Furunculosis - Furuncles (Boils) Treatment, Cause and picture of boil

Furunculosis is a condition familiar to every one. A furuncle or boil is a deep-seated septic affection of the hair follicle in which the hair rootis completely destroyed and comes out as the core of the boil. Multiple boils are given the anme of furunculoses. A carbuncle is a big conglomeration of boils, the inflammation spreading from one follicle to another under the epidermis. The intervening corium is destroyed and pus is discharged through multiple holes.

Boils are a rather more deep-seated infection of the skin, often caused by Staphylococcus. They can cause painful red swellings. They are commoner in teenagers and often recurrent. Recurrent boils may rarely occur in diabetes mellitus or in immunosuppression. Large boils are sometimes called 'carbuncles'.

Causes of Furunculosis
The causative organism in these conditions is Staphylococcus aureus, less frequent other staphylococci. Furunculosis is a common skin problem, very prevalent in the tropics. It is more common in the summer, especially the monsoon season. Maceration of the skin, dusty and dirty environments, and the ingestion of too many carbohydrates, predispose to furunculoses. The eating of too many mangoes has a similar effects (mango boil). A stye is a boil around an eyelash.

Treatment of Furunculosis (Furuncles)
Treatment is with oral antibiotics (e.g. erythromycin 500 mg four times daily for 10-14 days) and occasionally incision and drainage. Antiseptics such as povidone iodine, chlorhexidine (as soap) and a bath oil (e.g. Oilatum plusT) can be useful in prophylaxis.

In acute cases, the treatment consists of:

Surgical incision only when the boil is ripe.
Course of Septran (P) or penicillin or broad-spectrum antibiotics.
Removal or correction of the predisposing cause.
Applying an atiseptic locally and dressing the affected part. Kaolin poultice helps to ripen the boil.
In chronic cases the treatment of furunculosis consists of:

Chemotherapy is unnecessary. Locally, gentian violet or brilliant green 1% in 75% spirit, or lotio acid tannici may be used.
Tannic acid -- 5 gms
Spt. methylated indust. -- 60 cc.
Liquor hydrarg perchlor 1 in 1000 to 100 cc.
They tend to harden the skin. Magnesium sulphate pastes and hot fomentation are strongly contra-indicated.
Diet - Carbohydrates and fats should be cut down and extra proteins, fresh fruits and vegetables added.
Autogenous or stock vaccines or staphylococcal toxoid.
Improvement of general health - A holiday by the seashore has cleared up many an intractable case. Sunbathing, tonics, UVR exposures and sulphur spring baths are also beneficial.
Course of Stannoxyl (P) or Collosal manganese (P). These tend to increase the resistance against infections by increasing the phagocytic co-efficient. Septilin (P) has similar effect.
Course of fractional X-ray therapy in case of localized chronic furunculoses.