Induration
Formal Definition
Abnormal hardening or thickening of soft tissue, typically caused by edema, inflammation, fibrosis, or infiltration; detected on palpation as firm or woody consistency of skin and subcutaneous tissue, and used to characterize the extent and severity of skin and soft tissue infections.
How It's Used on the Ward
"The skin is indurated" or "there is induration around the wound" — palpation finding that distinguishes simple erythema from deeper infection or inflammatory process.
Example
""Perirectal area with 4 cm of fluctuance surrounded by 8 cm of induration and erythema — this is an abscess with surrounding cellulitis. OR is available for I&D under sedation.""
Clinical Context
Induration is central to TB skin test (TST) reading: the diameter of the indurated wheal (not the erythema) is measured at 48–72 hours. In cellulitis, induration suggests deeper tissue involvement (see fasciitis risk). In wound evaluation: induration with fluctuance = abscess (needs drainage); without fluctuance = cellulitis (needs antibiotics). Woody induration + pain out of proportion = consider necrotizing fasciitis (surgical emergency).
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