scabies

Question 1

what type of hypersensitivity is scabies ?

Answer 1

causes intense pruritis due to delayed type 4 hypersensitivity

Question 2

where does scabies mite lay its eggs ?

Answer 2

stratum corneum

Question 3

features of scabies ?

Answer 3

wide spread pruritis
linear burrows on the interdigital webs , flexor aspect of wrsit

zig zag grey line with a speck mite at one end

in infants - face and scalp

secondary features due to scratching

Question 4

management of scabies ?

Answer 4

permethrin 5 percent - first line

malathion 0.5 percent second line

= pruritis can persist 4-6 weeks posteradication

Question 5

how do we treat scabies

Answer 5

apply the insecticide to all areas, including the face and scalp, contrary to the manufacturer’s recommendation. Patients should be given the following instructions:

apply the insecticide cream or liquid to cool, dry skin

pay close attention to areas between fingers and toes, under nails, armpit area, creases of the skin such as at the wrist and elbow

allow to dry and leave on the skin for 8-12 hours for permethrin,

or for 24 hours for malathion, before washing off

reapply if insecticide is removed during the treatment period, e.g. If wash hands, change nappy, etc

repeat treatment 7 days later

Question 6

patient guidance on scabies ?

Answer 6

until treatment complete avoid close contact

household and close contacts should all be treated at the same time - even if asymptomatic

launder , iron and tumble dry clothes on the first day of treatmnets

Question 7

how crusted norweigen scabies occur ?

Answer 7

when patient is immunocompromised or have HIV
- IVERMETCIN IS TREATMENT OF choice and isolation