Scabies 12.pptx

Arthropods and diseases 1. 2. 3. 4.

Scabies Demodiciosis Pediculosis & Phthiriasis Myiasis

Arthropods and diseases

1.Scabies

Scabies (kudis, gudig, budug) • Found world wide • can spread easily in overcrowded living conditions • Most common are: –Orphanage –dormitory / Pondok pesantren –elderly people in nursing homes –prisoners

Prevalence • In Indonesia 6 -27 % in general, but higher in children & teenager (Sungkar, 1997). • Ma’ruf I et al (2003) found 48.81 % santri in Lamongan , Jawa Timur • In Jakarta 78,70% and Kabupaten Pasuruan : 66,70% (Kuspriyanto,2002).

Etiology : • Mites: Sarcoptes scabiei var

hominis

• Classification: – Phylum : Arthropoda Class- Arachnida Order- Acarina Family- Sarcoptidae

Morphology : • Rounded body with 4 pair of legs, 2 in the front 2 in the posterior. • Size : F: 300X 350 ; M: 150-200  • Anterior legs terminate in stalked disc (Ambulacra )

Sarcoptes scabiei

Source:http://www.medicalook.com

from http://www.tdh.state.tx.us/lab/images/scabies.jpg

Morphology (cont’d): • F : hair at the 3rd and 4th leg ; • M: hair at 3rd legs and 4th leg terminate in ambulacra

From www.gutenberg.org

Life Cycle : • Life cycle: 2- 4 weeks, the male died after copulation • Female lays 1 – 3 eggs per day for 30 days. • males die quickly, female can live for 4 - 6 weeks.

9-12 days

From: www.springerimages.com

Pathogenesis and symptoms • Transmission is mostly through prolonged close contact • make burrows in stratum corneum with variation of length

From: www.springerimages.com

Pathogenesis and symptoms • A papules and vesicular rash, • itching of infected areas—caused by allergic reaction to activities and secretions of the mites disturbed sleep • Itching especially bad at night. (pruritus nocturne) • scratching bleeding and can allow for secondary bacterial infection feel pain

Pathogenesis and symp.. (cont’d) • Predilection : skin with thin stratum corneum : between fingers , wrist, armpit, umbilicus, gluteus inguinal

Source: FLINDERS DC and DE SCHWEINITZ (Am Fam Physician. 2004 Jan 15;69(2):341-348. )

Source: Scabies treTment.net

Source: scabiesphotos.com

Baby with Scabies

Source: Baby Safety Concerns

Scabies with secondary infection Source: Medicalook.com

Diagnosis • Definitive diagnosis :

–requires microscopic identification – Detection of Sarcoptes scabiei : skin scraping or biopsy

Source: DermQuest.Com)

Source : Deba P Sarma, MD (ISPUB.com)

Treatment • Sulfur preparation : 5 – 10 % – Not effective for eggs • Gama benzene hexachloride – Effective for all stages – Neurotoxic : not save for < 5 years • Benzil benzoat emulsion • Crotamiton topical cream • permethrin 5% cream – Is safe for use on the head and neck of children less than two years old

Epidemiology • Found worldwide • affects people of all socioeconomic statuses. • Epidemics can arise in areas of poverty, poor sanitation, poor water-supply, or personal hygiene, unhealthy behavior, overcrowding.

Epidemiology • Scabies is sometimes classified as a sexually transmitted disease • transmitted through contact with the bedding or clothing of infected persons

• mites can survive up to 24 hours outside the skin. • clothing and bedding should be washed in hot for 10 minutes and dry : kill the scabies mite and eggs.

Arthropods and diseases

2. Demodiciosis

Prevalence • Demodicosis most often associated with facial skin disease: acne vulgaris and rosacea • Irina (2010): 12% positive (as in the group with healthy skin) and patients with rosacea (64 out of 79) positive Demodex ( 81% )

In eye lashes follicle: • Post DF, Juhlin E (1963) observed :

84% of the sample with a mean age of 61 years and –100% of those older than 70 years –

Demodex folliculorum, Demodex brevis Classification : • Family Demodicidae, order Acarina , Class Arachnida • Body : long, with striated abdomen • Size : 0.1 – 0.3 mm • 4 pairs of legs

From www.demodexsolutions.com

Estimated 14.5 days & female live 5 days after oviposition

Pathogenesis and Symptoms • Live in hair follicle • Preferred sites are facial skin, forehead, cheeks, nose wings, eyelashes and external ear channels. sometime on the scalp • slowly move on the skin especially during the night (locomotion at a rate of 8-16 mm/h).

Symptoms • Generally asymptomatic • heavy infestations : – Itching –lost of lashes /hair loss – skin complaints as acne rosacea‘. - Recurrent blepharitis : could disturb eye vision - Eye lid thickening

Source: acne-healed.blogspot.com Source: Pedigree Database

Source: www.optometric.com

Diagnosis • Microscopic confirmation: – detection and counting of Demodex eggs, lavae and adult mites in epilated lashes. • Slit-lamp examination: typical cylindrical dandruff at the root of eyelashes.

Diagnosis

Source: coo.fieldofscience.com,

Treatment • Topical cream containing sulphur • anti demodex products: face cream, the shampoo for scalp demodicosis and anti demodex eye lotion. • Slit-lamp examination: typical cylindrical dandruff at the root of eyelashes. • Microscopic confirmation: detection and counting of Demodex eggs, lavae and adult mites in epilated lashes.

Epidemiology • No racial predilect • Infestation is equal in males and females. • Infestation is correlated to the number of sebaceous glands • Healthy immune system controls demodex