Boil pathophysiology: Difference between revisions

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{{Boil}}
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==Overview==
==Overview==
Boil (furuncle) is the tender, deep, dome shaped skin infection of the [[hair follicle]].
Boils (furuncles) are a localized deep [[suppurative]] [[necrotizing]] form of [[folliculitis]] which involve the [[dermis]] and the [[subcutaneous tissue]]. ''[[Staphylococcus aureus]]'' is the most common causative agent. Following an [[abrasion]] or cut, the [[pathogen]] uses the wound site to invade and colonize the [[hair follicle]]. This leads to the formation of tender, [[erythematous]], perifollicular [[nodule]]. The boil later becomes painful and fluctuant leading to discharge of [[pus]] and formation of [[necrotic]] plugs, which may leave a [[scar]].<ref name="pmid24591845">{{cite journal| author=Ibler KS, Kromann CB| title=Recurrent furunculosis - challenges and management: a review. | journal=Clin Cosmet Investig Dermatol | year= 2014 | volume= 7 | issue=  | pages= 59-64 | pmid=24591845 | doi=10.2147/CCID.S35302 | pmc=3934592 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591845  }} </ref>


==Pathophysiology==
==Pathophysiology==
===Pathogenesis===
===Pathogenesis===
[[Image:furuncle pathophysiology.png‎|thumb|left|75px]]
*Boil (furuncle) is a localized deep [[suppurative]] [[necrotizing]] form of [[folliculitis]] which involves the [[dermis]] and the [[subcutaneous tissue]]. ''[[Staphylococcus aureus]]'' is the most common causative agent.  
*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 wound site to invade and colonize the [[hair follicle]]. This leads to the formation of a tender [[erythematous]] perifollicular [[nodule]].  
*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.  
*Boils may become painful and fluctuant, leading to the discharge of [[pus]] and formation of [[necrotic]] plugs, which may leave a [[scar]].<ref name="pmid24591845">{{cite journal| author=Ibler KS, Kromann CB| title=Recurrent furunculosis - challenges and management: a review. | journal=Clin Cosmet Investig Dermatol | year= 2014 | volume= 7 | issue=  | pages= 59-64 | pmid=24591845 | doi=10.2147/CCID.S35302 | pmc=3934592 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591845  }} </ref>
*It later becomes painful and fluctuant terminating in the discharge of [[pus]] and [[necrotic]] plug which may leave a [[scar]].<ref name="pmid24591845">{{cite journal| author=Ibler KS, Kromann CB| title=Recurrent furunculosis - challenges and management: a review. | journal=Clin Cosmet Investig Dermatol | year= 2014 | volume= 7 | issue=  | pages= 59-64 | pmid=24591845 | doi=10.2147/CCID.S35302 | pmc=3934592 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591845  }} </ref>
*Furunculosis is the [[acute]] or [[chronic]] appearance of a number of boils (furuncles) at multiple [[skin]] sites. Recurrent furunculosis is defined as three or more attacks within a 12 month period.<ref name="pmid24591845">{{cite journal| author=Ibler KS, Kromann CB| title=Recurrent furunculosis - challenges and management: a review. | journal=Clin Cosmet Investig Dermatol | year= 2014 | volume= 7 | issue=  | pages= 59-64 | pmid=24591845 | doi=10.2147/CCID.S35302 | pmc=3934592 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591845  }} </ref>
 
*It is a [[contagious]] condition, which usually develops in moist or sweaty areas such as the [[scalp]], [[face]], [[buttocks]], [[axillae]], and areas that are subject to [[friction]] and [[perspiration]].  
*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.<ref name="pmid24591845">{{cite journal| author=Ibler KS, Kromann CB| title=Recurrent furunculosis - challenges and management: a review. | journal=Clin Cosmet Investig Dermatol | year= 2014 | volume= 7 | issue=  | pages= 59-64 | pmid=24591845 | doi=10.2147/CCID.S35302 | pmc=3934592 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591845  }} </ref>
*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]].
 
 
 
 
 


*A group of furuncles coalesce to form a [[carbuncle]].
====Schematic of Pathogenesis====
<gallery>
Image:furuncle pathophysiology.png‎|Boil(furuncle)pathogenesis
</gallery>


===Associated Conditions===
===Associated Conditions===
Line 29: Line 25:


===Gross Pathology===
===Gross Pathology===
[[Image:furuncle.jpg‎|thumb|left|Gross pathology<ref name=furuncle> wikipedia. Furuncle (2016) https://en.wikipedia.org/wiki/Boil#/media/File:Furoncle.jpg Accessed on August 8,2016</ref>]]
On [[gross]] [[pathology]], characteristic findings of boils include firm, [[tender]], red, dome shaped [[nodule]]s, which progress to fluctuant, [[pus]]-filled, and painful lesions. Boils may vary in size.
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, characteristic findings of boils include:
*Infiltrate predominantly consists of [[neutrophils]] within the wall and ostia of [[hair follicle]]s
*Lesions may subsequently be infiltrated with [[lymphocytes]] and [[macrophages]] creating a central focus of [[necrosis]].
*[[Inflammation]] of [[hair follicle]] may be:
:*Superficial (primarily involving the infandibulum)
:*Deep


===Examples of Gross Pathology===
The following are images associated with boil:


<gallery>


Image:furuncle.jpg‎|Boil(furuncle) on Anterior leg: Dome shaped [[pus]] filled boil(furuncle) with [[erythema]] of [[skin]] - By The original uploader was Mahdouch at French Wikipedia - Transferred from fr.wikipedia to Commons., CC BY 1.0, https://commons.wikimedia.org/w/index.php?curid=3123389


===Microscopic Pathology===
On microscopic histopathological analysis, the following are characteristic findings of boil(furuncle):
</gallery>
*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


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 20:39, 29 July 2020

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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

Boils (furuncles) are a localized deep suppurative necrotizing form of folliculitis which involve the dermis and the subcutaneous tissue. Staphylococcus aureus is the most common causative agent. Following an abrasion or cut, the pathogen uses the wound site to invade and colonize the hair follicle. This leads to the formation of tender, erythematous, perifollicular nodule. The boil later becomes painful and fluctuant leading to discharge of pus and formation of necrotic plugs, which may leave a scar.[1]

Pathophysiology

Pathogenesis

  • A group of furuncles coalesce to form a carbuncle.

Schematic of Pathogenesis

Associated Conditions

Gross Pathology

On gross pathology, characteristic findings of boils include firm, tender, red, dome shaped nodules, which progress to fluctuant, pus-filled, and painful lesions. Boils may vary in size.

Microscopic histopathological analysis

On microscopic histopathological analysis, characteristic findings of boils include:

  • Superficial (primarily involving the infandibulum)
  • Deep

Examples of Gross Pathology

The following are images associated with boil:

References

  1. 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.

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