SCABIES

Muhammad Munawwar Masrur bin Adnan C 111 12 860

Mohamed Aidil bin Hamdan C 111 12 868
Wan Salahuddin bin Wan Abdullah Zubir C 111 12 871
Nursyahidah binti Jusoh C 111 12 872
Sunaia binti Ismail C 111 12 873

PEMBIMBING RESIDEN:
dr. A. DEWI CHANDRA KIRANA

PEMBIMBING SUPERVISOR:
dr. MUJI ISWANTY, SH,Sp.KK. M.Kes
 INTRODUCTION
Scabies synonym: kudis, the itch, gudig,
budukan, and gatal agogo

Scabies is a skin disease caused by infestation

and sensitization towards Sarcoptes scabiei
varian hominis and its product.

Transmitted through direct physical contact.

(Skin-to-skin) and indirect (clothing, bed)
EPIDEMIOLOGY
 ETIOLOGY

Sarcoptes scabiei is an obligate human

parasite, class Arachnida, order Ackarima,
Sarcoptes superfamily.
 FEMALE SCABIES MALE SCABIES
SIZE 0.4 mm long by 0.3 mm 0.2 mm long by 0.15 mm
wide wide

BODY Milky white and marked Milky white and marked

with a wavy line across the with a wavy line across the
back and on the surface back and on the surface
there are feathers and there are feathers and
dentikel dentikel

Two pairs of legs and hair Hair found on the third leg
at the end (Satae) pair and peduncles with
suckers on the fourth leg
pair
PATOGENESIS
Predilection
 DIAGNOSIS
Cinical signs and symptoms
i) Pruritus nocturna iv) sarcoptes scabies
found
ii) Group of people
iii) Tunnels found
 CLINICAL SIGNS
Scabies found on clean hygiene Scabies Incognito
 CLINICAL SIGNS
Nodular Scabies Scabies transmitted by animals
 CLINICAL SIGNS
Scabies Norwegia ( Crusted Scabies in infants and children
Scabies)
 LABORATORY EXAMINATION
Taking mites with needle
Burrow ink test
Epidermal shave biopsy
Biopsy slices with HE staining.
 DIFFERENTIAL DIAGNOSIS
Acute urticaria: the eruption of Insect bites, usually develop after
papules-itchy papules, always the clear no bites, efflorecens:
systemic urticaria papuler

Prurigo, usually in the form of

papules-itchy papules, a
Folliculitis in the form of miliar
predilection for extensor
pustules surrounded by areas of
extremities
erythema
TREATMENT
Drugs Dosis Explanation
Permethrin 5% Applied for 8-14 hours, repeated for First-line therapy in the US and pregnancy
cream 7 days. category B
Lindane 1% lotion Applied for 8 hours after it was Can not be given to children aged 2 years and
cleaned, spread 2nd time one week under, women during pregnancy and
later. lactation.

Crotamiton 10% Applied for 2 consecutive days, then

cream repeated in 5 days. Has anti-pruritic effect but its effectiveness is
not as good as other topical.
Precipitatum Safe for children less than 2 months and
Sulfur 4-20% Applied for 3 days and then cleaned. women in pregnancy and lactation, but looked
dirty in its use and efficiency of the drug in the
data is still lacking.

Benzyl Benzoat Applied for 24 hours and then Effective but can cause dermatitis on the face
20-25% cleared

Ivermectin 200 Single oral dose, can be repeated for Highly effective and safe. Can be used with
g/kg 10-14 days other topical preparations. Used in cases of
crusted scabies and scabies resistant.
 PREVENTION

People who have direct contact or close to the

patient should be treated with topical skabisid

To prevent reinfection :
Bed linens, pillows, towels and clothing used in the
last 5 days, must be washed and dried with hot air.
 COMPLICATION

Secondary infection in patients with scabies is the

result of a bacterial infection or due to scratching.

Erosion is a sign that most often appear on the

secondary lesions.

Secondary infections can be characterized by the

appearance of pustules, suppuration and ulcers.
 Moreover, it can appear erythema, scaling, and all
other inflammatory signs at ekzem as a strong body's
immune response to irritants.

Nodules appear in an enclosed area, such as the

buttocks, scrotum, groin, penis, and axilla.

Lymphangitis and septiksemia may also occur,

especially in Norwegian scabies, post-streptococcal
glomerulonephritis can occur because of scabies-
induced pyodermas caused by Streptococcus
pyogens.
 PROGNOSIS

Scabies infestations can be cured.

The prognosis is good, complaints of itching
and eczema will be cured if treated properly.
If untreated, this condition can persist for
several years.
In immunocompetent individuals, the number
of mites will diminish over time.
 CONCLUSION

Scabies is a skin disease caused by infestation and

sensitization to Sarcoptes scabiei var. hominis and
products.
Transmission with 2 ways, namely direct contact
and indirect contact.
There are four cardinal signs found in scabies are
pruritus nocturna, attack humans in groups,
tunnels (kunikulus) found in place of predilection
in white or grayish and find mites.
 Skin disorders in scabies are papules, vesicles,
erosion, excoriation, crusting and others, as well
as clinically manifest in a variety of ways. If a
secondary infection occurred, it can be caused by
bacteria that is characterized by the appearance
of pustules and symptoms of systemic infection
The main choice is primethrin 5% topical
application to the skin 8-12 hours as well as
patient education.