Lice scabies and spider bites

Question 1

Scabies treatment

Answer 1

Permethrin Cream 5%
Apply from head to feet
Leave on for 8-14 hours then wash with soap and water
Repeat in 7 days if necessary
Safe for children as young as 1 month old and pregnancy
Alternate:
Lindane Lotion 1% (neurotoxicity)
Oral Ivermectin (not for pregnant or lactating)

Question 2

Widow spiders

Answer 2

Worldwide
Unremarkable local lesions: systemic reaction
Not all are black
Neurotoxin: α- latrotoxin
Hx of gardening/chopping wood, etc

Question 3

Brown Recluse spiders

Answer 3

North & South America
Notorious for becoming necrotic (rare)
Systemic reaction mild
Nonspecific signs and symptoms
Bites usually sustained indoors

Question 4

Widow spiders wound site symptoms

Answer 4

Blanched circular patch
Surrounding red perimeter
Central punctum
Appears like a “target” lesion in 50% of cases

Question 5

Widow spider bite treatment

Answer 5

Local measures: Gently clean the bite with mild soap and water
Oral analgesia: Acetaminophen, Ibuprofen, Oxycodone or hydrocodone
Oral muscle relaxers: Benzodiazepines (Valium), Methocarbamol (Robaxin)
Tetanus prophylaxis if indicated
Antivenom if needed (can cause anaphylaxis)

Question 6

Brown Recluse spider bite treatment

Answer 6

Local wound care
Clean with mild soap and water
Apply cold packs
Maintain affected part in elevated or neutral position
Pain management: NSAIDS or opioids if necessary
Tetanus prophylaxis if indicated
Dapsone in some cases to prevent progression to necrosis & reduce pain
No Antivenom available