abscess

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Definition

An abscess is an enclosed collection of liquefied tissue, known as pus, somewhere in the body. It is the result of the body's defensive reaction to foreign material.

Description

There are two types of abscesses, septic and sterile. Most abscesses are septic, which means that they are the result of an infection. Septic abscesses can occur anywhere in the body. Only a germ and the body's immune response are required. In response to the invading germ, white blood cells gather at the infected site and begin producing chemicals called enzymes that attack the germ by digesting it. These enzymes act like acid, killing the germs and breaking them down into small pieces that can be picked up by the circulation and eliminated from the body. Unfortunately, these chemicals also digest body tissues. In most cases, the germ produces similar chemicals. The result is a thick, yellow liquid—pus—containing digested germs, digested tissue, white blood cells, and enzymes.

An abscess is the last stage of a tissue infection that begins with a process called inflammation. Initially, as the invading germ activates the body's immune system, several events occur:

• Blood flow to the area increases.
• The temperature of the area increases due to the increased blood supply.
• The area swells due to the accumulation of water, blood, and other liquids.
• It turns red.
• It hurts, because of the irritation from the swelling and the chemical activity.

These four signs—heat, swelling, redness, and pain— characterize inflammation.

As the process progresses, the tissue begins to turn to liquid, and an abscess forms. It is the nature of an abscess to spread as the chemical digestion liquefies more and more tissue. Furthermore, the spreading follows the path of least resistance—the tissues most easily digested. A good example is an abscess just beneath the skin. It most easily continues along beneath the skin rather than working its way through the skin where it could drain its toxic contents. The contents of the abscess also leak into the general circulation and produce symptoms just like any other infection. These include chills, fever, aching, and general discomfort.

Sterile abscesses are sometimes a milder form of the same process caused not by germs but by non-living irritants such as drugs. If an injected drug like penicillin is not absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess— sterile because there is no infection involved. Sterile abscesses are quite likely to turn into hard, solid lumps as they scar, rather than remaining pockets of pus.

— J. Ricker Polsdorfer, MD

[Latin abscessus, separation, abscess, from past participle of abscēdere, to go away, slough, form an abscess (possibly translation of Greek apostēma, distance, abscess , from aphistasthai, to withdraw, slough, form an abscess) : ab-, away; see ab-¹ + cēdere, to go.]

For more information on abscess, visit Britannica.com.

A localized accumulation of pus in a cavity formed by tissue disintegration.

Abscess. (Regezi/Sciubba/Jordan, 2003)

Definition

An abscess is a place of accumulation of the creamy white, yellow, or greenish fluid, known as pus, surrounded by reddened tissue. It is the result of the body's inflammatory response to a foreign body or a bacterial, viral, parasitic, or fungal infection. An abscess usually dries out and resolves when it is drained of pus. The most common parts of the body affected by abscesses are the face, armpits, arms and legs, rectum, sebaceous glands (oil glands), and the breast during lactation.

Description

Most abscesses are septic, which means they are the result of an infection. Abscesses occur when white blood cells (WBCs) gather in response to an infection. They produce oxidants (for example, superoxide radical) and enzymes to digest the invading bacteria, viruses, parasites, or fungi. The infective agents are then broken down by the WBCs into small pieces that can be transported through the bloodstream and eliminated from the body. Unfortunately, the enzymes may also digest part of the body's tissues along with the infective agents. The resulting liquid of this digestion is pus, which contains the remains of the infective agents, tissue, white blood cells, and enzymes.

A sterile abscess is one that is not produced by an infection. It is caused by irritants, such as foreign bodies or injected drugs, and medications that have not been totally absorbed. Sterile abscesses quite often heal into hardened scar tissue.

Common types of abscesses:

• Boils and carbuncles. Sebaceous glands and superficial skin are the places usually infected.
• Dental abscess. An abscess that develops along the root of a tooth.
• Pilonidal abscess. People who have a birth defect involving a tiny opening in the skin just above the anus may have fecal bacteria enter this opening, causing an infection and a subsequent abscess.
• Retropharyngeal, parapharyngeal, peritonsillar abscess. As a result of throat infections like strep throat and tonsillitis, bacteria invade the deeper tissues of the throat and cause a parapharyngeal or peritonsillar abscess. A retropharyngeal abscess is a result of something usually blood-borne, and not from a direct spread of tonsillitis. These abscesses can compromise swallowing and even breathing.
• Lung abscess. During or after pneumonia, an abscess can develop as a complication.
• Liver abscess. Bacteria, parasites, or amoeba from the intestines can spread through the blood to the liver and cause abscesses.
• Psoas abscess. An abscess can develop in the psoas muscles, when an infection spreads from the appendix, the large intestine, or the fallopian tubes.
• Butin abscess. Any blood-borne feeding off bacteria that stimulate pus production (pyogenic organisms). Can cause abscesses in possibly many sites.

Causes & Symptoms

Many different agents cause abscesses. The most common are the pyogenic, or pus-forming bacteria, such as Staphylococcus aureus, which is nearly always the cause of abscesses directly under the skin. Abscesses are usually caused by organisms that normally inhabit nearby structures or that infect them. For example, abscesses around the anus may be caused by any of the numerous bacteria found within the large intestine. Brain abscesses and liver abscesses are caused by the bacteria, amoeba, and fungi that are able to travel there through circulation.

Symptoms of an abscess are the general signs of inflammation. Symptoms that identify superficial abscesses include heat, redness, swelling, and pain over the affected area. Abscesses in other places may produce only generalized symptoms, such as fever and discomfort. A sterile abscess may present as painful lump deep under the site of an injection. A severe infection may bring on fever, fatigue, weight loss, and chills. Recurrent abscesses may indicate undiscovered allergies or decreased immune functioning.

Diagnosis

A general physical examination and a detailed patient history are used to diagnose an abscess. Recent or chronic disease or dysfunction in an organ suggests it may be the site of an abscess. Pain and tenderness on physical examination are common findings. There may also be a leakage of pus from a sinus tract connected to an abscess deep in the body tissue.

Treatment

Bentonite clay packs with a small amount of goldenseal powder (Hydrastis canandensis) can be placed on the site of a superficial abscess and used to draw out the infection. Tea tree oil (Melaleuca spp.) and garlic (Allium sativa) directly applied to abscesses may also help to clear them.

Applications of a hot compress to the skin over the abscess will hasten the draining or the reabsorption of the abscess. Contrast hydrotherapy, using alternating hot and cold compresses, can also be used. Additionally, localized warm/hot soaks three to five times daily frequently brings an abscess to heal.

Homeopathic remedies that can be taken to help diminish abscess formation include belladonna, silica, Hepar sulphuris, and calendula. Also, acupuncture may be recommended to help treat pain caused by an abscess. In addition, vitamins A and C, beta-carotene, zinc, liquid chlorophyll, and garlic are useful as supportive daily nutrients to help clear up abscesses.

Allopathic Treatment

Often, the pus of an abscess must be drained by a physician. Ordinarily, the body will handle the remaining infection. Sometimes antibiotics are prescribed. The doctor may often put a piece of cloth or rubber, called a drain, in the cavity of the abscess to prevent it from closing until all the pus has drained.

Expected Results

Once the abscess is properly drained, it should clear up in a few days. Any underlying diseases will determine the overall outcome of the condition. Recurrent abscesses, especially those on the skin, return due to either defective/altered immunity, or staph overgrowth, where there is high bacterial colonization on the skin. The patient should consult a physician for treatment with which to wash the skin areas, and treatment to eradicate colonization.

If the abscess ruptures into neighboring areas or if the infectious agent spills into the bloodstream, serious consequences are likely. Abscesses in and around the nasal sinuses, face, ears, and scalp may spread the infection into the brain. Abscesses in the abdominal cavity, such as in the liver, may rupture into that cavity. Blood poisoning, or septicemia, is an infection that has spilled into the bloodstream and then spreads throughout the body. These are emergency situations where the patient needs to be seen by a physician as soon as possible.

It is important to take note that abscesses in the hand may be more serious than they might appear. Due to the intricate structure and the overriding importance of the hand, any hand infection must be treated promptly and competently.

Prevention

Infections that are treated early with heat, if superficial, or antibiotics, if deeper, will often resolve without the formation of an abscess. It is even better to avoid infections altogether by promptly cleaning and irrigating open injuries, particularly bites and puncture wounds.

Resources

Books

Bennett, J. Claude and Fred Plum, ed. Cecil Textbook of Medicine. Philadelphia: W. B. Saunders Co., 1996.

Duke, James A., et al. The Green Pharmacy. Pennsylvania: Rodale, 1997.

Isselbacher, Kurt, et al, ed. Harrison's Principles of Internal Medicine. New York: McGraw–Hill, 1997.

Tierney, Jr., Lawrence M., et al, ed. Current Medical Diagnosis and Treatment. Connecticut: Appleton & Lange, 1996.

Other

AlternativeMedicine.com. (December 28, 2000).

[Article by: Patience Paradox]

An inflamed area (see inflammation) in the body tissues that is filled with pus.

A localized collection of pus in a cavity formed by the disintegration of tissue. Most abscesses are formed by invasion of tissues by bacteria, but some are caused by fungi or protozoa or even helminths, and some are sterile. Their effects are determined by their location and the pressure that they exert on nearby organs, and the degree of toxemia that they create from their bacterial content and the amount of tissue destroyed. So that for a reasonably active abscess the syndrome presented will be one of local pain, anorexia and fever, and a leukocytosis. For specific abscesses see under anatomical sites, e.g. brain abscess.

• Brodie's a. — a circumscribed abscess in bone, caused by hematogenous infection that becomes a chronic nidus of infection.
• cervical a. — see vertebral abscess.
• cold a. — one of slow development and with little inflammation, e.g. caseous lymphadenitis of sheep and goat.
• cornea stromal a. — small ulcers or puncture wounds of the corneal epithelium may permit entry of bacteria then heal, creating an abscess. Particularly important in horses.
• diffuse a. — a collection of pus not enclosed by a capsule.
• facial subcutaneous a. — a disease of cattle eating hay or pasture containing mature grass awns.
• gas a. — one containing gas, caused by gas-forming bacteria such as Clostridium perfringens.
• grass seed a. — in cattle occurs as a cold, subcutaneous abscess at the throat or on the mandible and is often diagnosed but rarely confirmed. In dogs it occurs in many sites, but most commonly between the toes. The causative grass awn(s) may be recovered by forceps or, in more extensive lesions, surgical exploration.
• infraorbital a. — occurs in birds as a sequel to chronic upper respiratory infection with sinusitis.
• injection site a. — an iatrogenic lesion resulting from incomplete skin disinfection before injection; usually contains Arcanobacterium pyogenes.
• intra-abdominal a. — include diaphragmatic, mesenteric, retroperitoneal; many are subclinical; clinical signs include those of chronic peritonitis. Called also omental bursitis.
• maxillary a. — see malar abscess.
• mediastinal a. — a very large abscess in this site may cause signs of congestive heart failure due to compression of pericardium and venae cavae.
• miliary a. — one of a set of small abscesses.
• milk a. — abscess of the mammary gland occurring during lactation.
• pectoral a. — a disease of horses in which abscesses occur in the pectoral muscles and ventral midline, and in some cases in internal organs, causing local pain and swelling and eventually rupturing and draining to the exterior. Endemic to areas of California, Texas and Colorado in the USA where it is also known as pigeon fever and has epidemic occurrence in the autumn of some years with a possible insect vector transmission. Caused by Corynebacterium pseudotuberculosis.
• periapical a. — inflammation and destruction of dental pulp and surrounding tissues, including the periodontal membrane and alveolar bone. The radiographic appearance is a translucency of the tooth apex and adjacent alveolar bone. Most common in dogs.
• periorbital a. — firm masses above or below the eyes occur in birds as a sequel to chronic respiratory disease and sinusitis.
• phlegmonous a. — one associated with acute inflammation of the subcutaneous connective tissue.
• phoenix a. — acute recurrence of a chronic periapical lesion.
• primary a. — one formed at the seat of the infection.
• rete mirabile a. — see pituitary abscess.
• retroarticular a. — one located between the intermediate phalanx and the deep flexor tendon in the hooves of cattle. It may be caused by extension of infection from the navicular bursa or from suppurative arthritis of the distal interphalangeal joint.
• retrobulbar a. — behind the orbit of the eye; cause pain on opening of the mouth, chemosis and exophthalmos, protrusion of the nictitating membrane, and systemic signs of infection. Most common in dogs and cats.
• stitch a., suture a. — one developed about a stitch or suture.
• vertebral body/epidural a. — usually of cervical or lumbar vertebrae; causes compression of cord manifested by incoordination, paresis, paralysis.
• wandering a. — one that burrows into tissues and finally points at a distance from the site of origin.

This article is about the medical condition. For the death metal band, see Abscess (band).

Abscess
Classification and external resources
Abscess
ICD-9	682.9
MeSH	D000038

Look up abscess in Wiktionary, the free dictionary.

An abscess (Latin: abscessus) is a collection of pus (dead neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process (usually caused by bacteria or parasites) or other foreign materials (e.g., splinters, bullet wounds, or injecting needles). It is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body.

The organisms or foreign materials kill the local cells, resulting in the release of cytokines. The cytokines trigger an inflammatory response, which draws large numbers of white blood cells to the area and increases the regional blood flow.

The final structure of the abscess is an abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.

Abscesses must be differentiated from empyemas, which are accumulations of pus in a preexisting rather than a newly formed anatomical cavity.

Contents 1 Manifestations 2 Treatment 2.1 Incision and drainage 2.2 Packing 2.3 Primary closure 2.4 Antibiotics 2.5 Recurrent infections 2.6 Magnesium sulfate paste 3 Perianal abscess 4 See also 5 References 6 External links

Manifestations

The cardinal symptoms and signs of any kind of inflammatory process are redness (rubor), heat (calor), swelling (tumor), pain (dolor) and loss of function. Abscesses may occur in any kind of solid tissue but most frequently on skin surface (where they may be superficial pustules (boils) or deep skin abscesses), in the lungs, brain, teeth, kidneys and tonsils. Major complications are spreading of the abscess material to adjacent or remote tissues and extensive regional tissue death (gangrene). Abscesses in most parts of the body rarely heal themselves, so prompt medical attention is indicated at the first suspicion of an abscess. An abscess could potentially be fatal (although this is rare) if it compresses vital structures such as the trachea in the context of a deep neck abscess.^{[citation needed]}

Treatment

Wound abscesses do not generally need to be treated with antibiotics, but they will require surgical intervention, debridement and curettage.^[1]

Incision and drainage

Main article: Incision and drainage

Abscess five days after incision and drainage.

The abscess should be inspected to identify if foreign objects are a cause, which may require their removal. If foreign objects are not the cause, a doctor will incise and drain the abscess and prescribe painkillers and possibly antibiotics.^[2]

Surgical drainage of the abscess (e.g., lancing) is usually indicated once the abscess has developed from a harder serous inflammation to a softer pus stage. This is expressed in the Latin medical aphorism: Ubi pus, ibi evacua.

In critical areas where surgery presents a high risk, it may be delayed or used as a last resort. The drainage of a lung abscess may be performed by positioning the patient in a way that enables the contents to be discharged via the respiratory tract. Warm compresses and elevation of the limb may be beneficial for a skin abscess.

Packing

In North America, after drainage, an abscess cavity is often packed. There however is no evidence to support this practice and it may in fact delay healing.^[3] To try to answer this question more definitely, a randomized double-blind study was started in September 2008 and is ongoing as of December 2008.^[4] A small pilot study has found no benefit from packing of simple cutaneous abscesses.^[5]

Primary closure

Primary closure has been successful when combined with curettage and antibiotics^[6] or with curettage alone.^[7] However, another randomized controlled trial found primary closure led to 35% failing to heal primarily and primary closure longer median number of days to closure (8.9 versus 7.8).^[8]

In anorectal abscesses, primary closure healed faster, but 25% of abscesses healed by secondary intention and recurrence was higher.^[9]

Antibiotics

As Staphylococcus aureus bacteria is a common cause, an anti-staphylococcus antibiotic such as flucloxacillin or dicloxacillin is used. With the emergence of community-acquired methicillin-resistant staphylococcus aureus MRSA, these traditional antibiotics may be ineffective; alternative antibiotics effective against community-acquired MRSA often include clindamycin, trimethoprim-sulfamethoxazole, and doxycycline. These antibiotics may also be prescribed to patients with a documented allergy to penicillin. (If the condition is thought to be cellulitis rather than abscess, consideration should be given to possibility of strep species as cause that are still sensitive to traditional anti-staphylococcus agents such as dicloxacillin or cephalexin in patients able to tolerate penicillin). It is important to note that antibiotic therapy alone without surgical drainage of the abscess is seldom effective due to antibiotics often being unable to get into the abscess and their ineffectiveness at low pH levels. Whilst most medical texts advocate surgical incision some medical doctors will treat small abscesses conservatively with antibiotics.

Recurrent infections

Recurrent abscesses are often caused by community-acquired MRSA. While resistant to most beta lactam antibiotics commonly used for skin infections, it remains sensitive to alternative antibiotics, e.g., clindamycin (Cleocin), trimethoprim-sulfamethoxazole (Bactrim), and doxycycline (unlike hospital-acquired MRSA that may only be sensitive to vancomycin IV).

To prevent recurrent infections due to Staphylococcus, consider the following measures:

• Topical mupirocin applied to the nares.^[10] In this randomized controlled trial, patients used nasal mupirocin twice daily 5 days a month for 1 year.
• Chlorhexidine baths,^[11] In a randomized controlled trial, nasal recolonization with S. aureus occurred at 12 weeks in 24% of nursing home residents receiving mupirocin ointment alone (6/25) and in 15% of residents receiving mupirocin ointment plus chlorhexidine baths daily for the first three days of mupirocin treatment (4/27). Although these results did not reach statistical significance, the baths are an easy treatment.

Magnesium sulfate paste

Historically abscesses as well as boils and many other collections of pus have been treated via application of magnesium sulfate paste. This works by drawing the infected pus to the surface of the skin before rupturing and leaking out, after this the body will usually repair the old infected cavity. Magnesium sulfate is therefore best applied at night with a sterile dressing covering it, the rupture itself is not painful but the drawing up may be uncomfortable. Magnesium sulfate paste is considered a "home remedy" and is not necessarily an effective or accepted medical treatment.

Perianal abscess

Perianal abscesses can be seen in patients with for example inflammatory bowel disease (such as Crohn's disease) or diabetes. Often the abscess will start as an internal wound caused by ulceration or hard stool. This wound typically becomes infected as a result of the normal presence of feces in the rectal area, and then develops into an abscess. This often presents itself as a lump of tissue near the anus which grows larger and more painful with the passage of time.

Like other abscesses, perianal abscesses may require prompt medical treatment, such as an incision and debridement or lancing.

See also

• Tooth abscess
• Brain abscess
• Hidradenitis suppurativa

References

1. ^ McLatchie G, Leaper D, (eds). 2007. Oxford Handbook of Clinical Surgery, 2nd ed. Oxford. OUP
2. ^ Green, James; Saj Wajed (2000). Surgery: Facts and Figures. Cambridge University Press. ISBN 1900151960. 
3. ^ "BestBets: abscesses; to pack or not to pack". http://www.bestbets.org/bets/bet.php?id=272. 
4. ^ "Study of Wound Packing After Superficial Skin Abscess Drainage - Full Text View - ClinicalTrials.gov". http://clinicaltrials.gov/ct2/show/NCT00746109. 
5. ^ O'Malley GF, Dominici P, Giraldo P, et al. (April 2009). "Routine Packing of Simple Cutaneous Abscesses Is Painful and Probably Unnecessary". Acad Emerg Med. doi:10.1111/j.1553-2712.2009.00409.x. PMID 19388915. 
6. ^ Abraham N, Doudle M, Carson P (1997). "Open versus closed surgical treatment of abscesses: a controlled clinical trial". The Australian and New Zealand journal of surgery 67 (4): 173–6. doi:10.1111/j.1445-2197.1997.tb01934.x. PMID 9137156. 
7. ^ Stewart MP, Laing MR, Krukowski ZH (1985). "Treatment of acute abscesses by incision, curettage and primary suture without antibiotics: a controlled clinical trial". The British journal of surgery 72 (1): 66–7. doi:10.1002/bjs.1800720125. PMID 3881155. 
8. ^ Simms MH, Curran F, Johnson RA, et al. (1982). "Treatment of acute abscesses in the casualty department". British medical journal (Clinical research ed.) 284 (6332): 1827–9. doi:10.1136/bmj.284.6332.1827. PMID 6805714. 
9. ^ Kronborg O, Olsen H (1984). "Incision and drainage v. incision, curettage and suture under antibiotic cover in anorectal abscess. A randomized study with 4-year follow-up". Acta Chirurgica Scandinavica 150 (8): 689–92. PMID 6397949. 
10. ^ Raz R, Miron D, Colodner R, Staler Z, Samara Z, Keness Y (1996). "A 1-year trial of nasal mupirocin in the prevention of recurrent staphylococcal nasal colonization and skin infection". Arch Intern Med 156 (10): 1109–12. doi:10.1001/archinte.156.10.1109. PMID 8638999. 
11. ^ Watanakunakorn C, Axelson C, Bota B, Stahl C (1995). "Mupirocin ointment with and without chlorhexidine baths in the eradication of Staphylococcus aureus nasal carriage in nursing home residents". Am J Infect Control 23 (5): 306–9. doi:10.1016/0196-6553(95)90061-6. PMID 8585642. 

External links

• MedlinePlus Medical Encyclopedia - Abscess
• MedlinePlus Medical Encyclopedia - Skin Abscess

v • d • e Diseases of the skin and appendages by morphology Growths Epidermal wart · callus · seborrheic keratosis · acrochordon · molluscum contagiosum · actinic keratosis · squamous cell carcinoma · basal cell carcinoma · merkel cell carcinoma · nevus sebaceous · trichoepithelioma Pigmented Freckles · lentigo · melasma · nevus · melanoma Dermal and subcutaneous epidermal inclusion cyst · hemangioma · dermatofibroma · keloid · lipoma · neurofibroma · xanthoma · Kaposi's sarcoma · infantile digital fibromatosis · granular cell tumor · leiomyoma · lymphangioma circumscriptum · myxoid cyst Rashes With epidermal involvement Eczematous contact dermatitis · atopic dermatitis · seborrheic dermatitis · stasis dermatitis · lichen simplex chronicus · Darier's disease · glucagonoma syndrome · langerhans cell histiocytosis · lichen sclerosus · pemphigus foliaceus · Wiskott-Aldrich syndrome · Zinc deficiency Scaling psoriasis · tinea (corporis · cruris · pedis · manuum · faciei) · pityriasis rosea · secondary syphillis · mycosis fungoides · systemic lupus erythematosus · pityriasis rubra pilaris · parapsoriasis · ichthyosis Blistering herpes simplex · herpes zoster · varicella · bullous impetigo · acute contact dermatitis · pemphigus vulgaris · bullous pemphigoid · dermatitis herpetiformis · porphyria cutanea tarda · epidermolysis bullosa simplex Papular scabies · insect bite reactions · lichen planus · miliaria · keratosis pilaris · lichen spinulosus · transient acantholytic dermatosis · lichen nitidus · pityriasis lichenoides et varioliformis acuta Pustular acne vulgaris · acne rosacea · folliculitis · impetigo · candidiasis · gonococcemia · dermatophyte · coccidioidomycosis · subcorneal pustular dermatosis Hypopigmented tinea versicolor · vitiligo · pityriasis alba · postinflammatory hyperpigmentation · tuberous sclerosis · idiopathic guttate hypomelanosis · leprosy · hypopigmented mycosis fungoides Without epidermal involvement Red Blanchable Erythema Generalized drug eruptions · viral exanthems · toxic erythema · systemic lupus erythematosus Localized cellulitis · abscess · boil · erythema nodosum · carcinoid syndrome · fixed drug eruption Specialized urticaria · erythema (multiforme · migrans · gyratum repens · annulare centrifugum · ab igne) Nonblanchable Purpura Macular thrombocytopenic purpura · actinic purpura Papular disseminated intravascular coagulation · vasculitis Indurated scleroderma/morphea · granuloma annulare · lichen sclerosis et atrophicus · necrobiosis lipoidica Miscellaneous disorders Ulcers Hair telogen effluvium · androgenic alopecia · trichotillomania · alopecia areata · systemic lupus erythematosus · tinea capitis · loose anagen syndrome · lichen planopilaris · folliculitis decalvans · acne keloidalis nuchae Nail onychomycosis · psoriasis · paronychia · ingrown nail Mucous membrane aphthous stomatitis · oral candidiasis · lichen planus · leukoplakia · pemphigus vulgaris · mucous membrane pemphigoid · cicatricial pemphigoid · herpesvirus · coxsackievirus · syphilis · systemic histoplasmosis · squamous cell carcinoma

v • d • e Diseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709) Infections Bacterial skin disease Staphylococcus (Staphylococcal scalded skin syndrome, Impetigo, Boil, Carbuncle) · Strep (Impetigo) · Corynebacterium (Erythrasma) Viral skin disease Wart · Molluscum contagiosum · Erythema infectiosum · Exanthema subitum · Herpes simplex (Herpetic whitlow, Eczema herpeticum) General Cellulitis (Paronychia) · Acute lymphadenitis · Pilonidal cyst · Pimple (Pustule) Bullous disorders acantholysis (Pemphigus, Transient acantholytic dermatosis) · Pemphigoid (Bullous, Cicatricial, Gestational) · Dermatitis herpetiformis Inflammatory Dermatitis and eczema Atopic dermatitis · Seborrhoeic dermatitis (Dandruff, Cradle cap) · Contact dermatitis (Diaper rash, Urushiol-induced contact dermatitis) · Erythroderma · Lichen simplex chronicus/Prurigo nodularis · Itch (Pruritus ani, Pruritus scroti, Pruritus vulvae) · Nummular dermatitis · Dyshidrosis · Pityriasis alba Papulosquamous disorders Psoriasis (Psoriatic arthritis) · Parapsoriasis (Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica, Lymphomatoid papulosis) · other pityriasis (Pityriasis rosea, Pityriasis rubra pilaris) · other lichenoid (Lichen planus, Lichen nitidus) Urticaria Dermatographic urticaria · Cold urticaria · Cholinergic urticaria · Solar urticaria Erythema Erythema multiforme/ drug eruption Stevens-Johnson syndrome · Toxic epidermal necrolysis · Erythema nodosum  · Acute generalized exanthematous pustulosis Other erythema Erythema annulare centrifugum · Erythema marginatum · Keratolytic winter erythema · Necrolytic migratory erythema · Erythema toxicum Radiation-related disorders Sunburn · actinic rays (Actinic keratosis, Actinic cheilitis) · Polymorphous light eruption (Acne aestivalis) · Radiodermatitis · Erythema ab igne Pigmentation/ Dyschromia hypopigmentation (Albinism, Vitiligo) · hyperpigmentation (Melasma, Freckle, Café au lait spot, Lentigo/Liver spot, Acanthosis nigricans, Acral acanthotic anomaly) Other skin keratosis/hyperkeratosis (Seborrheic keratosis, Callus) · other epidermal thickening (Ichthyosis acquisita, Palmoplantar keratoderma) skin ulcer (Pyoderma gangrenosum, Bedsore) Cutaneous Markers of Internal Malignancy (Florid cutaneous papillomatosis, acanthosis nigricans, sign of Leser-Trelat) atrophic (Lichen sclerosus, Acrodermatitis chronica atrophicans) necrobiosis (Granuloma annulare, Necrobiosis lipoidica) · other granuloma (Granuloma faciale, Pyogenic granuloma) cutaneous vasculitis (Livedoid vasculitis, Erythema elevatum diutinum) Connective tissues collagen disease: Keloid localized connective tissue disorders: Lupus erythematosus (Discoid lupus erythematosus, Subacute cutaneous lupus erythematosus) · Scleroderma/Morphea · Linear scleroderma · Calcinosis cutis · Sclerodactyly · Ainhum integument, SF, LCT navs: anat/physio, noncongen/congen/neoplasia, symptoms+signs/eponymous, proc

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Dansk (Danish)
n. - abcess, byld
v. intr. - danne bylder

Nederlands (Dutch)
abces

Français (French)
n. - abcès
v. intr. - percer un abcès

Deutsch (German)
n. - Abszeß
v. - einen Abszeß bilden

Ελληνική (Greek)
n. - (παθολ.) απόστημα

Italiano (Italian)
ascesso

Português (Portuguese)
n. - abscesso (Med.)

Русский (Russian)
нарыв, гнойник

Español (Spanish)
n. - absceso
v. intr. - sufrir un absceso

Svenska (Swedish)
n. - böld, bulnad

中文（简体）(Chinese (Simplified))
脓疮, 溃疡, 形成脓肿

中文（繁體）(Chinese (Traditional))
n. - 膿瘡, 潰瘍
v. intr. - 形成膿腫

한국어 (Korean)
n. - 종기
v. intr. - 종기가 생기다

日本語 (Japanese)
n. - 膿瘍
v. - 膿瘍を形成する

العربيه (Arabic)
‏(الاسم) خراج‏

עברית (Hebrew)
n. - ‮מורסה, פצע מוגלתי‬
v. intr. - ‮היה נגוע במורסה/מורסות‬

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