Derm - Scabies and Headlice Flashcards
What are scabies?
Tiny mites called
Sarcoptes scabiei
How long do symptoms take to appear in scabies?
8 weeks post initial infestation
Scabies mites lay eggs in skin
How does scabies present?
Incredibly itchy small red spots
Possible track marks where mites have burrowed
Finger webs, can spread to entire body
How is scabies managed?
Permethrin cream
Must be applied to entire body, completely covering skin
Skin must be clean and cool so skin does not absorb cream
Cream must be left on for 8-12 hours then washed off
Repeat after 1 week to kill all eggs that survived first treatment and now hatched
All clothes, bedding, towels etc must be washed at a high temperature to destroy mites
Thorough hoovering of carpets
What can be given for difficult to treat or crusted scabies?
Oral ivermectin as a single dose
Can be repeated a week later
How does scabies spread?
Highly contagious to all household and close contact
May be infected without symptoms
Sharing of clothes, bedding, towels
How long does itching carry on for in scabies after successful treatment?
4 weeks
What can be given for itching at night in scabies?
Crotamiton cream
Chlorphenamine
What is crusted scabies?
AKA Norwegian scabies
Serious infestation with millions of mites in immunocompromised patients
EXTREMELY CONTAGIOUS
Rather than individual spots and burrows, patients have patches of red skin that turn into scaly plaques
What can crusted scabies be misdiagnosed as?
Psoriasis
Why do patients with crusted scabies not necessarily have an itch?
They do not mount an immune response to the infestation
How is crusted scabies treated?
Admission for treatment as an inpatient
Oral ivermectin and isolation
What are head lice?
Pediculus humanus capitis parasites causing an infestation of the scalp
Who is most commonly affected by head lice?
School aged children
What are nits?
Egg shells that have hatched or contain unviable embryos and not lice themselves
How are head lice spread?
Close contact with someone that has head lice
Usually in schools or amongst family members
Transmission by head contact or sharing towels or combs
How does head lice present?
Itchy scalp
Nits and lice visible when examining scalp
How is head lice managed?
Dimeticone 4% lotion
Applied to hair and left to dry
Left on for 8 hours overnight then washed off
Repeated 7 days later to kill head lice that have hatched since treatment
Fine combs
Used to systematicalyl comb nits and lice out of hair
Can be used to check for successful treatment
NICE recommends The Bug Buster Kit
