[26F] Recurrent painful boil with pus and blood

Patient Description

A 26-year-old female has been experiencing a recurrent, painful boil located on the line between her breasts for about 4 months. The boil releases pus and blood, leaving an open wound that lasts for at least two weeks and reappears at least once a month. Despite being treated with two courses of antibiotics, including a 20-day course of 250mg Cefalexin and another 20-day course of 500mg Cefalexin, the boil temporarily disappeared for about 3 weeks but reappeared 4 days ago. Similar boils have also appeared under her right breast and under her armpit two months ago. The area around the boil is swollen, but she has not experienced any fever, chills, recent weight loss, night sweats, or other symptoms. There have been no recent injuries or trauma to the area. No other medications, over-the-counter drugs, supplements, or herbal remedies are being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing a condition called Hidradenitis Suppurativa (HS). HS is a chronic skin condition characterized by small, painful lumps under the skin that can open up into wounds and produce pus. These lumps typically occur in areas where skin rubs together, such as the armpits, groin, and breasts. They can persist for a long time, heal, and then reappear.

  • Treatment for HS typically involves medications to manage pain and inflammation, antibiotics to treat or prevent infections, and sometimes surgery for severe cases.

Another possible diagnosis is a recurrent skin abscess, which is a collection of pus that forms within the body tissue. They can be caused by a bacterial infection.

  • Treatment for skin abscesses usually involves draining the pus and taking antibiotics to clear the infection.

What you can do

  1. Continue to take your antibiotics as prescribed by your doctor.
  2. Apply warm compresses to the boil to help reduce pain and encourage the abscess to drain.
  3. Keep the area clean and dry to prevent further infection.
  4. Avoid squeezing or picking at the boil, as this can spread the infection.
  5. Maintain a healthy lifestyle, including a balanced diet and regular exercise, to boost your immune system.

What you should look out for

Please seek immediate medical attention if:

  • The boil becomes larger or more painful.
  • You develop a fever or chills.
  • The skin around the boil becomes red, warm, or swollen.
  • You notice red streaks leading away from the boil.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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7 mo ago

People Also Ask

What is Hidradenitis Suppurativa and how is it treated?

Hidradenitis Suppurativa (HS) is a chronic skin condition characterized by painful lumps under the skin, often in areas where skin rubs together. Treatment typically involves medications to manage pain and inflammation, antibiotics to treat or prevent infections, and sometimes surgery for severe cases.

Why do boils keep reappearing even after taking antibiotics?

Boils may reappear after antibiotics if the underlying cause, such as Hidradenitis Suppurativa, is not fully addressed. Antibiotics can help clear infections temporarily, but they may not prevent new boils from forming if the root cause persists.

What are the signs that a boil might be getting worse and require immediate medical attention?

Immediate medical attention is needed if the boil becomes larger or more painful, if you develop a fever or chills, if the skin around the boil becomes red, warm, or swollen, or if you notice red streaks leading away from the boil.

How can I prevent boils from forming or reoccurring in the future?

To prevent boils, maintain good hygiene, keep the skin clean and dry, avoid tight clothing that causes friction, and maintain a healthy lifestyle to boost your immune system. It's also important to follow any specific advice from your healthcare provider.

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