Wednesday, June 27, 2012

Scabies


Scabies is caused by Sarcoptes scabiei.

Spreads in households and environment when there is high frequency of intimate personal contacts.
The main symptom is itch.
Secondary eczema elsewhere in the body ( face and scalp are never involved except in infants)
Involvement of genitalia is pathognomic in boys.
Even after successful treatment the itch can continue and ocassionally nodular lesion persist.
In small children palms and soles can be involved with pustule formation.


Diagnosis:

1.Identifying the scabietic burrows, usually found on the edges of fingers, toes or sides of hands and feet.
2. Extraction of the mite using blunt needle.

1.                                              



2.

Treatment: Aqueous solution of Permethrin or Malathion, two application one week apart to the whole body excluding the head.
Asymptomatic family members are also treated.


In some cases like poor compliance, immunocompromised individuals and heavy infestations( Norwegian scabies) , Oral Ivermectin 200mcg/kg as a single dose is appropriate.

Complications:
Secondary infections
Post streptococcal glomerulonephritis





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