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Dermatology - Clinical Medicine IV > Parasitic Skin Infections > Flashcards

Parasitic Skin Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

What are parasitic dermatoses?

A

pediculosis and scabies

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2
Q

What causes pediculosis?

A

ectoparasites that live on body

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3
Q

What is the common term for pediculosis?

A

lice

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4
Q

What causes the pruritis with lice?

A

pierce skin and inject saliva

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5
Q

Are lice able to survive away from human host?

A

yes

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6
Q

How long does it take for lice to die of starvation?

A

10 days away from host

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7
Q

How many eggs does a female louse lay each day?

A

3-6, white 1mm long

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8
Q

How long does it take a nit to latch and mature?

A

8-10 days hatch, 12-15 mature, live for 10 days

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9
Q

What lice infest head?

A

Pediculosis capitis

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10
Q

What lice infest body?

A

Pediculosis corporis

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11
Q

What lice infect pubic area?

A

Pediculosis pubis or Pthirus pubis

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12
Q

What is the most common manifestation of pediculosis?

A

pruritis

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13
Q

Where does p corporis cause itching?

A

axilla, truncal and groin

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14
Q

What are associated features of pediculosis?

A

papules, wheals, bit reaction, excoriation

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15
Q

What is pathognomic for infestation of life?

A

maculae cerulea

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16
Q

How do maculae cerulea?

A

blue-gray macules, enzyme in saliva break down human bilirubin

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17
Q

How long does head lice survive away from human?

A

1-2 days

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18
Q

What are the effected areas in pediculosis capitus?

A

scalp, neck, postauricular

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19
Q

How do you get head lice?

A

combs, brushes, hats, scarves, bedding

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20
Q

How do you dislodge lice?

A

sweater removal, hair combing

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21
Q

How far can head lice travel?

A

23 cm/min

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22
Q

What are symptoms of p. capitis?

A

scalp pruritius, occipital lymphadenopathy, impetigo

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23
Q

Where is heaviest infection for p. capitis?

A

retroauricular scalp

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24
Q

Where do p. corporis lay their eggs?

A

clothing fibers

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25
Q

How long can p. corporis survive?

A

10 days

26
Q

What has p humanus corporis?

A

typhus, trench fever, relapsing fever

27
Q

What do you see with p. corporis?

A

multiple lesions from bites present, uninfected are papules 2-4 mm, located anywhere

28
Q

What are eyelash nits a manifestation?

A

pubic louse infestation

29
Q

What lice species is less mobile?

A

p. pubis

30
Q

How long can p pubis survive off human?

A

1 day

31
Q

What are the medical treatments for head lice?

A 
permethrin topical
melathion topical
Invermectin
Lindane topical
Benzyl alcohol
Spinosad topical
32
Q

What is permethrin topical?

A

Apply lotion once, can repeat in 7-9 days
First line therapy, although some resistance has developed
Must also use fine-toothed comb to remove nits
Indicated in adults and children over 2 months of age

33
Q

What is malathion topical?

A

Apply once, repeat in 7-9 days
Binds to hair for longer lasting effect
Indicated in adults and children over 6 years of age

34
Q

What is invermectin topical?

A

Apply once, no combing needed

Indicated in adults and children over 6 months of age

35
Q

What is lindane topical?

A

Apply apply 30mL of shampoo once
Do not apply on open wounds
Not safe for use in children, due to transcutaneous absorption/neurotoxicity
although still FDA approved down to 1 month of age

36
Q

What is benzyl alcohol?

A

Apply to hair once, then repeat in 7 days
Dosing based on hair length (varies 4oz to 48 oz)
Indicated in adults and children

37
Q

What is spinosad topical?

A 
Apply once (maximum 120mL), repeat in 7 days 
Indicated in adults and children over 4 years old
38
Q

What is the treatment for pubic lice?

A 
Permethrin topical (1% lotion)
Malathion topical (0.5% lotion)
Lindane topical (1% shampoo) – 30mL
repeated in 7-10 days
39
Q

How do you treat eyelash infestations?

A

petrolatum ointment

40
Q

How do you treat body lice?

A

clean clothes and bed linens, educate about hygiene
Permethrin spray on clothes
Oral ivermectin 12 mg 3 doses 7 days apart - heavy pediculosis

41
Q

What is the environmental treatment of head lice?

A 
treat fomites
launder everything temp 131 for 5 min
Place in dryer high heat 30 m in
seal in plastic bag 2 weeks
vacuuming
discard combs and hairbrushes or soak in hot water 5 min
42
Q

What is intensely pruritic skin infestation caused by host specific mite?

A

scabies

43
Q

What causes scabies?

A

sarcoptes scabiei hominis

44
Q

What is the pathognomic sign for scabies?

A

burrow - intreepidermal tunnel by moving female mites
serpiginous grayish threadlike elevations in superficial dermis
2-10 mm long

45
Q

Where does scabies occur in geriatric?

A

back, appear as excoriation

46
Q

Where do you see scabies in infants and small children?

A

palms and soles

47
Q

Where are high yield locations for scabies?

A 
Webbed spaces of the fingers
Flexor surfaces of the wrists
Elbows
Axillae
Belt line
Feet
Scrotum (men)
Areolae (women)
48
Q

How does scabies look?

A

vesicles are discrete lesions filled with clear fluid, although the fluid may appear cloudy if the vesicle is more than a few days old

49
Q

What is crusted scabies?

A

lesions are hyperkeratotic and crusted
Cover large areas
Marked scaling is common
Pruritus may be minimal or absent
Nail dystrophy and scalp lesions may be prominent
Hands and arms are the usual locations for lesions
Mites can number in the thousands to millions in this form of scabies

50
Q

What is nodular scabies?

A

Nodules occur in 7-10% of patients with scabies
young children (neonates unable to scratch)
pinkish brown nodules
ranging in size from 2-20 mm in diameter

51
Q

What are scabies agents?

A

Permethrin or ivermectin (1st line)
Malathion or benzyl benzoate (2nd line)
Lindane (3rd line)

52
Q

What is special about scabies and preg?

A

only treat if benefit exceeds risk and + skin scraping

53
Q

Who is premethrin safe to use in?

A

pregnant and children >2mo

54
Q

How do you treat neonates with scabies?

A

precipitated sulfur 6% petroleum

55
Q

What is the treatment for crusted scabies?

A

several different medications used sequentially
Typically permethrin OR benzyl benzoate & invermectin
AND keratolytic (urea topical) allows for drug penetration in crusted areas

56
Q

How do you treat scabetic nodules?

A

intranodular steroid injections

57
Q

What does bed bugs cause?

A

erythematous papules, somtimes with prominent urticarial component

58
Q

When do bugs come out?

A

night, 1 hr before dawn

59
Q

How do you treat bed bugs?

A

sysmptomatic - steroids or antihistamines

60
Q

How do you prevent bed bugs?

A

insecticides and eliminate bedbug hiding spots, permethrin spray can be applied to clothes, prevent bedbugs from gaining access to the bed

Dermatology - Clinical Medicine IV (31 decks)

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