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PARASITIC INFECTIONS
• Scabies• Pediculosis• Leishmaniasis• Larva migrans• Trichomoniasis• Myiasis
SCABIES
Sarcoptes scabiei ‐var.hominis
Life cycle
Life span 4‐6 weeks
40 ‐ 50 eggs in life
Adult female eggs Six legged larva
3‐4 days
Copulation adult nymph
Incubation
2 – 3 months ‐ first exposure
1day ‐1 month ‐ re‐exposure
Pathology
Delayed hypersensitivity (mite antigen)
Mode of infestation
Close intimate contact
(Skin to skin)
Pregnant female ‐ nymph
Clinical featuresGeneralized pruritus (night)
Skin lesions ‐ burrow
Hands
Abdomen,
Male genitalia,
Female breast
Burrow - characteristic lesion
Papules,Vesiculo-pustulesCrustExcoriationsSecondary pyoderma Family history
ComplicationsSecondary infectionGlomerulonephritis
Nodular scabies
Diagnosis Clinical features
Demonstration of MiteOva,Nymph Faecal pellets
TREATMENT
1. Permethrin 5% lotion/cream ‐ once2. Gamma‐benzene hexachloride 1%3. Benzyl benzoate lotion (25%)‐3 applic4. Crotamiton 1% ‐ twice daily x 2 weeks5. Ivermectin – 12mg, single oral dose
• Symptomatic ‐ Antipruritic• Sec infection ‐ Antibiotics• Eczematization ‐ Steroids• Treat Contacts ‐ both
symptomatic/ asymptomatic
NORWEGIAN SCABIES
(Crusted scabies)
Immunocompromised
Diabetic
Leukemia
Lymphomas
Mental illnesses
Specific Features
no pruritus (Slight)
• Mites – Millions
• Sources – for large outbreaks
• Treatment – same as scabies‐ repeat
Methotrexate
Animal scabies (mange)
Cat, dog
No burrows
Self limiting
Treat animal
PEDICULOSIS
•Pediculus humanus
var.Capitis – P.capitis
var.Corporis – P.corporis
•Phthirus pubis – Pediculosis pubis
Life cycle
Life span 40 Days
300 eggs in life : 7 ‐10 eggs / day
Adult female eggs(nits) in 7days
Copulation adult (1month) nymph
Pediculosis capitis
Pediculus humanus var. capitis
‐ Close intimate contact
‐ Combs, bed,
unhygienic living
Clinical features
Scalp pruritus
Scalp pyoderma
Suboccipital
Cervical L.N.
DiagnosisMite ‐ adult, nymph, eggs
Treatment
• Permethrin 1%
• GBHC 1%
• 25% Benzyl benzoate
Pediculosis corporis(Vagabond’s disease)
Pediculus humanus var. corporisMorphologically same – white/grey
Generalised pruritusExcoriationsSecondary infection
•Seams of clothes
Sharing clothes
DiagnosisDemonstration of mite/nymph/egg
Treatment•Disinfect clothes
•Wash – steam Iron
Pediculosis pubis(Phthirus pubis)
• Sexually transmitted disease
• Generalized pruritus
•Site - pubic hair- axillary hair- umbilicus- eyebrows- eyelashes
Diagnosis
•Lice – adult, eggs, nymph
Treatment
Same as Pediculosis capitisTreat sexual partner(s)
Larva migrans(Creeping eruption)
Cutaneous larva migrans
Ankylostoma brazalienseGnathosterma spinigerum
Strongyloides stercoralisLarva currens
DermatitisWavyStreaky
Treatment Thiabendazole under occlusionAlbendazoleExcision
MYIASIS (Maggot infestation)Primary
FuruncularSubcutaneous migratory
SecondaryWound myiasis
DipteraHypoderma
GastrophilusOestrusDermatobisMusca
Treatment
• Turpentine oil
• Manual extraction
• Exploration
LeishmaniasisVisceral (Kala‐azar)
Cutaneous
Oriental sore (Delhi boil)
L.tropica
L. major
L.aethiopica
Vector – Sandfly (Phlebotomus)
Clinical features
I.P. – 2 months
Small nodule
Ulcer 2‐3 months
Diagnosis Biopsy – granulomaL‐D bodies
TreatmentAntimony compounds (Sodium stibogluconate 10mg/kg x3‐4 timesKetoconazoleItraconazole
Thank you