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SCABIES

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SCABIES

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  1. A 30-year-old man reported to have diffuse intense itching. He reports that his girlfriend has the same itching. Examination of the skin reveals interdigital lesions, with small papules, vesicles, and excoriations on the hands, and indurated nodules on the genitalia, How should this case be managed?

  2. SCABIES -INFESTATION WITH ITCH MITE KNOWN AS SARCOPTES SCABIES VAR HUMANUS -FIRST DESCRIBED IN 1687 -DISEASE FOUND WORLD WIDE -IT CAN BE TRANSMITTED SEXUALLY AS WELL AS BY NONSEXUAL CLOSE SKIN TO SKIN CONTACTE SPECIALY WTHIN FAMILY AND AT SCHOOL -WHEN MORE THEN ONE MEMBER OF HOUSEHOLD IS AFFLICTED WITH AN INTENSLY PRURITIC ERRUPTION, SCABIES INFESTATION MUST BE CONSIDERED

  3. SCABIES • Scabies is a common parasitic infection caused by the mite Sarcoptes scabiei variety hominis, an arthropod of the order Acarina. • The worldwide prevalence has been estimated at about 300 million cases yearly, • Scabies occurs in both sexes, at all ages, in all ethnic groups, and at all socioeconomic levels. • In an epidemiologic study in the United Kingdom, scabies was shown to be more prevalent in urban areas and among women and children and more common in winter than in summer. • Scabies is generally a nuisance on account of itching, rash, and its ability to spread among people; superinfection may also occur. • The risk of severe outbreaks and complicated scabies is particularly high in institutions (including nursing homes and hospitals) and among socially disadvantaged populations and immunocompromised hosts.

  4. SARCOPTES SCABEI

  5. CLINICAL PRESENTATION • INTRACTABLE PRURITUS CHARECTERISTICALLY MORE SEVER AT NIGHT • TYPICAL LESIONS PRESENT AT WEB SPACES, SIDES OF FINGER, FLEXURS OF WRIST, ELBOWS AXILARY FOLDS, GENIATALIA IN MAN, AREOLAE IN FEMALE • MAY BE ECZEMATOUS AND EXCOREATED ERYTHEMATOUS PAPULAR LESIONS • PATHOGNOMONIC LESION “BURROWS- A SHORT,WAVY,DARK LINE, CLASSICAL LESIONA OFTEN OBSCURED BY EXCORIATIONS,IMPETIGINIZATION OR ECZEMATIZATION

  6. CONTIN…….. • NODULAR SCABIES – ITCHY PAPULAR NODULAR LESIONS USUALLY PRESENT AT COVERED ARES • REPRESENT HYPERSENSITIVIY REACTON TO RETAINED MITE PARTS • CRUSTED SCABIES- ADVANCED AGE,DEBILITY,IMMUNOSUPPRESSION AND IN MENTAL ASYLAMS • THOUSEND & MILION OF ORGANISM PRESENT OVER BODY SURFACE

  7. NODULAR LESIONS

  8. LESIONS AT GENITALIA

  9. THE BURROWS

  10. HISTOLOPATHOLOGY OF SKIN LESION

  11. TREATMENT • PERMETHRIN 5% CREAM –CONTRAINDICATED IN INFANTS LESS THEN 2 MONTHS OF AGE & IN PREGNANCY & LACTATING MOTHERS • GAMMA BENZEN HEXACHLORID 1% LOTION • BENZYL BENZOATE 25% LOTION THREE APPLICATION • CROTAMITON CREAM • SULFUR 6% CREAMDAILY NIGHT APLICATON FOR THREE NIGHTS, SAFE I INFANTS PRAGNENT & LACTATING MOTHERS • IVERMECTIN – ORALLY 200 MIC.GRAMS/KG BODY WEIGHT • TOPICALLY 1% CREAM • COMBINATON THERAPY WITH VARIOUS TOPICAL GENT WITH SYSTAMIC AGENT IN AIDS & IMMUNOCOMPROMISED PATIENS

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