Boil pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Boil(furuncle) is a localized, deep, suppurative, necrotizing form of folliculitis which involves dermis and subcutaneous tissue. Staphylococcus aureus is the most common causative agent. Following an abrasion or cut the pathogen uses the entry site to invade and colonize the hair follicle leading to the formation of tender, red, perifollicular nodule. It later becomes painful and fluctuant terminating in the discharge of pus and necrotic plug which may leave a scar.[1]
Pathophysiology
Pathogenesis
- Boil(furuncle) is a localized, deep, suppurative, necrotizing form of folliculitis which involves dermis and subcutaneous tissue. Staphylococcus aureus is the most common causative agent.
- Following abrasion or cut the pathogen uses the entry site to invade and colonize the hair follicle leading to the formation of tender, red, perifollicular nodule.
- It later becomes painful and fluctuant terminating in the discharge of pus and necrotic plug which may leave a scar.[1]
- Furunculosis is the acute or chronic appearance of a number of furuncles at multiple skin sites. Recurrent furunculosis is defined as three or more attacks within 12 month period.[1]
- It is a contagious condition which usually develops in moist or sweaty areas such as the scalp, face, buttocks, axillae and areas which are subject to friction and perspiration.
- Group of furuncles coalesce to form carbuncle.
Associated Conditions
Gross Pathology
On gross pathology, the following are characteristic findings of boil(furuncle):
- It begins as a firm, tender, red, dome shaped nodule
- It later becomes fluctuant (Pus filled) and painful
- They vary in size
Microscopic histopathological analysis
On microscopic histopathological analysis, the following are characteristic findings of boil(furuncle):
- Infiltrate predominantly consists of neutrophils with in the wall and ostia of hair follicle which later becomes more mixed with lymphocytes and macrophages creating a central focus of necrosis.
- Inflammation of hair follicle can either be:
- Superficial(primarily involving the infandibulum)
- Deep
Images
The following are the images associated with boil(furuncle).
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Boil(furuncle): pathogenesis
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Furunculosis: Group of boils(furuncles). [3]
References
- ↑ 1.0 1.1 1.2 Ibler KS, Kromann CB (2014). "Recurrent furunculosis - challenges and management: a review". Clin Cosmet Investig Dermatol. 7: 59–64. doi:10.2147/CCID.S35302. PMC 3934592. PMID 24591845.
- ↑ wikipedia. Furuncle (2016) https://en.wikipedia.org/wiki/Boil#/media/File:Furoncle.jpg Accessed on August 8,2016
- ↑ Principles of Pediatric Dermatology. Bacterial skin infections http://www.drmhijazy.com/english/chapters/chapter06.htm Accessed on August 10,2016