Folliculitis profunda (boil/carbuncle)

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: -

Staphylodermia follicularis et perifollicularis profunda, Staphylodermia follicularis profunda necroticans, Staphylodermia follicularis profunda.

A boil is an often painful, abscessing inflammation of the follicles and perifollicular with scarring healing. Several confluent boils combine to form a carbuncle.

Infection with Staphylococcus aureus, especially in patients with immune suppression. Mostly due to autoinoculation.

  • Furuncle:
    • Size-progressive pustules which eventually form a nodule with surrounding oedema. Fluctuation occurs in the course of the disease. Often crusts are also visible
    • A pain on pressure is typical
    • When splitting, pus empties
    • Partially red. General condition with febrile temperature, fatigue and exhaustion

  • Carbuncles:
    • Confluent boils

  • Clinic
  • BB (e.g. leukaemic disease), ESR, temp, DM exclusion if necessary
  • Nasal vestibule swab

Predilection sites include the external auditory canal (extremely painful), upper lip, nose, neck, buttocks and inner thighs.

Locoregional lymphadenitis, thrombosis (sinus vein thrombosis) and thrombophlebitis in nasal and auricular furuncles, orbitaphlegmone, menigitides in centrofacial localisation.

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