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Definition Types

ABSES Acute or chronic localized inflammation, associated with a collection of pus and tissue destruction (Fitzpatrick, Atlas of Dermatology) Abscess can be classified as acute and chronic depending upon the period of suffering. Also it can be classified as septic abscess and sterile abscess. Septic abscess is caused by bacterias and the bacteria can be identified with culture reports, whereas sterile abscess is caused by injury or injection or foreign substances without bacterial invasion. The abscess can be localized or become multiple (generalized) with blood contamination Trunk, extremities, axillae, or head and neck, and perineal (ie, inguinal, vaginal, buttock, perirectal) region.

Predilection Etiology

Infection - Bacteria (Staphylococcus aureus or Streptococcus), fungus, viral, etc. Injections and injuries including thorn pricks and insect bites Diseases diabetes, cancer and AIDS Drugs and therapy (steroidal and chemotherapy) Skin diseases psoriasis, eczema,herpes, etc In all the cases, poor hygienic measures and negligencein taking treatment account for the increased intensity of disease / suffering Pathophysiology Normally, abscess formation is a natural process in expelling the disease/foreign substances from our body. It needs to get opened on its own or with surgical intervention to expel the liquid contents. Initially, the infected or injured part will be flooded with blood. This causes redness, swelling and heat on that part. Increased blood supply also dilutes the toxins, supplies defence forces (white blood cells, enzymes and antibodies) to the affected part and nourishment to the inflamed part for better healing. Abscess finally makes destruction/necrosis of the solid tissue around infective agent / bacteria / foreign substance to form pus (yellow or green inflammatory liquid containing digested /active germs, WBCs, cell debris, etc.), so that it can simply washout with the disease / foreign substances from our body. Normally, it will take a week or two. Sometimes it can even persist for months and also be recurrent in nature. Clinical Cutaneous abscesses are painful, tender, indurated, and sometimes Manifestation erythematous. They vary in size, typically 1 to 3 cm in length, but sometimes much larger. Initially the swelling is firm; later, as the abscess points, the overlying skin becomes thin and feels fluctuant. The abscess may then spontaneously drain. Diagnosis Examination Gram stain and culture to identify MRSA (Methicillin Resistance S.Aureus)

Treatment Prognosis

Antibiotics, anti-inflammation, analgesics, antipyretic (for fever) Incision and drainage Most abscesses will continue to get worse without care and proper incision and drainage. The infection can potentially spread to deeper tissues and even into the bloodstream.

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