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Pathology

1. Furuncle
   • Infection of hair follicles with staphyloccocus aureus
2. Carbuncle
   • Extensive infection of hair follicles by staphylococcus aureus
   • Involvement of adjacent follicles and development of draining sinuses
   • Associated with diabetes and is treated by combination of systemic antibiotics and surgical excision

Approach

• Examine as for any lump

1. Inspect
   • any hair-bearing area of the skin, particularly face, neck ,buttocks, groins, axillae
   • May be multiple
2. Palpation
   • Tender

Completion

1. Look for other affected areas
2. Establish predisposing risk factors - DM, steroids, immunodeficiencies 

Treatment

1. Non-surgical
   • Risk factor modification - establish good diabetic control
2. Surgical
   • Incision and drainage of large and painful boils