parsitic skin diseases
TRANSCRIPT
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PARSITIC SKIN DISEASES
BY
DrNagatSobhy
Assistant prof .of dermatology
Scabies
Scabies is an ectoparasite infestation.
It is caused by the mite Sarcoptesscabieivariety hominisan obligate human parasite that
burrows tunnels downwards into the epidermis (not deeper than the stratum granulosum).
Mites of all developmental stages tunnel into the stratum corneum and deposit faeces behind
them; the female also lays eggs in the tunnels.
A photomicrograph of an itch mite (Sarcoptesscabiei).
Photograph of the mite, S. scabiei, seen on a skin scraping from scabetic patient
In classic scabies, there are only about 11-12 female mites per case.
Hypersensitivity of both immediate and delayed types to the mite or its products has been
implicated in the development of lesions other than burrows.
Mode of transmission
:
-Close person-to-person contact.
-Sexual intercourse .
-Fomites may transmit the infection.
Clinical picture
Itching : Nocturnal , scratching ..
The affected sites : Delicate skin as ..
Morphology of the lesion : poly morphic .
A scabies burrow under magnification
Clinical variations of scabies
1-Scabies incognito .
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2-Scabies in infants and young children .
3-Nodular scabies .
4-Crusted ( Norwegian ) scabies .
5-Animal scabies .
Crusted (Norwegian) scabies
This type represents an abnormal host immune response to the sarcoptesscabiei.The condition
is primarily seen in the following groups:
1-The mentally retarded ( Down,s syndrome )
2-Patients with poor cutaneous sensation ( leprosy ,syringomelia ,and tabesdorsalis . )
3-Patients with severe systemic diseases ( leukemia diabetes )
4-Patients with severe immunesuppression.
Crusted scabies in a patient with no overt immunosuppressive illness
Photograph of patient with hyperkeratotic rash typical of crusted (Norwegian) scabies.
Crusted scabies in a patient with claw hand
from past leprosy.
Bullous Scabies
-These scabies can be seen in adults over 65 years of age.
-There is no linkage to an underlying condition or disease.
-It can mimic bullous pemphigoid clinically, pathologically,andimmunopathologically.
Diagnosis of scabies
History
Examination
Investigations : Scraping
Complications of scabies
-Bacterial infections
- Eczematization
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-Urticaria
-Acarophobia
Treatment of scabies
-Instructions
-Drugs : Topical and systemic .
Topical scabicides
1-Benzyl benzoate 10% and 25% lotions
2-Pyrethrins: permethrin 5% cream, lotion
3-Malathion 05% lotion
4-Sulphur (precipitated) 210% in petrolatum
5-Crotamiton 10% cream (Eurax )
6-Gamma benzene hexachloride 1% cream or emulsion .
Special care fore Infant------ Pregnant
Systemic drug for scabies
Ivermectin. (200 g/kg once and repeated after 1-2 weeks) .
Ivermectin
1-The full benefit becomes evident when
eradication of scabies in epidemic or endemic situations
2-in nursing homes and prisons is needed since ivermectin leads to reliable disease control.
3-Along the same lines, crusted scabies has been effectively treated with ivermectin in adults
and children, sometimes in combination with topical permethrin.
Mechanism of action
Ivermectininterrupts the GABA-induced neurotransmission of many parasites.leading to
paralysis of the parasites.
Novel drug
Recently, the essential oil of the tea tree (Melaleucaalternifolia), containing
oxygeneticterpenoids, was found to have rapid scabicidal and antibacterial activity.
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vaccine development
The multifunctional enzyme glutathione S-transferase ofS scabieicould represent a specific
target for vaccination against human scabies.
Pediculosis
Pediculosis is an infestation oflice blood-feeding ectoparasiticinsects of the order
Phthiraptera. The condition can occur in almost any species of warm-blooded animal (i.e.,
mammals and birds), including humans.Although "pediculosis" in humans may properly refer to
lice infestation of any part of the body, the term is sometimes used loosely to refer to
pediculosiscapitis, the infestation of the human head with the specific head louse.
Pediculushumanuscapitis () Lice are small gray brown,blood sucking insects which crawl among
the hairs
Classification
Pediculosis may be divided into the following types
1- Pediculosiscapitis (Head lice infestation)
2- Pediculosiscorporis (Pediculosisvestimenti, Vagabond's disease) typhus $relapsing fever
3- Pediculosis pubis (Crabs) STD
Pediculosis, or louse infestation, remains a
worldwide problem. The lice that infest human beings are almost always sucking lice that live in
close association with the host and lay their eggs on hair shafts or in the seams of clothing
A and B, Identifying characteristics of a head louse.
Head louse nit attached to hair shaft
Identifying characteristics of a crab louse
Treatment
Malathion o.5 % lotion
Anti scabetic drugs