Skip to Main Content


  • • Furuncles and carbuncles: Cutaneous abscess that begin in skin glands and hair follicles

    • Furuncles (boils) usually start in infected hair follicles, some caused by retained foreign bodies and other injuries

    • Infection can spread as cellulitis or form a subcutaneous abscess

    • Furuncles may take a phlegmonous form, ie, extend into the subcutaneous tissue, forming a long, flat abscess

    • Furuncles can be multiple and recurrent (furunculosis)

    • Carbuncle is a deep-seated mass of fistulous tracts between infected hair follicles

    • Staphylococci and anaerobic diphtheroids are most common organisms

    • Hidradenitis suppurativa is a serious skin infection of the axillae or groin consisting of multiple abscesses of the apocrine sweat glands




  • • Furunculosis usually occurs in young adults and is associated with hormonal changes resulting in impaired skin function

    • Carbuncles on the back of the neck are seen almost exclusively in diabetic patients or other relatively immunocompromised patients


Symptoms and Signs


  • • Furuncles itch and cause pain

    • Skin first becomes red and then turns white and necrotic over the top of the abscess

    • Surrounding erythema and induration

    • Regional lymphadenopathy

    • Carbuncles start as furuncles, with infection dissecting through dermis and subcutaneous tissue in connecting tunnels; extensions open to the surface, giving the appearance of large furuncles with many pustular openings

    • Patients may be febrile and mildly toxic

    Hidradenitis: Abscesses are concentrated in the apocrine gland areas, ie, the axillae, groin, and perineum


  • • Rheumatoid nodules

    • Gout

    • Bursitis

    • Sinusitis

    • Erythema nodosum

    • Fungal infections

    • Benign or malignant skin tumors

    • Sebaceous or epithelial inclusion cysts


  • • History and physical exam


  • • Drainage of abscesses

    • Invasive carbuncles treated by excision and antibiotics

    • Extensive laundering of all personal clothing

    • Excision is continued until sinus tracts are removed, usually far beyond the cutaneous evidence of suppuration

    • Hidradenitis is usually treated by drainage of the individual abscess followed by careful hygiene

    • Apocrine sweat-bearing skin must be excised; if the deficit is large, closure with a skin graft may be indicated

    • Avoidance of antiperspirant and deodorant






  • • Diabetic or immunocompromised patients require urgent attention

    • Abscesses on the face usually must be treated with antibiotics as well as by prompt incision and drainage




  • • Use of antibiotics depends on location of the abscess and extent of infection

    • Washing with soaps containing hexachlorophene

    • Topical and systemic antibiotics may be beneficial




  • • Suppurative phlebitis when located near major veins




  • • Left untreated or inadequately treated may lead to infiltration of adjacent organs and body cavities

    • Without adequate excision, hidradenitis may become chronic and disabling



Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.