nodules are hot, tender, red, and hard. They may break down to form a necrotic core
that has a pus-filled center and pus point. A boil starts with a hair follicle and occurs
especially at the neck, axilla, and buttock. They are painful because of pressure being
put on nerve endings, particularly in areas where there is little room for swelling of
(2) Treatment. DO NOT squeeze lesions near the nose. Treat these and
other boils in this way. Administer penicillin VK by mouth four times daily for 10 days.
Apply warm soaks to make the boil form a head. Make an incision and drain the boil.
(1) Description/characteristics. A carbuncle is an abscess of skin and
deeper tissues--an extension of a furuncle invading multiple follicles. Carbuncles are
caused by staphylococcal infections. Deeper than a furuncle and usually located on the
lower neck and upper back, carbuncles heal slowly and leave a large scar. Signs and
symptoms include the following:
(a) Possible fever.
(b) Two or more cores to one lesion.
(d) Deep suppuration (production and discharge of pus).
(e) Extensive local sloughing.
Multiple draining abscesses.
(2) Treatment. Apply hot compresses. Then perform an incision and allow
the lesion to drain. Apply an antibiotic topically to the lesion or have the patient take an
oral antibiotic. Consult a physician if the patient is resistant to conservative local
(1) Description/characteristics. Cellulitis is an acute or chronic infection of
the skin caused by complication of a wound, ulcer, or impetigo. Invasion of normal skin
is possible, especially on the feet and lower legs. Cellulitis is usually caused by
streptococcal bacteria, but rarely caused by staphylococcus bacteria. The affected area
becomes warm, red, and tender. When pressure is applied to the skin, there is pitting
edema in various places around the affected area. Later, blisters with pus form. If the
affected area is large, the patient's entire body reacts. The lower extremities are often
involved. Recurrent attacks of cellulitis may sometimes affect the lymphatic vessels and
produce permanent swelling called "solid edema."