Ectoparisites
Digafe Tsegaye
MD ,Dermato-venerologist
Ectoparisites
 Pediculosis
 Scabies
 Myiasis
 Tungiasis
Pediculosis
• Pediculosis capitis / (head louse)
• Pediculosis corporis/ (body or clothing
louse)
• Phitriasis pubis / (cr...
Introduction
• Lice are wingless,dorsoventrally flattened
blood-sucking insects
• Lice have three pairs of legs
• Head and...
Medical importance of lice
• Pruritis
• Hypersensitivity reaction
• Endemic typhus , relapsing fever
• Excoriations freque...
Pediculosis capitis / (head louse)
• Transmission is head-to-head contact ,
shared towels ,brushes, and combs
• DX :
– Act...
Pediculosis capitis. Myriads of oval, grayish-white egg capsules
(nits) are firmly attached to the hair shafts.
Pediculosis corporis (body or
clothing louse)
• Infestations of body lice are found mainly in low
income ,poor hygiene, ho...
• Vertical excoriations xic
• Crusts and at times pus or serum may stain the
underclothing.
• Transitory wheals and bacter...
Phitriasis pubis / (crab)
• Transmitted sexually, frequently coexisting
with other sexually transmitted diseases.
• Most a...
Pediculosis pubis. Eyelash infestation with Pthirus pubis. Nits can be
seen attached to the eyelashes.
Treatment
• Pediculosis capitis
5 % PERMETHRINE
• Method of application
– Hair is first washed with a regular
shampoo, ri...
 Lindane shampoo
• The hair should then be rinsed thoroughly with water and
dried.
• The patient should lather the scalp ...
Scabies
• Caused by Sarcoptes scabies Var
humanis
• Fertilized female burrows in to the stratum
corneum and depoits her eg...
Clinical feature
(burrow is a pathognomonic lesion)
• Pruritic papular erruptions worse at bed
time
–Excoriations
–Licheni...
• Site : finger webs,wrist,axillae, areola,
umblicus, lower abdomen, genitalia
and buttocks.
• Circle of Hebra .
• In adul...
Secondary bacterial infection
Scabies in infants
• Generalized (face and scalp are involved )
• Bullous lesions are seen on the palms and
soles
Norwegian scabies
• Also called Crusted scabies
• Seen in immunocompromised or debilitated
patients
• Also patients with n...
Crusted scabies
Nodular scabies
• An itchy nodule on the scrotum is
to be considered like Scabies
unless proved other wise !!!!
Treatment
5 % perimethrine is a DOC
• Single application , wash after 8 hours
• You may repeat after a week
• Treat close...
1 % Lindane (GHCB) : toxic to the
nerve
BBL 25 % for three consecutive days
10 % Sulphur PPt in white Petrolatum
Crota...
Myiasis
Etiology
- Myiasis can be caused by
several spp of arthropods
of the order Diptera
- Worldwide, the most
common fl...
Cordylobia anthropophaga ( tumbu fly) :Deposit
eggs on soiled clothing → when a person in
contact eggs hatch, larvae burro...
Treatment
 surgical extraction
 suffocation with Occlsuion
 Inject lidocaine at the base of the
tissue cavity → local s...
Tungiasis
- Infestation caused by the flea; Tunga
penetrans
- Endemic in certain area of the world
• T. penetrans lives in warm, dry soil
- After contact, invade the unprotected skin ,
feet /interdigital, subungal
- C / F...
Complication
o Bacterial superinfection
o Tetanus
o Gangrene
o Autoamputation of a digit
RX
Removal of the gravid female flea
In early case, lift by enlarging the orifice
with a sterile needle
Late, curettage...
Ectoparisites
Ectoparisites
Ectoparisites
Ectoparisites
Ectoparisites
Ectoparisites
Ectoparisites
Ectoparisites
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Ectoparisites

  1. 1. Ectoparisites Digafe Tsegaye MD ,Dermato-venerologist
  2. 2. Ectoparisites  Pediculosis  Scabies  Myiasis  Tungiasis
  3. 3. Pediculosis • Pediculosis capitis / (head louse) • Pediculosis corporis/ (body or clothing louse) • Phitriasis pubis / (crab)
  4. 4. Introduction • Lice are wingless,dorsoventrally flattened blood-sucking insects • Lice have three pairs of legs • Head and body lice, which travel up to 23 cm/min, crab lice are sluggish and travel a maximum of 10 cm/day • Head and body lice develop in adults in 19 to 25 days from the time the egg is laid and crab lice in 22 to 27 days.
  5. 5. Medical importance of lice • Pruritis • Hypersensitivity reaction • Endemic typhus , relapsing fever • Excoriations frequently lead to pyoderma • Parasitophobia
  6. 6. Pediculosis capitis / (head louse) • Transmission is head-to-head contact , shared towels ,brushes, and combs • DX : – Active infestation is based on finding live adult lice, immature nymphs, and/or viable- appearing eggs. – Empty shells (nits) are not diagnostic of active infestation.
  7. 7. Pediculosis capitis. Myriads of oval, grayish-white egg capsules (nits) are firmly attached to the hair shafts.
  8. 8. Pediculosis corporis (body or clothing louse) • Infestations of body lice are found mainly in low income ,poor hygiene, homeless ,refugees living in crowded conditions. • The infestation is transmitted chiefly by contaminated clothing or bedding • Clinical feature : • macules or papules at the site where the louse punctures the skin to obtain blood
  9. 9. • Vertical excoriations xic • Crusts and at times pus or serum may stain the underclothing. • Transitory wheals and bacterial infections may complicate the process • Post inflammatory pigmentation is common. • Few or no adult organisms are seen except in heavily infested persons • Numerous nits are found in clothing seams, particularly in contact with the crotch, armpits, belt line, and collar
  10. 10. Phitriasis pubis / (crab) • Transmitted sexually, frequently coexisting with other sexually transmitted diseases. • Most are self-diagnosed
  11. 11. Pediculosis pubis. Eyelash infestation with Pthirus pubis. Nits can be seen attached to the eyelashes.
  12. 12. Treatment • Pediculosis capitis 5 % PERMETHRINE • Method of application – Hair is first washed with a regular shampoo, rinsed with water, and towel-dried. – Sufficient permethrin cream rinse is supplied to coat the hair and scalp thoroughly. – Left on for 10 min and rinsed off with water
  13. 13.  Lindane shampoo • The hair should then be rinsed thoroughly with water and dried. • The patient should lather the scalp thoroughly for 4 min with 30 to 40 mL of lindane shampoo . • Unlike permethrine ,lindaine leaves the hair tangled and difficult to comb. • Toxic ….single application / not suitable for infants
  14. 14. Scabies • Caused by Sarcoptes scabies Var humanis • Fertilized female burrows in to the stratum corneum and depoits her eggs . • Sensitization begins 2-4weeks after the infection • But with days if patient were already sensitized already
  15. 15. Clinical feature (burrow is a pathognomonic lesion) • Pruritic papular erruptions worse at bed time –Excoriations –Lichenification • Burrows : slightly elevated ,grayish ,tortous lines • Vesicle or pustule containing the mite may be noted
  16. 16. • Site : finger webs,wrist,axillae, areola, umblicus, lower abdomen, genitalia and buttocks. • Circle of Hebra . • In adults face and scalp are spared • Impetigo / furunclosis if not treated
  17. 17. Secondary bacterial infection
  18. 18. Scabies in infants • Generalized (face and scalp are involved ) • Bullous lesions are seen on the palms and soles
  19. 19. Norwegian scabies • Also called Crusted scabies • Seen in immunocompromised or debilitated patients • Also patients with neurological abnormality like down syndrome , leprosy • C / F : contains millions of mites • Heavy scaling and crusting on face ,scalp ,pressure bearing sites • Psoriasis like changes are noted on the nail or under it ,,,, nail deformity
  20. 20. Crusted scabies
  21. 21. Nodular scabies • An itchy nodule on the scrotum is to be considered like Scabies unless proved other wise !!!!
  22. 22. Treatment 5 % perimethrine is a DOC • Single application , wash after 8 hours • You may repeat after a week • Treat close contacts
  23. 23. 1 % Lindane (GHCB) : toxic to the nerve BBL 25 % for three consecutive days 10 % Sulphur PPt in white Petrolatum Crotamiton for 5 consecutive nights • Ivermectin 200 microgram / kg Q for crusted Scabies • IL steroide / excision for Nodular Scabies
  24. 24. Myiasis Etiology - Myiasis can be caused by several spp of arthropods of the order Diptera - Worldwide, the most common flies in human infestation : ○Dermatobia hominis ○ Cordylobia anthropophaga /(tumbu fly)
  25. 25. Cordylobia anthropophaga ( tumbu fly) :Deposit eggs on soiled clothing → when a person in contact eggs hatch, larvae burrow into the skin. Clinical presenation of cutaneous myasis - Furuncular : itchy papule- painful or tender papule : - Lesions consist of one or few larvae - May feel sensation of movement
  26. 26. Treatment  surgical extraction  suffocation with Occlsuion  Inject lidocaine at the base of the tissue cavity → local swelling force it to the surface
  27. 27. Tungiasis - Infestation caused by the flea; Tunga penetrans - Endemic in certain area of the world
  28. 28. • T. penetrans lives in warm, dry soil - After contact, invade the unprotected skin , feet /interdigital, subungal - C / F - No symptom , pruritic , painful - a black furuncular nodule surrounded by a white halo
  29. 29. Complication o Bacterial superinfection o Tetanus o Gangrene o Autoamputation of a digit
  30. 30. RX Removal of the gravid female flea In early case, lift by enlarging the orifice with a sterile needle Late, curettage, electrodessication or excision Topical Rx- alternatives  ivermectin  thiabendazole TAT prophylaxis
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