IMPETIGO

Yedy Purwandi Sukmawan

EPIDEMIOLOGY and ETIOLOGY
CLINICAL MANIFESTATION
 DIAGNOSIS

 Physical Examination and Clinical Manifestation

 NON-PHARMACOLOGY

 Advise adults, young people and children, and their parents or 5 carers if
appropriate, about good hygiene measures to reduce the 6 spread of
impetigo to other areas of the body and to other people (NICE, 2019).
(AAFP, 2019) ADVICE
TREATMENT (AAFP, 2014)
TREATMENT
NICE , 2019
 MONITORING

 IMPROVEMENT OF THE LESIONS IN 24-48 HOURS

 NO BACTEREMIC SIGN / FEVER
 ADVERSE DRUGS REACTIONS
SCABIES
Definition

 Human scabies is an intensely pruritic skin infestation caused by the host-

specific mite Sarcoptes scabiei hominis.

Barry M, 2019. Scabies. Available at https://emedicine.medscape.com/article/1109204-overview

https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-scabies-overview
EPIDEMIOLOGY
PATHOPHYSIOLOGY

 The female S scabiei var hominis mite lays 60-90 eggs in her 30-day lifespan.
LIFE CYCLE

 Eggs incubate and hatch in 3-4 days (90% of the hatched mites die)
 Larvae (3 pairs of legs) migrate to the skin surface and burrow into the intact stratum corneum to
make short burrows, called molting pouches (3-4 days)
 Larvae molt into nymphs (4 pairs of legs), which molt once into larger nymphs before becoming
adults
 Mating takes place once, and the female is fertile for the rest of her life; the male dies soon after
mating
 The female makes a serpentine burrow using proteolytic enzymes to dissolve the stratum corneum
of the epidermis, laying eggs in the process; she continues to lengthen her burrow and lay eggs
for the rest of her life, surviving 1-2 months
 Transmission of impregnated females from person-to-person occurs through direct or indirect skin
contact

Barry M, 2019. Scabies. Available at https://emedicine.medscape.com/article/1109204-overview

IMMUNE RESPONSE
TREATMENT
European guideline, 2017
CDC, 2015
SPECIAL CONDITION (EUROPEAN, 2017)

 Permethrin is safe in pregnancy {level of evidence III; grade B

recommendation}41 and lactation42,43 and is licensed for use in children
from age 2 months onwards.3,37
 • Benzyl benzoate and sulphur are considered safe in pregnancy {level of
evidence III; grade B recommendation}.1
 • Ivermectin should not be used during pregnancy or in children weighing
less than 15 kg.44
 • Malathion was not studied in pregnant women. Animal studies suggest
that there is no risk. However, animal reproductive studies are not always
predictive of human responses.45 Inappropriate use of agricultural grade
malathion for treating human infestations can induce acute toxicity {level
of evidence IV; grade C recommendation}.
TERIMA KASIH