SCABIES-IMPETIGO Flashcards
typically 10-15 mites (range, 3-50) live on the host; little evidence of infection exists during the first month (range, 2-6 wk), but after 4 weeks and with subsequent infections, a delayed type IV hypersensitivity reaction to the mites, eggs, and scybala (feces) occurs.
Classic Scabies
is a distinctive and highly contagious form of the disease; in this variant, hundreds to millions of mites infest the host individual, who is usually immunocompromised, elderly, or physically or mentally disabled and impaired.
Crusted Scabies
occur in 7-10% of patients with scabies, particularly young children; in neonates unable to scratch, pinkish brown nodules ranging in size from 2-20 mm in diameter may develop.
Nodular scabies
The most common symptoms of scabies, are caused by sensitization (a type of “allergic” reaction) to the proteins and feces of the parasite.
Skin rash
happens especially at night, in the earliest and most common symptom of scabies.
Pruritus (severe itching)
A pimple-like (papular) itchy (pruritic) is also common.
Scabies rash
are seen on the skin; these are caused by the female scabies mite tunneling just beneath the surface of the skin
Burrows in skin
can be locate a burrow by rubbing a washable felt-tip marker across the suspected site and removing the ink with an alcohol wipe; when a burrow is present, the ink penetrates the stratum corneum and delineates the site; this technique is particularly useful in children and in individuals with very few burrows.
can be locate a burrow by rubbing a washable felt-tip marker across the suspected site and removing the ink with an alcohol wipe; when a burrow is present, the ink penetrates the stratum corneum and delineates the site; this technique is particularly useful in children and in individuals with very few burrows.
Burrow in test
is an alternative to the burrow ink test; after application and removal of the excess tetracycline solution with alcohol, the burrow is examined under a Wood light; the remaining tetracycline within the burrow fluoresces a greenish color; this method is preferred because tetracycline is a colorless solution and large areas of skin can be examined.
Topical tetracycline solution
Definitive testing relies on the identification of mites or their eggs, aggshell fragments, or acybala; this is best undertaken by placing a drop of mineral oil directly over the burrow on the skin and then superficially scraping longitudinally and laterally across the skin with a scalpel blade.
skin scraping
are applied to areas suspected of being burrows and then tapidly pulled off; these are then applied to microscope slides and examined; the adhesive tape test is easy to perform and had high positive and negative predictive values making it a good screening test.
adhesive tape test
can reliably suggest the presence of scabies; lesion distribution and intractable pruritus that is worse at night, as well as scabies symptoms in close contacts (including multiple family members), should immediately rank scabies at the top of the clinical differential diagnosis.
History
Clinical findings include primary and secondary lesions; primary lesions are the first manifestation of the infestation and typically include small papules, vesicles, and burrows; secondary lesions are the result of rubbing and scratching, and they may be the only clinical manifestation of the disease.
Physical Exam
Nursing Interventions for Scabies
Prevent Infection
Restore Skin Integrity
Relieve Pain
