lymph node boils/freedivers/SA sores?

[Reidfish]

I just found this forum, so hope this is the right place to ask....

Several spearfishers here in NZ often seem to have persistant problems with small pussules of staph. aureous sores scattered around their bodies, and at times this seems to become systemic, resulting in boils undrer armpits in lymph nodes, and larger s.a. sores elsewhere. Treatment is usually antibiotics like augmentin or flucloxycillin (sorry about my spelling I'm a layman!) which usually clears the problem effectively for the time being.

Problem is, it does happen again and again, and the GP's I have seen do not seem to have any suggestions for avoiding it.

Most fredivers use superior suits to those scuba divers use, which have cut neoprene inside with no nylon lining, and use a mix of diluted shampoo or soap to slide into their suits (Picasso, Omer, etc typical brands). They also stay in the water for 6 hours or so a day and are suited up for up to 10 hours a day. Divers with a 'ducksbill' (sorry, don't think the scuba set has picked up on these - a fitting pee-tube for males, with non-return valve at one end) set in their suits or a fly zipper still do have the problem, despite effectively eliminating all urine from the equation.

I did think it was the suits, but it happened to me again last week when I was using a nylon lined suit, which had been soaked in an antibacterial for 2 hours each day after use.

Soaking my wetsuit was suggested by previous doctors, and does seem to reduce the incidence of the problem, but obviously does not eliminate it.

Is there someone out there who actually knows about this problem?

 

[Saturation]

It sounds like a variant of hidradenitis suppurativa, and if it occurs elsewhere due to constrictive clothing like neoprene dive suits, the only solution is to disinfect affected areas with antibacterial scrubs as best possible before wearing the suits, as you have done. However, the patient has a predisposition to this, as few divers suffer from this disease. As is then, a solution is unfortunately to remove the suits when not diving as soon as possible, leaving it on throughout the day as one gets in-out of the water maybe fine for most people, but not for one prone to this disease. If you are a freediver, you have less options, but if you are a scuba diver, then a dry suit is less constricting.

http://www.dermnetnz.org/index.html

 

[Reidfish]

Thanks for your input Dr Saturation! Having read those references I am sceptical that that's it, however.
I just met with another GP who is quite experienced with divers.
He has taken swabs to see what I'm carrying, but has suggested a range of things I could do to help. Interestingly, he pointed out that he gets 5 x more reports of folliculitis from spa pools (jacuzzis, that is for you lot in the US) and saunas than anything else. Funny thing is I used a spa pool the day before it flared up last time. thinking back, there has probably a few cases of this correlation. I am going to see where this takes me, but we think it's most likely a combination of things like: spa pools after diving to be avoided, wear suit for shorter periods, use less soap to retain natural protection, change out of my wettie sooner and shower, more care in washing clothes and bedding etc, and possibly a run (or cycle) of antibiotics to clear any residual SA or other bugs, depending on the swabs.
Will see how it goes.

 

[Saturation]

Good to know then. Hidradenitis is a like a severe form of folliculitis, but it affects a sweat gland versus the hair follicles. While its different pathology, the hair and the glands are very close together. If it every gets very painful or boil like and requires antibiotics by mouth, its closer to hidradenitis than folliculitis.

Items #9 and #10 are sweat and oil glands that can get infected during hidradenitis. Item #7 is a hair, and the bottom of the hair is the follicle.

http://maxshouse.com/schematic_illustrations_of_histo.htm

Info on hidradenitis.

http://www.emedicine.com/emerg/topic259.htm

 

[miguel sanz]

i CAME OUT WITH AND IDEA maybe it´s crazy, but since it´s probably multifactorial...
the cutaneous barrier is "broken" because of the long water contact, it gets moisted (is that word right? sorry for my english) and the bacteria in the skin penatrate anf infect the host. Possible solutions: get the skin reinfforced (medical tape or similar stuff) in the places where the suit moves more and can hurt moisted skin, and reduce bacterial load of the skin with antiseptics, like surgeons.
How does that sound?

 

[Reidfish]

Yeah, I'm sure that's part of the problem, the cutaneous barrier IS broken by bacteria, especially through pores and with the soap lubricant used by most of us, but the wetsuits really do not rub or chaffe anywahere, because of the soap lubricant used. Tape is impractical due to random locations of the problem, and suspect the swollen lymph nodes are indicative more of a systemic problem, not a local intrusion. What you think?

 

[miguel sanz]

Yeah, I'm sure that's part of the problem, the cutaneous barrier IS broken by bacteria, especially through pores and with the soap lubricant used by most of us, but the wetsuits really do not rub or chaffe anywahere, because of the soap lubricant used. Tape is impractical due to random locations of the problem, and suspect the swollen lymph nodes are indicative more of a systemic problem, not a local intrusion. What you think?

Bacteria don´t break the barrier, the barrier is broken and normal cutaneous bacteria get to get in. So my idea was to fight to ways, by strenghing the barrier and by reducing the amount of bacteria. Of course there are probably other factors increasing the host susceptibility to infections.
Some questions: where are the lymph nodes swollen? and don´t you get any rubbing from the suit (neck...) eventhough it might not hurt?