SCABIES SLIDE 5 MARET 2013.pptx

7/28/2019 SCABIES SLIDE 5 MARET 2013.pptx

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DEPARTMENT OF DERMATOVENEROLOGY MARCH 2013

MEDICAL FACULTY

HASANUDDIN UNIVERSITY

PRESENTING AS A TASK ON CLERKSHIP

DEPARTMENT OF DERMATOVENEROLOGY

MOSLEM UNIVERSITY OF INDONESIA

MAKASSAR2013

SCABIES

BY :

Andi Firman Mubarak 110 209 0088Rezky Putri Indarwati Abdullah 110 209 0116

Ade Irmasari 110 209 0120

ADVISOR :

dr. Ade Indrayani

SUPERVISOR :

Dr. dr. Anis Irawan Anwar, Sp.KK(K)


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DEFINITION

Scabies is a human skin infestation caused by the infestationand sensitation by sarcoptes scabiei var, hominis and itsproducts

Synonim : The itch, pruritic agogo , gudig, kudil

Transmition : direct and indirect contact


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ETIOLOGY

Sarcoptes scabiei var, hominis

- Obligat parasite, phylum arthropods, class arachnida, ordo accarima,family sarcoptes.

- : 0,2 mm long by 0,15 mm broad : 0,4 mm long by 0,3 mm broad.

- cannot fly or jump but crawl at the rate 2,5 cm/minute.


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EPIDEMIOLOGY

The worldwide prevalence has been estimatedat about 300 million, it is estimated beingepidemic in every 30 years

Indonesia

dr.Sutomo hospital 1983 1984 is 2,7%.

Dadi hospital 1987 1988 is 0,67%

Many factors caused the scabies


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RISK FACTOR

Poor sanitationDensely

populated and

social disruption

Low economic


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Transmitted

DirectSkin to skin / sexual

Sensitation andinfestation on

skin

IndirectBed cover, clothes, etc

Sensitation andinfestation on

skin

PATHOGENESIS


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- Secreta

-excreta

Clinical finding

Itch

- Papul, vesicle,

Urticaria- erotion, excoriation,

crust + secondary

infection)

4 6 weeks

8 12 days


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CLINICAL FINDING

Cardinal Sign

Nocturnal pruritic

Attack to group ofpeople

Find burrow/tunnel

Find mite

Additional test

Skin scrapping

Burrow ink test Take with neddle

Epidermal shave biopsy

Biopsy with

Hematoxylin eosin Tetracyclin test


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Another form of atypical

1. Cultivated scabies

2. Nodular scabies

3. Incognito scbies4. Animal scabies

5. Norwegian/crust scabies

6. Infants and children scabies

7. Bed ridden scabies


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DIFFERENTIAL DIAGNOSIS

Insect bites

Papules urticariaerithematous

folliculitis

Macula erithemapapule pustuleemerge with hair

Nodular prurigo

Pruritic nodule


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TREATMENT

Education

Warm bath and dry

Medication to all part Treatment is best done at night before going to bed

Avoid touching mouth/eyes

Change underclothing and launder them

May itch for few days/dont repeat treatment

Everyone in the house should be treated

Report to doctor after one week


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Drugs and topical agents

DRUG DOSE COMMENT

Permethrin 5%

cream

Applied for 8-14 h;

often repeated in 7

days.

First-line treatment in the United

States; pregnancy category B

Lindane

1%lotion

Applied for 8 h then

washed off, Secondapplication

recommended after 1

wk.

Not recommended for Children

under 2, during pregnancy, orlactation;

resistance has been increasing;

banned in california

Crotamiton10% cream

Applied on 2consecutive days;

repeated once within

5 days.

Antipruritic Qualities; may not be aseffective as other topicals


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DRUG DOSE COMMENT

Precipitated

sulfur 5%-10%

Applied for 3

days and then

washed off.

safe in children under 2mo

and during pregnancy, but

messy to

apply and limited efficacy

data

Benzylbenzoate 10%

lotion

Applied for 24 hthen washed off.

Not available in United States

lvermectin,

200 ug/kg

Single oral dose,

can be repeated

in 10-14 days,

Highly effective with a good

safety profile; can be used

along with

topical agents, particularly in

crusted or resistant cases


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Special treatment

Form TreatmentNorwegian/Crust scabies -permethrin/+ lindane

and sulphur

- keratolytic

Nodular scabies-Anti scabitic

- Steroid

Complication -Anti biotic (eritromycin)

Symtomatic-Anti histamine

- Hydrocortison 1%

- Emolient

- Triamsinolon 0,1%


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PREVENTION

Individual in close contact with theinfected person Should be treated

Re-infection with fomites, bed sheetetc should be washed and dried inthe hot cycle

The mite can be llive up to 3 days of theskin Vacuum cleaner


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COMPLICATION

Secondaryimpetiginizati

on

Lymphangitis

septicemia

Post

streptococcalglumerulone

phritis


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PROGNOSIS

If left untreated persist for manyyears

Immunocompetent individual thenumber of mite decrease over time

Correctly treated good prognosis


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THANK YOU

SCABIES SLIDE 5 MARET 2013.pptx

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