to
another person through skin to skin contact or Sharing of personal items.
 RISK FACTORS

• Old age .
• Obesity
• Poor hygiene
• Irritation or abrasions of the skin surface due to tight clothing
• Insect bites
• Any conditions which weakens immune system
• Affects mainly in body areas with heavy perspirations
PATHOGENESIS

INFECTION

DEVELOPMENT OF SMALL VESICLES

SIEVE LIKE PATTERN

RED INDURATED SKIN WITH DISCHARCHING PUS

MANY FUSE TOGETHER TO FORM A CENTRAL NECROTIC ULCER WITH PERIPHERAL FRESH VESICLE LOOKING LIKE A ROSETTE[ CRIBRIFORM]

SKIN BECOMES BLACK DUE TO BLOCKAGE OF CUTANEOUS VESSELS

DISEASE SPREADS TO ADJACENT SKIN RAPIDLY

SYMPTOMS

• GENERAL SYMPTOMS OF CARBUNCLE IS FORMATION OF RED BOILS UNDER

THE SKIN
• A CARBUNCLE CAN RANGE FROM A SIZE OF A PEA TO A SIZE OF HALF
GROWN ONION
• OTHER SYMPTOMS ARE Fatigue,Fever,Irritation,Swelling,Itching,Pain around affected
area,spreading of lump to other skin areas
INVESTIGATIONS

• URINE SUGAR AND URINE KETONE BODIES.

• BLOOD SUGAR.
• PUS SAMPLE FOR BACTERIAL CULTURE
TREATMENT

• MOST OF THESE ARE TREATABLE AT HOME .

• IF BOILS ARE NEAR EYES,NOSE OR SPINE IT'S RECOMMENDED TO SEE A DERMATOLOGIST.

• THERE ARE VERY RARE CHANCES THAT CARBUNCLE COULD LEAD TO INFECTION THAT ARE SERIOUS IN
NATURE.

• CONTROL OVER DIABETES IS ESSENTIAL BY USING INSULIN.

• ANTIBIOTICS LIKE PENICILLIN,CEPHALOSPORINS OR DEPENDING ON CLINICAL SYMPTOM IS GIVEN.

• DRAINAGE IS DONE BY A CRUCIATE INCISION AND DEBRIDEMENT OF ALL DEAD TISSUES IS DONE.EXCISION IS
DONE LATER.

• ONCE WOUND GRANULATES WELL , SKIN GRAFTING MAY BE REQUIRED.

PREVENTION

• REGULARLY WASH CLOTHES,SHEETS AND TOWEL.

• ALWAYS WASH HANDS BEFORE EATING ANYTHING.
• AVOID SHARING TOWEL, RAZOR, OR TRIMMER.
• USE ANTIBACTERIAL SOAP TO PREVENT BACTERIAL INHABITANCY.
COMPLICATIONS

• ABSCESS OF THE BRAIN, SKIN, SPINAL CORD OR ORGANS SUCH AS KIDNEY.

• ENDOCARDITIS.
• OSTEOMYELITIS.
• PERMANENT SCARRING OF SKIN.
• SEPSIS .
• SPREAD OF INFECTION TO OTHER AREAS.