| ID | 201 |
|---|---|
| Name | SCABIES |
| Cause | Causative factors in Pakistan 1. Overcrowded living condition 2. Poor hygiene 3. Poor nutrition |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigations: 1. Blood for sugar. 2. Urine for R/E. 3. Stool for ova of worms. 4. Examination of skin scraping from the burrow may show eggs of female acaras. |
| Management | Management 1. Take a scrape bath with warm water & soap to remove crusts & to open burrows. 2. Permethrin 5% cream- adult, apply once over whole body and wash off after 8-24 hours; child, apply over whole body including face, neck, scalp and ears. If hands are washed with soap and water within 8 hours of application, cream should be reapplied. If needed, may be repeated after one or two weeks. 3. Apply any one of the following drugs throughout the body except face & scalp for 3 consecutive days without any bath. Take soap bath on 4th day. It is better to repeat the treatment after 7 days, i. 25% Benzyl benzoate in adult & 12.5% in children. Or, ii. Tetrethyle thiouracil monosulphide emulsion. Or, 4. Crotamiton 10% cream- apply over the whole body omitting the head, neck & eyes after a hot bath and remove by washing on the following day. The application may be repeated 24 hours later but bath should not be taken until the following day. Or, 5. Antihistamines tablet or syrup. 6. If secondary infection present give antibiotic before scabicidal drugs. 7. All other family members should be treated properly & simultaneously. 8. All clothes should be boiled. |
| Introduction | It is a contagious skin disease caused by a mite sarcoptes scabiei, characterised by papulovesicular lesions, and itching spcially at night. Mode of transmission: 1. Closed contact including sexual intercourse. 2. Sharing in common bed, towel, toilet etc. Incubation period- 2 to 4 weeks. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: 1. Papulovesicular lesions 2. Intense itching specially nocturnal itching. 3. Family history- appearance of similar lesions in several members of the family. 4. Common sites- Finger webs, ridges, wrist, genital area, buttock, around umbilicus, anterior axillary folds, nipple incase of females. 5. Burrows- Irregular zig-zag fine linear tract about 0.5 cm to 1 cm. long & greyish in colour in the epidermis of above mentioned area. It is formed by the eggs & feces of female worm. |
| Preventions | |
| Treatment | |
| Complications | Complications: 1. Impetigo, pyoderma, hypo- or hyperpigmentation. 2. Eczematization. 3. Folliculitis. 4. Furuncle, carbuncle, scar formation. 5. Acute glomerulonephritis- if the patient is untreated for more than one month or maltreated. 6. Nephrotic syndrom (in children) 7. Exfoliative dermatitis. |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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