Dr. Dilip Kumar Meena
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have had random eruptions on my skin for the past few weeks. They are present mostly on the thighs, forearms, and lower back. They feel tight and are painful to touch. What are these eruptions? Do I need to get them treated or will they go away with time? Please help.
Hello,
Welcome to icliniq.com.
These are furuncles, a bacterial infection of the hair follicles. I suggest you use the following medications for five days. Kindly visit your physician, discuss the suggestion, and take treatment with consent.
You will get better with these medications. If you have these again and again, then you might need some other drugs but for now, use these for five days.
I hope I have resolved your queries. Do get back if you have any further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I took a one-month antibiotic course twice. The condition disappears while I take antibiotics and then appears after a few days of discontinuation. After the second course, the furuncles went away, but now they are back again. Do you still want me to continue with the five-day course again? Kindly help.
Hello,
Welcome back to icliniq.com.
If you have taken two months of antibiotics, then you need to take the following medication for two weeks to prevent further recurrence along with five days of the above drugs. I suggest you take capsule R-Cin 600 mg (Rifampicin) before breakfast for two weeks. This medicine will cause slight reddish discoloration of urine, but it is normal.
I wish you good health.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
I am sorry for pestering you, again and again, but I have a few follow-up questions:
1. Should I take the tablet RCIN 600 mg after the five-day antibiotic course that you prescribed or should I take both at the same time?
2. This condition had been troubling me for months. It had subsided for a while but now it has come back. I did not mention this earlier as I thought these eruptions are something else but when you told me that these are furuncles, I got worried.
3. In all the previous cases, my dermatologist prescribed an antibiotic course and the situation subsided for a while and then came back again. Is this frequent recurrence normal? My dermatologist had mentioned that it might be due to a problem with the immune system as he had never seen such persistent furunculosis (once again this got me really worried). What is your opinion on this?
4. The furuncles occur the most on the lower back along the waistline and on the stomach. This also makes wearing jeans, etc. painful at times.
5. What is your prognosis after your recommended course? I know this is a premature question as you do not have all the information. This condition is painful and distracting for me. Also, it leaves behind a lot of mild scars, which I hope would go away soon.
I am sorry for asking you such a long question. Please feel free to answer only the points you think are relevant.
Thank you.
Hello,
Welcome back to icliniq.com.
Glad to have you back.
I can understand your concern.
1. Start both at the same time and continue taking the tablet Rifampicin (R-Cin) after completion of antibiotics for two weeks.
2. All the more reason to take the tablet Rifampicin is that it is given in cases of recurrent furunculosis.
3. Recurrent furunculosis is seen when our skin and mucosa harbor bacterial reservoirs at particular sites like the nasal vestibules and needs to be removed by some topical antibiotics or oral medications like Rifampicin. You can get your blood sugar level checked if not done already. I suggest you use the prescribed cream in the nasal vestibules and body folds like behind the ear, nasolabial folds, gluteal clefts, etc.
4. I understand but they can appear anywhere where hairs are present.
5. Let us see how effective the tablet Rifampicin is. In my experience, I have seen good results with this drug.
Please start the medications and follow up after that.
Thank you.
Patient's Query
Hello doctor,
Hope you are doing well.
I have been following the medication schedule as per your instructions. I am done with the five-day course of antibiotics and continuing with the tablet R-Cin 600 mg. However, I have a question. Once I stopped the five-day antibiotics course, I noticed the appearance of one to two new boils that are very mild and not too painful when compared to the occurrences before the treatment. Is this normal? Should I continue with just the tablet R-Cin as you prescribed, or do I need to take more antibiotics? Kindly suggest.
Thank you.
Hi,
Welcome back to icliniq.com.
I suggest you continue taking the tablet Rifampicin (R-Cin) for now.
Thank you.
Patient's Query
Hello doctor,
Hope you are doing well.
It has been five days since your prescribed course of medication was over. I am seeing good results. However, I have two new boils after stopping the medication. Can this again lead to the recurrence of recurrent furunculosis? What more can I do to prevent the recurrence? Also, I have been left with a lot of scars on my stomach and back. Will they go away on their own with time? Please let me know about this.
Thank you.
Hello,
Welcome back to icliniq.com.
I hope you have completed two weeks of taking the tablet Rifampicin. Just use the Mupirocin (T-bact) cream if it is not so severe. I hope it does not come back like before. If it does, then kindly get your pus culture and sensitivity tests of the furuncle done to know if there are any different causative organisms, and then antibiotics can be taken accordingly. Please send photographs of your scars.
I hope I have resolved your queries. Do get back if you have any further queries.
Thank you.
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