Skin and soft tissue abscess

What it is

Skin and soft tissue infections divide into two groups, and the division is the first thing to decide. The non-purulent group is cellulitis, necrotizing fasciitis and erysipelas. The purulent group is impetigo or ecthyma, furuncle, carbuncle and abscess.

An abscess belongs to the purulent side. What the hand finds is a localised fluctuation, and that is what separates it from the flat redness of the non-purulent infections. The tissue runs from the epidermis to the dermis, then the subcutaneous tissue, then the muscle. Under the skin the layers run epidermis, then dermis with its papillary and reticular layers, then the subcutaneous layer.

The Bartholin's glands are two rounded pea sized glands at the entrance of the vagina, sited between the posterior part of the labia minora and the vaginal walls, and they secrete mucus as a lubricant during coitus. Their position is given as 5 and 7 o'clock in one source and 4 and 8 o'clock in another. The normal gland cannot be palpated, and 2% of adult women develop enlargements of one or both glands. Infection of the duct and gland results in closure of the duct and formation of a Bartholin's cyst or abscess. Pilonidal disease is an abscess of the same family in another place: a chronic recurring abscess or chronic draining sinus in the sacrococcygeal area. It comes of obstruction of the hair follicles in that area, which leads to formation of cysts, sinuses or abscesses, and it occurs most frequently in young men age 15-40 yr and is rare over 50 yr.