Pseudofurunculosis is a purulent lesion of sweat glands that develops when staphylococci or other pathogens enter them. The infectious process in pseudofurunculosis captures not only the ducts of the sweat glands, but also their glomeruli. It is characterized by the appearance of dense nodules in the subcutaneous tissue, the skin above which has a healthy appearance. Gradually, the nodules increase and soften, then they are opened. Diagnosis of pseudofurunculosis is based on the results of dermatological examination and bacteriological examination of the separated nodes. Treatment is carried out in a hospital with the use of antibiotics, detoxifying solutions, immunocorrectors and local remedies.
Pseudofurunculosis mainly affects newborns and children under one year old. Weakened children with hypotrophy, rickets, immune disorders, anemia, hypovitaminosis are predisposed to pseudofurunculosis. In adults, the disease is extremely rare. The name “pseudofurunculosis” was given to the disease due to symptoms similar to furunculosis. At the same time, the elements of pseudofurunculosis lack necrotic rods characteristic of boils. The second name is pseudofurunculosis Finger — named after the scientist who studied this disease.
Clinical dermatology refers pseudofurunculosis to a group of purulent-inflammatory skin diseases — pyoderma. The most common infectious agent in pseudofurunculosis is Staphylococcus aureus. In some cases, proteus, hemolytic staphylococcus, E. coli and other flora are sown. Infection of the sweat glands is promoted by improper nursing, dirty underwear and clothes, excessive sweating, overheating, diarrhea, infectious diseases.
In some cases, the infectious process affects only the mouths of the excretory ducts of the sweat glands with the development of periporitis. At the same time, small superficial pustules form on the skin, after which crusts remain, which eventually disappear without scarring or hyperpigmentation.
However, more often there is a complete defeat of the sweat glands. Subcutaneous nodules appear, characterized by a dense consistency. At the beginning of the development of pseudofurunculosis, the skin above the nodules has a healthy appearance. Gradually, the nodules increase in size, reaching the diameter of a forest (sometimes walnut) nut. The skin above them acquires a red-bluish color. There is a softening of the nodes with a characteristic symptom of fluctuation when probing them. The skin on the tops of such nodes becomes thinner and breaks through with the expiration of purulent yellow-green contents. Healing occurs with the formation of a scar.
Usually, with pseudofurunculosis, there is a lesion of those areas of the skin that directly touch the bed. These are the back, thighs, buttocks, the back of the head and the scalp. The appearance of ten or more nodes of pseudofurunculosis indicates a generalized process in which changes in the general condition of the child are possible: fever, intoxication, decreased appetite.
In emaciated and weakened children, pseudofurunculosis has a generalized character and a recurrent course with the appearance of new elements after 10-20 days. In such children, pseudofurunculosis can be complicated by the development of conjunctivitis, otitis, sinusitis, phlegmon, pneumonia. In severe cases, purulent meningitis, osteomyelitis, sepsis are possible.
The diagnosis of the disease is carried out by a dermatologist. The doctor relies on the characteristic clinical manifestations of the disease and the age of the patient. Dermatological examination reveals a typical picture of pseudofurunculosis: a symptom of fluctuation during palpation of the largest nodes and the absence of visible skin changes over other elements. Determination of the type of pathogen is carried out by back-seeding of the separated nodes.
The differential diagnosis of pseudofurunculosis is carried out with furunculosis, hydradenitis, scrofuloderma (colliquative tuberculosis). Furunculosis is characterized by the presence of a necrotic rod in the center of the boil, which is not observed in pseudofurunculosis. Hydradenitis usually does not occur in infants and has a typical localization (armpits, groin area). Scrofuloderma rarely affects children under one year old. For her, the slow development of the process is typical, the opening of nodes with the formation of fistulous passages and ulceration, bridge-like scarring.
Pseudofurunculosis requires inpatient treatment. It is mandatory to conduct antibiotic therapy (gentamicin, penicillin, cefotaxime, cefazolin) taking into account the data of the antibioticogram. To prevent dysbiosis, probiotics are prescribed along with antibiotics. With symptoms of intoxication, drip administration of dextran, albumin, salt solutions or native plasma is carried out. Vitamin therapy, general tonic agents and immune preparations are used: staphylococcal toxoid, gamma globulin, antistaphylococcal plasma.
In local therapy, solutions of aniline dyes, ointments with antibiotics, “Levomekol”, ichthyol ointment are used. The skin around the nodes is treated with camphor alcohol. UHF therapy is performed. In some cases, pseudofurunculosis may require surgical opening and drainage of fluctuating nodes.
Prevention of pseudofurunculosis consists in regularly changing diapers, ironing them after washing, observing hygienic rules in the care of infants, avoiding overheating of the child, proper feeding.