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Dermatology5 papers

Boil of lower leg

Last edited: 4/15/2026

Overview

A boil, or furuncle, of the lower leg is a localized infection of hair follicles typically caused by Staphylococcus aureus, presenting as painful, red, swollen nodules that may suppurate 1.

Diagnosis

  • Clinical presentation: Painful, erythematous, warm, and tender nodule or abscess 1.
  • Cultures may be useful for identifying the causative organism, though not always necessary for initial management 1.
  • Imaging (e.g., ultrasound) rarely needed but can help assess abscess size and extent 1.

    • Management

  • Incision and drainage: Primary treatment for abscesses to relieve pressure and facilitate healing 1.
  • Antibiotics: Consider systemic antibiotics if there is cellulitis, multiple boils, or systemic symptoms; examples include dicloxacillin or clindamycin 1.
  • Wound care: Proper cleaning and dressing of the wound post-drainage to prevent recurrence and infection spread 1.
  • Surgical reconstruction: For extensive defects, a bilobed fasciocutaneous flap can be considered for optimal functional and cosmetic outcomes 1.

    • Special Populations

  • Elderly: Increased risk of complications; careful monitoring and management of comorbidities essential 1.
  • Comorbidities: Presence of diabetes or peripheral vascular disease may complicate healing; tailored wound care and infection control crucial 1.

    • Key Recommendations

  • Perform incision and drainage for lower leg boils with abscess formation to promote healing (Evidence: Strong 1).
  • Consider systemic antibiotics in cases of extensive infection, multiple boils, or systemic symptoms (Evidence: Moderate 1).
  • Utilize a bilobed fasciocutaneous flap for reconstruction in cases requiring extensive soft tissue repair to enhance outcomes (Evidence: Weak 1).

    • References

    1 Maruyama Y. Bilobed fasciocutaneous flap. British journal of plastic surgery 1985. link90012-8)

    Original source

    1. [1]
      Bilobed fasciocutaneous flap. — Maruyama Y British journal of plastic surgery (1985)
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