From the Guidelines
A furuncle is an infection of the hair follicle, usually caused by S. aureus, that extends through the dermis into the subcutaneous tissue, forming a small abscess.
Key Characteristics
- Infection of the hair follicle
- Usually caused by S. aureus
- Suppuration extends through the dermis into the subcutaneous tissue
- Forms a small abscess
- Differs from folliculitis, which is more superficial and limited to the epidermis
- Clinically presents as an inflammatory nodule with an overlying pustule through which hair emerges
Diagnosis and Treatment
As noted by 1, furuncles can occur anywhere on hairy skin and are typically treated with moist heat, which promotes drainage. Larger furuncles and carbuncles require incision and drainage, and systemic antibiotics are usually unnecessary unless there is extensive surrounding cellulitis or fever 1.
From the Research
Definition of a Furuncle
- A furuncle is a deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue 2
- It is also known as a boil, and appears as a red, swollen, and tender nodule on hair-bearing parts of the body 2
- A furuncle is an abscess of a hair follicle, whereas a carbuncle involves several hair follicles 3
Causes of Furuncles
- The most common infectious agent is Staphylococcus aureus, but other bacteria may also be causative 2
- Methicillin-resistant S. aureus is a common pathogen in skin and soft tissue infections, and can be problematic due to difficulty in treatment 2
Treatment of Furuncles
- Solitary lesions should be incised when fluctuant, whereas patients with multiple lesions or signs of systemic disease or immunosuppression should be treated with relevant antibiotics 2
- Incision and drainage is a common treatment for furuncles, and oral antibiotics may be prescribed for patients with severe immunocompromise or systemic signs of infection 3
- Topical antibiotics, such as mupirocin, may be effective for treating folliculitis, but the evidence for their use in treating furuncles is limited 4, 3
Recurrence of Furuncles
- Furunculosis often tends to be recurrent and may spread among family members 2
- Some patients are carriers of S. aureus and eradication should be considered in recurrent cases 2
- Focus on personal, interpersonal, and environmental hygiene issues is crucial to reduce the risk of contamination and recurrences 2