Parasitic infections of the skin Flashcards

1
Q

Nereden scabies (uyuz) kapmış?

A
  • Skin-to-skin contact:
    1. Hayvandan geçmez. İnsandan insana geçer.
    2. Genç erişkinler diğer STD’ler açısından da
      taranmalı
  • Fomites:
    1. Otelde iyi yıkanmayan çarşaftan vs. geçebilir.
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1
Q

Muayenede nelere bakacaksın? (scabies/ uyuz)

A
  • Itching and pimple like rash. Excoriations are frequent.
  • Özellikle akşamları kaşıntı
  • Aile üyelerinde 1 tanesinde bile kaşıntı olması şüphelendirmeli
  • Seyahat öyküsü
  • Burrowlar tanı koydurucu: tiny raised and cooked grayish-white lines
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2
Q

Yetişkinde en çok nereyi, bebekte en çok nereyi tutar?
(scabies/ uyuz)

A

Finger webs, ulnar border of forearm, axilla, nipple, waist, buttocks and penis.
Common on genitelia (aktif enfeksiyon mu, hipersensitivite reaksiyonu mu ddx)
Scalp and face are spared in adults

Entire skin may be involved in infants: scalp, plantar burrows, palm in infants

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3
Q

Dermoskopta ne görürüz? (scabies/ uyuz)

A

Dermoscopic finding of jetrail makes diagnosis stronger

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4
Q

Treatment of Scabies (uyuz)

A
  • Tedavisi: Bütün aile üyeleri, cinsel partnerler ve onların aileleri
  • Yetişkinler: FDA 2 ayın üstündeki infantlar için onayladı. Pregnancy class B.
    1. %5 permethrin (Kwellada)
    1. Boyundan ayağa, ayak dahil (bütün vücut için en az 60 g krem lazım)
    2. Akşam yatmadan önce sür. 8-14 saat sonra durula.
    3. 2 defa, bir hafta arayla uygulama
  • Infants:
    1. %5-10 sulfur ointment: infantlarda ve hamilelerde güvenli
    1. Scalp ve yüze de sürülür
    2. 3 üst üste gece sürülür
    3. 24 saatten sonra durulanır
    4. 1 hafta arayla 2 siklüs
  • Environmental:
    1. Clothing, bed linens, and towels should be machine washed in hot water and ironed rigt after rinsing the medication
    2. Those that cannot be washed (i.e., stuffed animals) should be stored in vacuumed bags for 1 week. Balkon gibi serin bir yerde
  • Diğer:
    1. Topikal Steroid/Oral Antihistaminik: kaşıntı scabies geçtikten sonra kaşıntı kalırsa. (Ama steroid vermek için parazitin gittiğinden emin olmamız lazım)
    1. Genital lezyonların yavaş geçtiğini unutma
      1. Tırnaklar kısa
      2. Enfekte insanlar ile yakın kontaktan kaçılmalı
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5
Q

Different types + agent of leishmaniasis

A

-Cutaneous leishmaniasis by L. tropica, major, infantum

-Mucocutaneous leishmaniasis by L. brasiliensis

-Visceral leishmanisis by L. donovani, L. infantum

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6
Q

DDx of Leishmaniasis

A

Lupus vulgaris, sarcoidosis, deep mycosis etc

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7
Q

What are CF of leishmania

A

Common in children
Head and neck involvement 60 %
Volcano sign: Distinctive
Spiny projections under the crust
Not specific
Direct smear
Perfect place for hunting parasites

Moist - Rural type - L. major
-Furuncle like lesions, papule-nodule-ulceration
-Develops quickly w/i 2-3 weeks
-Spontaneous healing w/i 6 months
-Characteristic scar

Dry - Urban type - L. tropica , infantum
-Papule at the site of inoculation
-Develops very slowly w/i a 2-8 months
-Spontaneous healing w/i a year

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8
Q

How is leishmaniasis treated? + why

A

lokalize ise intralezyonal 5-antimon / kriyoterapi

why:
healing takes months or even years
Prevent ugly scars on face or ears
Prevent functional morbidity near the joints
Reduce risk for mucosal dissemination
Reduce risk for relapse (clinical reactivation)
Remove reservoir of infection

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9
Q

How are leishmanias diagnosed?

A

Squeeze the pustule
check for serous fluid to spread (under microscope) -> amastigotes are seen.

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10
Q

What are tick bites vectros for?+ how removed

A

Rickettsial infections (Mediterranean spotted fever)*
Congo-Crimean hemorrhagic fever virus*
Ehrlichiosis
Lyme disease
Babesiosis
Tularemia

remove via forceps close to skin, clean bite area with iodine scrub

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11
Q

Pediculosis capitis can cause what?

A

Intense scalp pruritus and cervical LAP
Excoriations (skin-picking disorder) and secondary impetigo

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12
Q

How is pediculosis pubis treated?

A

1% permethrin (şampuan, losyon / rezistans var) occlusive ajanlar,
aile tedavisi şart

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