Skin Infestation (Scabies) Flashcards

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1
Q

What is scabies?

A

Scabies = very itchy rash caused by a parasitic mite that burrows in the skin surface

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2
Q

Who is at risk of scabies?

A

Most common in children, young adults, and elderly

Factors leading to the spread of scabies include:

=> Poverty and overcrowding

=> Institutional care i.e. care homes, hospitals, prisons

=> Refugee camps

=> Immunodeficiency

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3
Q

What is scabies spread?

A

Skin-to-skin contact with someone else with scabies

Sometimes sexually transmitted

Several scabies mites infest an affected host => after mating, the male mite dies.

Female scabies mite burrows into the outside layers of the skin => lays up to 3 eggs each day for her lifetime of 1-2 months.

The development from egg to adult scabies mite takes 10–14 days.

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4
Q

What are the clinical features of scabies?

A

Widespread intensely itchy, excoriated, eczematous rash triggered by a hypersensitivity response to mite allergens

Pruritus = worse at night + disturbs sleep

Small red papules, vesicles and sometimes pustules develop over the body

May be complicated by secondary bacterial infection

Fine linear or curved burrows a few millimetres long = diagnostic sign

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5
Q

How is scabies diagnosed?

A

Diagnosis sign = Fine linear or curved burrows a few millimetres long

Not always visible => dermascopy

Scabies can be confirmed under microscopy of potassium hydroxide treated skin scrapings from the tip of the burrow
*time consuming + treatment usually based on clinical findings

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6
Q

How is scabies treated?

A
  1. Topical 5% permethrin applied overnight

=> treat all skin neck down inc. genitalia, palms and soles

=> treat all close contacts

=> Reapply to hand if washed during treatment

=> Wash recently worn clothes

=> Re-apply permethrin after 1 week

  1. Malathion can be used is permethrin is unavailable
  2. Oral ivermectin 2 doses 2 weeks apart esp in residential homes
  3. Pruritus takes a few weeks to settle => antihistamines + cooling creams i.e. menthol 2%
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