MINISTRY OF HEALTH OF UKRAINE Ukrainian medical stomatological academy “Approved” On the meeting chair Of Propaedeutics Surgical Stomatology The Head of the Department prof. Novikov V.M. ___________ “ ____ ” _____________ 20 ____ GUIDELINES Individual work of students During preparation for Practical classes Educational discipline Surgical stomatology Module № 2 Inflammatory diseases in maxillofacial region. Nonodontogenous inflammatory diseases in Content module № 4 maxillofacial region Furuncles, carbuncles and erysipelas of head. Theme lesson Etiology, pathogeny, classification, clinic, diagnostics, medical treatment. Course 3 Faculty Stomatological Poltava 2018 1. Actuality of the topic: Skin infections are very common occurrences throughout life. Some infections are self-limiting and resolve on their own, but many others require medical attention. Bacterial skin infections technically have specific names based on their origin and extent, but even in the medical community we often lump these technical terms into the common term "boil" or "abscess". This article will clarify the technical terms we use to describe the diagnosis of specific bacterial infections caused mainly by the bacteria, Staphylococcus aureus. 2. The objectives of the studies: Etiology, pathogens, pathological anatomy, classification, features of a clinical course, methods of diagnostics furuncles, carbuncles and erysipelas of head. To be able: to establish the diagnosis of furuncles, carbuncles and erysipelas of head. 3. Basic knowledge, skills, skills necessary for study topics (interdisciplinary integration). Name of previous courses These skills Microbiology Agents who produce above named diseases, their property. Pathological anatomy An etiology, pathogens, of furuncles, carbuncles and erysipelas of maxillofacial region. Pathophysiology A pathogenesis of above named diseases. Histology Topography and anatomy of skin Propedeutics of a surgical Methods examination of patients stomatology 4. Tasks for independent work in preparation for the classes. 4.1. A list of key terms, parameters, characteristics that must learn the student in preparation for the lesson: Term Definition A boil, also called a is a deep folliculitis, infection of the hair follicle furuncle Erysipelas is an acute streptococcus bacterial infection[2] of the upper dermis and superficial lymphatics. 4.2. Theoretical questions to lesson: 1. Give definition of furuncle, carbuncle. 2. The etiology and pathogen of furuncle. 3. Classification of furuncles, carbuncles. 4. Clinic of furuncle. 5. Complex medical treatment of furuncle. 6. Medical treatment of carbuncle. 7. Possible complications of furuncles, carbuncles. 8. The etiology and pathogen of erysipelas. 9. Classification of erysipelas. 10. Clinical motion of erysipelas. 11. Diagnostics is that differential diagnostics of erysipelas. 12. Medical treatment and prophylaxis of erysipelas. 4.3. Practical works (tasks) are performed in class: − To take possession of technique of realization observation of the patients with furuncle, carbuncle and erysipelas. − To make a treatment planning of furuncle, carbuncle and erysipelas. − To acquire technique of carrying out observation of patient with furuncle, carbuncle and erysipelas. − To make the plan of examine of the patient with furuncle, carbuncle and erysipelas. − To make the plan of local treatment of patients with furuncle, carbuncle and erysipelas. 5. Theme contents: A furuncle is an infection of a hair follicle. Folliculitis Folliculitis is an infection that is localized to the hair follicle. A folliculitis looks like small, yellow pustules that are confined to the hair follicle. Factors that can lead to the development of a folliculitis include: - Trauma; - Chronic friction; - Occlusive clothing; - Occlusive chemicals; - Excessive sweating; - Exposure to water; Pictures of Folliculitis: - Folliculitis on the scalp; - Folliculitis on the leg; - Hot Tub Folliculitis. A special case of folliculitis that is not caused by S. aureus is hot tub folliculitis. This self- limited infection is caused by Pseudomonas aeruginosa contracted from hot tubs, whirlpools, and pools with inadequate chlorine levels. Treatment of Folliculitis. Mild cases of folliculitis and small furuncles may heal on their own with good hygiene and wound care. Furuncle Causes A furuncle (boil) is a skin infection involving pilosebaceous unit an entire hair follicle and nearby skin tissue. Infection also involves the sebaceous gland. Is more extensive than a folliculitis. Factors that contribute to the development of furuncles include: - Obesity; - Blood disorders; - Taking oral steroid medications; - Diabetes. Furuncles are very common. They are caused by staphylococcus bacteria, which are normally found on the skin surface. Damage to the hair follicle allows these bacteria to enter deeper into the tissues of the follicle and the subcutaneous tissue. Furuncles may occur in the hair follicles anywhere on the body, but they are most common on the face, neck, armpit, buttocks, and thighs. Furuncles are generally caused by Staphylococcus aureus, but they may be caused by other bacteria or fungi. They may begin as a tender, red nodule but ultimately feel like a water-filled balloon. A furuncle may drain spontaneously, producing pus. More often the patient or someone else opens the furuncle. Furuncles can be single or multiple. Some people have recurrent bouts with abscesses and little success at preventing them. Furuncles can be very painful if they occur in areas like the ear canal or nose. A health care provider should treat furuncles of the nose. Furuncles that develop close together may expand and join, causing a condition called carbunculosis. Symptoms: The lesions themselves are the primary symptoms: Small firm tender red nodule in skin (early); Fluctuant nodule (later); Located with hair follicles; Tender, mildly to moderately painful; May be single or multiple; Usually pea-sized, but may be as large as a golf ball; Swollen; Pink or red; May grow rapidly; May develop white or yellow centers (pustules); May weep, ooze, crust; May join together or spread to other skin areas; Increasing pain as pus and dead tissue fills the area; Decreasing pain as the area drains; Skin redness or inflammation around the lesion. Less common symptoms include the following: Fever; Fatigue; General discomfort, uneasiness, or malaise. Note: Itching (pruritus) of the skin may occur before the lesion develops. Exams and Tests Diagnosis is primarily based on the appearance of the skin. Skin or mucosal biopsy culture may show staphylococcus or other bacteria. Treatment Furuncles may heal on their own after an initial period of itching and mild pain. More often, they progress to pustules that increase in discomfort as pus collects. They finally burst, drain, and then heal spontaneously. Furuncles usually must drain before they will heal. This most often occurs in less than 2 weeks. Boils that persist longer than 2 weeks, recur, are located on the spine or the middle of the face, or that are accompanied by fever or other symptoms require treatment by a health care provider because of the risk of complications from the spread of infection. Warm moist compresses encourage furuncles to drain, which speeds healing. Gently soak the area with a warm, moist cloth several times each day. Deep or large lesions may need to be drained surgically by the health care provider. Never squeeze a boil or attempt to lance it at home because this can spread the infection and make it worse. Meticulous hygiene is vital to prevent the spread of infection. Draining lesions should be cleaned frequently. The hands should be washed thoroughly after touching a boil. Do not re-use or share washcloths or towels. Clothing, washcloths, towels, and sheets or other items that contact infected areas should be washed in very hot (preferably boiling) water. Dressings should be changed frequently and discarded in a manner that contains the drainage, such as by placing them in a bag that can be closed tightly before discarding. Antibacterial soaps and topical antibiotics are of little benefit once a furuncle has formed. Systemic antibiotics may help to control infection in those with repeated furuncles. Prognosis. Full recovery is expected. Some people may experience many repeated episodes. Possible Complications: Spread of infection to other parts of the body or skin surfaces; Abscess formation; Sepsis (general internal infection); Abscess of kidneys or other internal organs; Osteomyelitis; Endocarditis; Brain infection; Brain abscess; Spinal cord infection; Spinal cord abscess; Permanent scarring. When to Contact a Medical Professional Call for an appointment with your health care provider if furuncles develop and do not heal with home treatment within one week. Call for an appointment with your provider if furuncles recur or are located on the face or spine. Call for an appointment with your provider if boils are accompanied by fever, red streaks extending from the boil, large fluid collections around the boil, or other symptoms. Prevention: Good attention to hygiene. Antibacterial soaps. Antiseptic washes. Carbuncle A carbuncle can simply be defined as an extension of a furuncle to multiple follicles. A carbuncle usually involves the deeper layers of the skin - the subcutaneous fat. It looks like a large, red nodule that is indurated and may be fluctuant or have visible layers of pus just beneath the surface of the skin. Carbuncles often occur on