SCABIASIS / SCABIES

 Secreting enzymes that dissolves skin

 Female mites lay eggs in stratum granulosum
 Transmission by direct contact. Fomites bisa tapi jarang, biasanya pada stadium crusted (parah,
akibat kurangnya respon cellular mediated immunity tapi IgE tinggi)
 Scratching can control the mite population
1. Clinical Syndromes
 Itch worsen at night
 Rash results from 2 process = papular/vesicular lesion at site of burrows of the mites
= immune mediated
 Skin predilection = in few/no hair follicles, thin and soft stratum corneum
 Complications = secondary bacterial infections, glomerulonephritis from S. pyogenes
2. Treatments
 5% permethrin = neurotoxic in young children
 Crotamiton = suitable for infants
 Topical benzyl benzoate is more scabicidal than permethrin in vitro
 Cursted scabies = Ivermectin oral 200–300 µg/kg multiple dose + topical or keratolytic
creams (salicylic acid/urea)
 Ivermectin bioavailability increased 2 times with food --> should be taken with food
 Ivermectin not recommended in children <5 years or weight <15kg because can cross BBB
(neurotoxicity) and contraindicated in pregnant women
 Antibiotics to secondary skin infection to prevent sepsis and post streptococcal acute
glomerulonephritis

3. Preventions
 Endemic scabies = whole community treatment with topical permethrin
 Mass drug administration = Oral ivermectin for > 5 years and topical permethrin for <5
years or < 15 kg
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 PEDICULOSIS

1. ETIOLOGY
 Pediculus capitis(head louse)
 Pediculus humanus(body louse)
 Pthirus pubis(crab or pubic louse).

2. BIOLOGY AND DESCRIPTION

 Six legs terminates in a claw which allows the lice to move rapidly and to transfer to new
hosts.
 Head lice are generally smaller than body lice (2–3 mm and 3–4 mm in length, respectively)
 Pubic lice are crab-like in shape 1.3–2 mm long and slower than the other types
 All human lice are haematophagous, 2–5 times a day

3. TRANSMISSION
 Close contact, vomites, sexual

4. DIAGNOSIS
 Visual identification of at least one live adult louse
 Detection of viable eggs on the hair shafts (for head lice) and/or clothing (for body and
pubic lice).

5. PEDICULUS HUMANIS CAPITIS

 Dirty-white to grayish-black in colour
 Live on the scalp and attach their eggs (nits) close to the base of the hair shaft
A. Epidemiology
 Children aged 3–11 years are most frequently affected
 Girls twice as likely to be infested (closer physical contact, sharing of hair accessories)
B. Clinical Features
 Pruritus in scalp, the back of the neck and post-auricular areas.
 Cervical lymphadenopathy and conjunctivitis may occur.
 Glomerulonephritis may occur as a consequence of group A streptococcal super-
infection of the skin

6. PEDICULUS HUMANIS CORPORIS

 Females lay their nits in the seams or hems of clothes (especially underwear) that are
adjacent to the surface of the skin
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