Are you or your child's skin is often exposed to disease due to allergies or infection? Do you reply that skin disease is not the same kind or medicine. So be careful to treat your skin disease with drugs that are often found in the market, one-of your skin disease becomes worse. This review is about one skin disease caused by infection, which is very often found in people, especially in children. Furunkolosis name, is one form than pyoderma. At the Dermatology and Gender, University of Indonesia Faculty of Medicine, the incident ranks third most, and are closely related to socio-economic condition.
Furunkolosis can cause fatal complications. One of them is the furunkel malignant furunkel arising in the triangle area bounded by the upper lip and the lateral edge of the eye, because it may spread to the intra-cranial. Another problem is the spread of bacteria can occur in a more extensive or more so that it can also occur cellulitis or bakterimia. And if hygiene or poor patients suffering diebetes militus, furunkel become frequent relapses. The following will be presented of the causes, pathogenesis, to management.
Furunkolosis can cause fatal complications. One of them is the furunkel malignant furunkel arising in the triangle area bounded by the upper lip and the lateral edge of the eye, because it may spread to the intra-cranial. Another problem is the spread of bacteria can occur in a more extensive or more so that it can also occur cellulitis or bakterimia. And if hygiene or poor patients suffering diebetes militus, furunkel become frequent relapses. The following will be presented of the causes, pathogenesis, to management.
Regarding understanding of this disease
Pyoderma is a skin disease caused by Staphylococcus and Streptococcus, or by both. Furunkel is inflammation of the hair follicle and surrounding tissue, caused by Staphylococcus aureus. Furunkelnya If more than one is called furunkolosis.
Endemic
Pyoderma is a common disease in the community. At the Dermatology and Gender, University of Indonesia Faculty of Medicine, the incident took third place, and are closely related to socio-economic condition.
Furunkel more often in the summer, because a lot of sweating. In terms of age onsetnya can occur in children and young people. More frequency in boys.
Pyoderma is a common disease in the community. At the Dermatology and Gender, University of Indonesia Faculty of Medicine, the incident took third place, and are closely related to socio-economic condition.
Furunkel more often in the summer, because a lot of sweating. In terms of age onsetnya can occur in children and young people. More frequency in boys.
Etiology / Causes
Etiologinya mostly by Staphylococcus aureus, the cells are spherical or Gram-positive coccus that the four pairs and groups. Staphylococcus aureus is a form of positive koagulase, this is what distinguishes it from other species, and is a major pathogen for humans. On the negative Staphylococcus is koagulase human normal flora. Staphylococci produce catalase which distinguishes it from streptococcus.
Etiologinya mostly by Staphylococcus aureus, the cells are spherical or Gram-positive coccus that the four pairs and groups. Staphylococcus aureus is a form of positive koagulase, this is what distinguishes it from other species, and is a major pathogen for humans. On the negative Staphylococcus is koagulase human normal flora. Staphylococci produce catalase which distinguishes it from streptococcus.
Predisposing factors that influence the emergence of this disease
Actually, the influence to the occurrence of pyoderma, especially furunkel or furunkolosis there are three factors that host factors, agents, and the environment.
Host factors
1. bad hygiene
2. diabetes militus
3. obesity
4. hyper IgE syndrome
5. Chronic Carier S. aureus (nose)
6. kemotaktik interference
7. no underlying diseases such as HIV
8. as a complication of dermatitis atopy, ekscoriasi, or pedikulosis scabies (a skin or lesions on the skin can also incomplete due to frequent scratching or rubbing)
Agent: usually S. aureus
Environment
1. environment clean, dirty or ugly
2. hot climate
Actually, the influence to the occurrence of pyoderma, especially furunkel or furunkolosis there are three factors that host factors, agents, and the environment.
Host factors
1. bad hygiene
2. diabetes militus
3. obesity
4. hyper IgE syndrome
5. Chronic Carier S. aureus (nose)
6. kemotaktik interference
7. no underlying diseases such as HIV
8. as a complication of dermatitis atopy, ekscoriasi, or pedikulosis scabies (a skin or lesions on the skin can also incomplete due to frequent scratching or rubbing)
Agent: usually S. aureus
Environment
1. environment clean, dirty or ugly
2. hot climate
Pathophysiology, Pathogenesis, Pathology
Many things affect a person until the occurrence of pyoderma include host factors, agents, and the environment as has been described above in which the imbalance between the three factors. Staphylococcus contain polysaccharides and proteins that are antigens which are important substances in the cell wall structure. Peptidoglycan, a polysaccharide polymer containing subunit-subunit is strung, is eksoskeleton rigid cell wall. Peptidoglycan was destroyed by strong acid or lysozyme. This is important in infection potogenitas: This substance causes monocytes to interleukin-1 (endogenous pyrogen) and antibody opsonik, and this substance is also a chemical attractants (kemotraktan) for Polymorphonuclear leukocytes, endotoxin has a similar activity, activate komplement.
Pathology is the prototype lesion furunkel staphylococcus or other local abscess. S. groups aureus, which lives in the hair follicles causing tissue necrosis. Produced and Koagulase around mengkoagulasi fibrin within the lesion and lymph channels, resulting in the formation of a wall that limits preses and reinforced by the accumulation of inflammatory cells and tissue fibrosis. In the middle of the lesion, there was necrotic tissue melting (aided by slow type hypersensitivity) and abscesses that lead to the smallest lifetimes, after flowing out of necrotic tissue, cavity gradually filled with granulation tissue and eventually recovered.
Many things affect a person until the occurrence of pyoderma include host factors, agents, and the environment as has been described above in which the imbalance between the three factors. Staphylococcus contain polysaccharides and proteins that are antigens which are important substances in the cell wall structure. Peptidoglycan, a polysaccharide polymer containing subunit-subunit is strung, is eksoskeleton rigid cell wall. Peptidoglycan was destroyed by strong acid or lysozyme. This is important in infection potogenitas: This substance causes monocytes to interleukin-1 (endogenous pyrogen) and antibody opsonik, and this substance is also a chemical attractants (kemotraktan) for Polymorphonuclear leukocytes, endotoxin has a similar activity, activate komplement.
Pathology is the prototype lesion furunkel staphylococcus or other local abscess. S. groups aureus, which lives in the hair follicles causing tissue necrosis. Produced and Koagulase around mengkoagulasi fibrin within the lesion and lymph channels, resulting in the formation of a wall that limits preses and reinforced by the accumulation of inflammatory cells and tissue fibrosis. In the middle of the lesion, there was necrotic tissue melting (aided by slow type hypersensitivity) and abscesses that lead to the smallest lifetimes, after flowing out of necrotic tissue, cavity gradually filled with granulation tissue and eventually recovered.
Bacteria enter the hair follicles causing folliculitis and perifolikulitis, appears as a red node and very painful. In severe conditions can be accompanied by symptoms of fever, malaise, etc.. After 2-4 days there is a process and formed an abscess supurasi this was known by the fluctuations. At the center of the lesion is yellowish spots that are necrotic tissue, and is called the eye sores (core). If the abscess broke the core of necrotic tissue will be out. Special treatment is the malignant furunkel ie furunkel arising in the triangle area bounded by the upper lip and the lateral edge of the eye, because it may spread to the intra-cranial. Another problem is the spread of bacteria can occur in a more extensive or more so that it can also occur cellulitis or bakterimia. And if hygiene or poor patients suffering diebetes militus, furunkel become frequent relapses. Predileksi this disease is usually in areas such as facial hair, back, head, armpits, buttocks and ekstrimitas, and especially in the area that a lot of rubbing.
Efloresensi, early lesions of small infiltrates, enlarged to form a cone-shaped eritematosa nodules, pain, there are core (eye ulcers), and then softened into an abscess, rupture, formed ulcers.
How to diagnose it.
Furunkel or furunkolosis diagnosis can be established most clinically considering the typical clinical picture of early lesions of small infiltrates, enlarged to form conical eritematosa nodules, pain, there are core (eye ulcers), and then softened into an abscess, rupture, ulcers formed. But for better enforce the terms of the diagnosis:
1. anamnesis: arise boils or painful lumps and no eyes.
2. physical examination, especially erythema efloresensi conical nodules, and there are core ditengahnya
3. investigation: painting Gram, culture and sensitivity tests
Furunkel or furunkolosis diagnosis can be established most clinically considering the typical clinical picture of early lesions of small infiltrates, enlarged to form conical eritematosa nodules, pain, there are core (eye ulcers), and then softened into an abscess, rupture, ulcers formed. But for better enforce the terms of the diagnosis:
1. anamnesis: arise boils or painful lumps and no eyes.
2. physical examination, especially erythema efloresensi conical nodules, and there are core ditengahnya
3. investigation: painting Gram, culture and sensitivity tests
Differential diagnosis
Furunkolosis diagnosis was folliculitis and karbunkel. Between furunkolosis and folliculitis can be distinguished in terms of folliculitis efloresensinya if the macula of eritematus, papul, pustules, there is no core and the surrounding tissue is not inflamed. Between furunkolosis with karbunkel, can be distinguished in terms similar to efloresensinya only furunkel bigger and his eyes more than a single boil. And usually common in people with DM.
Furunkolosis diagnosis was folliculitis and karbunkel. Between furunkolosis and folliculitis can be distinguished in terms of folliculitis efloresensinya if the macula of eritematus, papul, pustules, there is no core and the surrounding tissue is not inflamed. Between furunkolosis with karbunkel, can be distinguished in terms similar to efloresensinya only furunkel bigger and his eyes more than a single boil. And usually common in people with DM.
Complications
Here are a few complications furunkel:
1. furunkel malignan: namely furunkel arising in the triangle area bounded by the upper lip and the lateral edge of the eye, because it may extend into the intra-cranial venous facialis and anguular emissary veins and also in that they have not spread to the valve so that later cavernosus sinus could be meningitis.
2. cellulitis can occur if furunkel become deeper and widespread.
3. bakterimia and haematogenous: bacteria in the blood can about heart valves, joints, spine, long bones, visceral organs, especially kidneys
4. Repeated furunkel, this is caused by a bad higine
Here are a few complications furunkel:
1. furunkel malignan: namely furunkel arising in the triangle area bounded by the upper lip and the lateral edge of the eye, because it may extend into the intra-cranial venous facialis and anguular emissary veins and also in that they have not spread to the valve so that later cavernosus sinus could be meningitis.
2. cellulitis can occur if furunkel become deeper and widespread.
3. bakterimia and haematogenous: bacteria in the blood can about heart valves, joints, spine, long bones, visceral organs, especially kidneys
4. Repeated furunkel, this is caused by a bad higine
About Management / Treatment
As for management to furunkelatau furunkolosisi are as follows:
1. Topical
Given topical ointment containing basitrasin and neomycin, fusidat acid, sodium-containing fusidat or mupirosin. In the event of ulcer or lesion was performed eksudatif open with a solution compresses permanganas kalikus 1 / 5000, 0.1% solution rivanol or povidin iodine 5% -10%.
1. Systemic
Given systemic antibiotics, such as
Koksasilin 3 x 500 mg per oral / day for 5-7 days or
Sefadroksil 2 x 500 mg peroral / day for 10-14 days
If allergic to penicillin are given erythromycin
In malignant furunkel given intramuscular sefotaksim 1 gram per 8 hours for 10 days.
As for management to furunkelatau furunkolosisi are as follows:
1. Topical
Given topical ointment containing basitrasin and neomycin, fusidat acid, sodium-containing fusidat or mupirosin. In the event of ulcer or lesion was performed eksudatif open with a solution compresses permanganas kalikus 1 / 5000, 0.1% solution rivanol or povidin iodine 5% -10%.
1. Systemic
Given systemic antibiotics, such as
Koksasilin 3 x 500 mg per oral / day for 5-7 days or
Sefadroksil 2 x 500 mg peroral / day for 10-14 days
If allergic to penicillin are given erythromycin
In malignant furunkel given intramuscular sefotaksim 1 gram per 8 hours for 10 days.
Prognosis
Generally good. Provided getting adequate treatment and causative factor is eliminated, and the prognosis becomes poor if complications occur.
Generally good. Provided getting adequate treatment and causative factor is eliminated, and the prognosis becomes poor if complications occur.
This paper Source:
1. Djuanda, A. Ilmu Penyakit Kulit dan Kelamin, edisi keempat, Fakultas Kedokteran Universitas Indonesia, Jakarta, 2005, p. 110-112 , 379-381
2. Duarsa, W., Pindha, S., Bratiartha, Adiguna, S., Wardhana, Darmada, Wiraguna, Nusantara, A. Pedoman Diagnosis dan Terapi Penyakit Kulit dan Kelamin Rumah Sakit Umum Pusat Denpasar, Fakultas Kedokteran Udayana, Denpasar, 2007, p. 27-28
3. Freeberg, I.M., Elsen, A.Z., Wolff, K. Fitzpatrieks Dermatology in General Med, 6 th ed, McGraw Hill, 2003, vol 2 p. 1856-1863.
4. Fitzpatrieks Color atlas and Synopsis of Clinical Dermatologg, 5 th ed, McGraw Hill, 2003, p. 595-597
5. Katzung, B.G. Basic & Clinical Pharmacology, 9 th ed, McGraw Hill, 2004, p. 801-806
6. Siregar, R.S. Atlas Berwarna Saripati Penyakit Kulit, edisi kedua, EGC, Jakarta, 2004, p. 80-81, 84-87
7. Jawetz, dkk., Mikrobiologi Kedokteran. Edisi 20, EGC , 1996.
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