Skin Infestations Flashcards
What is the medical term for lice?
Pediculosis
How is lice spread?
Head to head contact (they can’t fly or jump); often at class/daycare
Where is lice usually found on the body?
Head - behind the ears, nape of the neck, and hairline (but it can technically be found in any hair)
What is the treatment for lice? When can a child return to school?
-Permethrin 1% cream (apply to scalp, leave on for 10 min; may need to repeat in 1 week) -Leave location where lice are for 24 hours if possible (lice can’t survive >24 hrs off host head) -Can also use Elimite, Nix -Can return to school after treatment
What is the causative agent of scabies? What are the two types of scabies?
Sarcoptes scabieie, a burrowing mite that gets under the skin and lays egg, which hatch in 2-4 days Two types: Noncrusted (common) and Crusted/Norweigen
How is scabies transmitted?
Skin-to-skin contact; typically by people living in close quarters with many other people, indigent populations, institutionalization; can also be immunosuppressed/poor hygiene
Describe physical findings of scabies
-burrows seen in interdigital web space -papules/nodules -itching gets worse at night -Crusted will have thick, crusted lesions with thousand sod mites
How would you treat scabies?
-wash clothes/bedding in hot water the day after treatment -bag everything that can’t be washed for 1 week -Permethrin 5% cream; apply from neck down, wash after 8-14 hrs (may need to repeat after 2 weeks) -Crusted: add Ivermectin
What is this condition?
Lice (pediculosis)
Eggs are white, mites are black
What is this condition?
Scabies
What is this?
How is the difinitive diagnosis made?
Black Widow bite
Definitive diagnosis is made IF: the spider is seen biting the patient AND the spider is caught
What complications may occur from a Black Widow Spider bite?
What follow up may be needed
Tx:
Consider need for antivenom
Complication: possibility for secondary infection
Follow up: consider referal for alergy testing in anaphalaxis
True or false:
Black Widow Bites cause tissue necrosis
False
Tissue Necrosis may occur with brown recluse bites
True or False:
This bite leads to HTN, n/v, SOB, and tachycardia
False
HTN, SOB, n/v and tachycardia may occur with Black widow spider bites, this is a bite from a brown recluse
What is this mark called, what does it indicate?
This is an Erythema Migrans
and is indicitive of Lyme disease
Reminder: this may not always appear perfectly targetoid
A patient presents with a wood tick imbeded in his skin that he wants removed. The patient had been hiking/camping and the tick has been imbeded in his skin for a few days…he thinks….
Should you test for Lyme Disease?
Why or why not?
And what is the actuall infectious agent transmited by the tic that causes Lyme disease?
No testing for lyme needed based on given information
Lyme disease is transmitted by Ixodes scapularis ( a.k.a deer, bear, or black leged tick) not wood ticks
Infection is caused by Borrelia burgdorferi
You have screened a patient for Lyme disease, he suspected his exposure was 5-7 days ago. The test came back negative.
This patient is good to go! True or False
and why
False.
Lyme screen is not 100% sensitive and will produce a false negative if tested too early; recheck 2 weeks
1: Tx for a patient exposed to Lyme disease (tick had been
imbeded 36 hours...probably) presenting within 3 days of exposure.
2: Tx for sympotmatic patient?
1: Doxycycline 200mg PO q day x 1 day
2: Doxycycline 100mg bid 14 days
follow up/possible complications of Lyme disease?
Arthritic, cardiac, neurological
Your patient has Lyme disease, is symptomatc and has an allergy to tetracycline abx so Doxy is off the table…now what do you do?
Amoxicillin 500mg tid x 14 d
or
Cefuroxime 500 mg bid x 14 d
