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- Acute bacterial abscess of a hair follicle (often Staphylococcus aureus)
- System(s) affected: skin/exocrine
- Synonym(s): boils
- Predominant age
- Adolescents and young adults
- Clusters have been reported in teenagers living in crowded quarters, within families, or in high school athletes.
- Predominant sex: male = female
Exact data are not available.
Etiology and Pathophysiology
- Infection spreads away from hair follicle into surrounding dermis.
- Pathogenic strain of S. aureus (usually); most cases in United States are now due to community-acquired methicillin-resistant S. aureus (CA-MRSA), whereas methicillin-sensitive S. aureus (MSSA) is most common elsewhere (1).
- Carriage of pathogenic strain of Staphylococcus sp. in nares, skin, axilla, and perineum
- Rarely, polymorphonuclear leukocyte defect or hyperimmunoglobulin E–Staphylococcus sp. abscess syndrome
- Diabetes mellitus, malnutrition, alcoholism, obesity, atopic dermatitis
- Primary immunodeficiency disease and AIDS (common variable immunodeficiency, chronic granulomatous disease, Chédiak–Higashi syndrome, C3 deficiency, C3 hypercatabolism, transient hypogammaglobulinemia of infancy, immunodeficiency with thymoma, Wiskott-Aldrich syndrome)
- Secondary immunodeficiency (e.g., leukemia, leukopenia, neutropenia, therapeutic immunosuppression)
- Medication impairing neutrophil function (e.g., omeprazole)
- The most important independent predictor of recurrence is a positive family history.
Patient education regarding self-care (see “General Measures”); treatment and prevention are interrelated.
Commonly Associated Conditions
- Usually normal immune system
- Diabetes mellitus
- Polymorphonuclear leukocyte defect (rare)
- Hyperimmunoglobulin E–Staphylococcus sp. abscess syndrome (rare)
- See “Risk Factors.”