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Questions and Answers
Which topical scabicide is considered the treatment of choice and is safe for infants and pregnant women?
What is a common side effect of treatment that can cause persistent itching after scabies therapy?
Which systemic treatment for scabies requires a single dose based on weight?
What distinguishing feature characterizes lice as the causative agents of pediculosis?
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Which is NOT a common site for pediculosis capitis?
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What is one significant disadvantage of using sulfur as a scabicide?
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What is the primary method of transmission for pediculosis capitis?
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What is the recommended treatment for nodular scabies?
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What is the primary cause of scabies?
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Which of the following is a characteristic lesion of scabies?
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Where are scabies lesions typically distributed on the body?
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What symptom is most commonly associated with scabies?
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How does scabies primarily spread?
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What is a significant difference between human classic scabies and animal scabies?
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Which of the following areas is typically free from scabies lesions?
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In infants and young children, where are scabies lesions often found?
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What is a characteristic feature of prurigo of Hebra?
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Which of the following criteria is NOT a major criterion for atopic dermatitis?
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In a case of suspected scabies, where should the classic examination focus be?
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What is the primary lesion associated with scabies?
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What is the common cause of papular urticaria?
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What is the preferred antibacterial for treating pediculosis capitis due to its additional pediculicide effect?
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What is the typical duration for wheals associated with acute urticaria?
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What must be done after applying topical pediculicide lotion to the hair?
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Which of the following is NOT a characteristic of urethria?
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Which of the following is NOT a recognized type of urticaria?
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Which condition is commonly associated with angioedema?
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Which type of lice is considered sexually transmitted and primarily affects young adults?
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What is a common characteristic that distinguishes urticaria from other skin lesions?
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What is the purpose of using white vinegar in the treatment of pediculosis?
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What is the primary treatment for urticaria?
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What can trigger urticaria apart from allergic reactions?
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Papular urticaria is most frequently seen in which age group?
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What is the ideal dosing of oral Ivermectin for treating pediculosis capitis?
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In chronic urticaria, how long do the symptoms typically persist?
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Which of the following foods is a common trigger for urticaria?
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Which of the following is NOT a symptom associated with urticaria?
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Study Notes
Scabies
- Highly contagious skin condition caused by a mite, Sarcoptes scabiei.
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Transmission:
- Direct contact with infected individual.
- Indirect contact through contaminated items like towels or bedding.
- Incubation period: 2 weeks to 2 months.
- Characteristic lesion: Burrows, appearing as small lines on the skin, typically seen early in infection.
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Symptoms:
- Intense itching, especially at night.
- Other lesions include papules, vesicles, and crusting.
- Distribution: Commonly found on the hands, wrists, elbows, axillae, abdomen, genitalia, and lower limbs.
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Types:
- Human classic scabies: The most common type.
- Animal scabies: Transmitted from animals to humans.
- Scabies in infants: Atypical distribution, affecting the scalp, face, and soles.
Treatment of Scabies
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Topical scabicides:
- Permethrin 5% (treatment of choice): Apply twice, 24 hours apart. Safe in infants and pregnant women.
- Crotamiton 10%: Apply twice, 24 hours apart.
- Benzyl benzoate 25%: Apply twice, 24 hours apart.
- Sulfur 10% (adults) / 3-5% (infants): Apply every night for four nights. Safe in infants, children, and pregnant women.
- Gamma benzene hexachloride 1%: Apply once for 12 hours. Not recommended for infants, children, pregnant or lactating women, or those with seizures.
- Malathion 0.5%: Apply for 12 hours, then wash off.
- Ivermectin 1% solution: Apply for 12 hours, then wash off. Repeat after a week.
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Systemic scabicides:
- Oral Ivermectin: Effective against scabies. Dose: 6 mg/15 kg (0.2-0.4 mg/kg). Repeat after one or two weeks. Not recommended for children under 15 kg, pregnant or breastfeeding individuals.
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Additional treatment:
- Antihistamines for itching.
- Antibiotics for bacterial infections.
Nodular Scabies
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Treatment:
- Intralesional steroid injection.
- Surgical excision.
Causes of Persistent Itching After Scabies Treatment
- Hypersensitivity to mite antigens.
- Reinfection.
- Unsuccessful treatment.
- Irritation from scabicides.
- Acarophobia (fear of mites).
Pediculosis (Lice)
- Def: Infestation with lice, small blood-sucking parasites.
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Life cycle:
- Females lay eggs (nits) that attach to the hair shaft.
- Nits hatch within a week.
Pediculosis Capitis (Head Lice)
- Site: Scalp, primarily above the ears and occiput.
- Transmission: Direct contact or sharing hats, combs, and brushes.
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Symptoms:
- Itching.
- Nits visible on the hair shaft.
- Possible impetigo and cervical lymphadenopathy.
Treatment of Pediculosis Capitis
- Step 1: Treat bacterial infections if present (e.g., impetigo) with systemic antibiotics.
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Step 2: Apply topical pediculicides after controlling bacterial infection:
- Malathion 0.5%, Ivermectin 1%, or Permethrin 5%.
- Apply to clean, dry hair for 12 hours, then wash off.
- Repeat treatment after one week to ensure eradication.
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Nit removal:
- Apply a vinegar solution (equal parts white vinegar and water) to loosen the glue holding nits to the hair.
- Wash after 1-2 hours and comb hair with a fine-toothed comb to remove nits.
- Oral Ivermectin: Alternative treatment, 0.2-0.4 mg/kg single dose, repeated after 8 days.
Pediculosis Pubis (Crab Lice)
- Transmission: Sexually transmitted.
- Site: Pubic and perineal hair. Can also affect eyelashes.
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Symptoms:
- Intense itching.
- Lice firmly attached to the base of hairs.
Urticaria (Hives)
- Def: Acute skin condition characterized by wheals (raised, red, itchy bumps).
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Causes:
- Allergic reactions (e.g., food, drugs, pollen).
- Non-allergic reactions (e.g., physical factors, infections).
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Symptoms:
- Sudden appearance of itchy wheals that last for hours to 48 hours.
- Wheals can be localized or generalized, ranging in size from small to large.
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Associated conditions:
- Angioedema: Swelling in the skin and subcutaneous tissue (face, lips, genitalia).
- General symptoms: Nausea, vomiting, dysphagia, hoarseness, wheezing, dyspnea.
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Types:
- Acute urticaria: Symptoms last for less than 6 weeks.
- Chronic urticaria: Symptoms last longer than 6 weeks.
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Special types:
- Angioedema
- Dermographism
- Cold urticaria
- Aquagenic urticaria
- Cholinergic urticaria
- Solar urticaria
- Contact urticaria
- Serum sickness
Treatment of Urticaria
- Primary focus: Identifying and removing the triggering cause.
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Medications:
- Antihistamines: Primary treatment.
- Systemic steroids: Adjuvant treatment for severe cases.
- Adrenaline, calcium gluconate (in severe, life-threatening cases).
Papular Urticaria (Prurigo Simplex)
- Def: Hypersensitivity reaction to insect bites (e.g., fleas, mosquitos).
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Symptoms:
- Occurs mostly in infants and children.
- Itchy red papules (1-5 mm).
- Lesions located primarily on the limbs; occasionally on the trunk.
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Course:
- Often subsides spontaneously, even with continued exposure to insects.
- Desensitization to insect antigens may occur over time.
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Prurigo of Hebra (Atopic prurigo):
- Persistent form of papular urticaria, especially in individuals with atopic dermatitis (eczema).
- Characterized by numerous, lichenified (thickened) lesions, excoriated papules, and superficial lymphadenopathy.
Atopic Dermatitis (Eczema)
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Diagnosis: Four major criteria should be present.
- Pruritis (itching)
- Typical morphology and distribution for age group.
- Chronic or chronically relapsing dermatitis.
- Personal or family history of atopy (allergies, asthma, eczema).
Treatment of Atopic Dermatitis
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General measures:
- Environment modifications.
- Avoid triggers (e.g., irritating clothing, skin products, allergens).
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Medications:
- Oral antihistamines.
- Short-course systemic steroids for extensive cases.
- Topical soothing lotions or corticosteroids.
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Description
This quiz provides essential information about scabies, a highly contagious skin condition caused by the mite Sarcoptes scabiei. Explore its transmission methods, symptoms, and effective treatments, including topical scabicides. Test your knowledge on scabies types and management strategies.
