At A Glance: Skin abscess versus carbuncle

A skin abscess may develope after a minor wound

SKIN ABSCESS

Discriminatory signs 

  •  Open sore or closed, red-domed nodule, may drain pus. Localised swelling with induration.
  • Common. Usually caused by Staphylococcus aureus.
  • Develops after a minor wound, injury, or as a complication of folliculitis or boils.
  • May occur anywhere on the body.
  • Tender and warm. Fever or rigors.

Management 

  • Incision and drainage when fluctuant.
  • Heat application may speed healing, reduce inflammation and relieve pain.
  • Elevate the affected part.
  • If recurrent, consider checking for diabetes and eradication from carriage sites.

CARBUNCLE

Discriminatory signs

  • Confluent infection of multiple, contiguous hair follicles.
  • Infection limited to the subcutaneous tissue by overlying dense skin and fascia.
  • Usually caused by Staphylococcus aureus.
  • Commonly occur on the back of the neck and in patients with diabetes.

Management 

  • Incision and drainage.
  • Antibiotics.
  • Fasting blood glucose in non-diabetics.
  • Swab and eradicate carriage sites.
Contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey

 

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