This document summarizes various parasitic infestations and their clinical features. It discusses papular urticaria caused by sensitivity to insect antigens, scabies caused by the mite Sarcoptes scabiei, and different types of pediculosis caused by head lice, body lice, and crab lice. It also mentions other conditions like myiasis, pulicosis, tungiasis, cimicosis, blister beetle dermatitis, spider bites, demodicidosis, larva migrans, leishmaniasis, and lymphatic filariasis. For each condition, it provides details on the causative organism, clinical manifestations, distribution of lesions

1. PARASITIC INFESTATIONS

2. PAPULAR URTICARIA
• Syn lichen urticatus,prurigo simplex
• Acquired specific sensitivity to antigens in
insects
• 2-7 years
• Immigrants
• Cancer patients
• Mosqitoes,bed bugs ,fleas,mites
• seasonal

3. • Wheals,papules,wheals surmounted by
papules
• Central h’gic punctum
• Pruritic-excoriated,crusted
• Sec. Infection
• Rec. crops
• Site depend on insect

5. SCABIES
• By sarcoptes scabiei var hominis
• F-0.4x 0.3mm.
• 2-3 eggs/d. 10-25eggs. Lives 30 d.
• M- 0.2x0.15
• Burrow 2mm. moult thrice.

7. Clinical features
• Itching –more at night
• Typical distribution of lesions-finger
webs,flexor wrist,elbow, ant.axillary
fold,umbilicus,periumbilical,genitalia,upper
thighs,knees &ankles
• Family history
• Burrow-thread like,grayish or dark line

10. • Nodular scabies
• Crusted scabies
• Scabies incognito
• Scabies in clean
• Scabies in infants
• Animal transmitted scabies
• Complications…..

14. TREATMENT
• Permethrin5%
• GBH 1%
• Benzyl benzoate 25%
• Others-crotamiton 10%, malathion 0.5%
• Oral- ivermectin 12mg tab

15. PEDICULOSIS
• Pediculus humanus var capitis
• Pediculus humanus var corporis
• Phthirius pubis
• Dorsoventrally flattened
• Head,thorax,abdomen
• Legs-3 pairs with claws

16. • Body louse-larger ,grey,300 eggs/d, eggs
glued to clothing
• Head louse- smaller,darker,100 eggs/d,
eggs to hair
• 2-3 blood meals/d

18. PEDICULOSIS CAPITIS
• Mainly scalp
• Louse pit
• No- rarely>20
• Nits laid close to scalp
• Itching-sec. Infection&LNE

22. TREATMENT
• Permethrin 1%
• GBH 1%, .5% malathion
• Repeat 10-14 d later
• Antibiotics esp cotrimoxazole

23. PEDICULOSIS CORPORIS
[Vagabond’s disease]
• Ery.macules or urticarial wheals ,excoriated
papules and parallel linear scratch marks
• Pararallel linear scratch marks&
hyperpigmentaton over upper back-
vagabonds dis.
• Clothes-Laundering,hot iron
• Pt- scrub bath
• Vector –epidemic typhus,relapsing
fever,trench fever

25. PEDICULOSIS PUBIS
• Crab louse
• Pubis,abd, thighs,axillae,beard,areolar hair,
eyebrow eyelash
• May be STD
• Maculae cerulae,bluish grey macules upper
thighs,abdomen
• Rx- permethrin GBH, petrolatum
over eyelash, flourescien e/d, ivermectin

27. MYIASIS
• Infestation of tissues of living vertebrates with
larvae of dipterous flies
• Cutaneous
• Ophthalmic
• Nasopharyngeal
• Intestinal

28. • Creeping myiasis-hypoderma bovis ,
gastrophilus
• Furuncular/true cutaneous
• Traumatic/ wound
• Rx-furuncular-inscise&pick out,
creeping-+antihelmintics, wound-
use turpentine/chloroform&pick out

29. PULICOSIS
• By flea
• Human flea-pulex irritans
• Wheal/.papule with a central hgic
punctum
• Grouped lesions
• Where cloth fit tightly

30. TUNGIASIS-
• By sandflea
• Tunga penetrans/burrowing flea
• Flourish best in sandy soil
• fertilised female burrows into feet-under the
nail,toe webs and medial side of foot
• Genital and perineal regions
• Black dotulcer
• Extract with a pin,turpentine

31. CIMICOSIS
• By bed bug
• Cimex hemipterus& cimex lectularis
• Exposed parts
• Bites painless, non pruritic in non sensitised
individuals , Sensitised-irritable papules with
hgic punctum, wheal
• Back of trunk &buttocks-in bed
• Insecticides like BHC

32. BLISTER BEETLE DERMATITIS
• Lytta vesicatoria (spanish fly)-cantharadin
• Epicauta solani
• Paederus(rove beetles)-pederin

33. • Alarmed on waking up
• Burning,pain,itching
• Wheal……rapidly blisters in 12 hrs
• Linear whiplash dermatitis patchy
,herpetiform,bizarre
• Kissing lesions
• Exposed parts
• Residual hyperpigmentation

35. SPIDER BITE
• LACRODECTISM-L.mactans-black widow spider
• Local reaction with 2 punctae
• Neurotoxic-vomiting,cramps,delirium, partial
paralysis
• Recover in 2-3 d
• Morphine,calcium gluconate

36. • LOXOSCELISUM-L reclusa-brown recluse spider
• Necrotic cutaneous loxoscelism-localised type
• Viscero-cutaneous loxoscelism –hemotoxic,
joint pain
• Ice bag,elevation,rest,antibiotics

37. DEMODICIDOSIS
• Follicle mites
• D folliculorum in hair follicle&D brevis-
sebaceous and meibomian glands
• Usually in older children and adults
• Forehead,cheeks,nasolabial folds,chin
,scalp,external ear,upper chest

38. • Burning &itching with diffuse erythema of
face with dryness and follicular scales
• Addl rosacea like lesions
• Benzoyl peroxide,Benzyl benzoate,
permethrin,ppt sulphur

39. CUTANEOUS LARVA MIGRANS
• Hookworms-A braziliense,A canium, A
ceylonicum
• S stercoralis
• F hepatica

40. • Itchy red papule-vesicular
• Itchy,skin coloured.tortuous,3mm wide tract
• Ankylostoma-1-2cm/d
• Larva migrans-10cm/d
• Self limiting
• Albendazole 400mg/dx3
• Mebendazole 100mg tid x7d

42. LEISHMANIASIS
• Old world leishmaniasis-oriental sore, delhi
boil
• L major,L tropica,L aethiopica,L infantum
• P papatasi,P sergenti
• L major-nodule-crust-ulcer-heal in 2-6months
with scar. Satellite lesons

43. • L tropica-nodule,plaque,ulcer with crust , heal
in 8-12 months with scar
• Rx-sodium stibogluconate, pentamaidine

46. NEW WORLD leishmaniasis
• L mexicana-chiclero ulcer ..face,
retroauricular areas
• L brasiliensis
• Primary lesion-pruritic nodule.. ulcerate

47. • Mucosal lesions - espundia
• 2-10 yrs after primary infection-due to
hematogenous spread
• mainly affect nose mucosa …ulceration and
destruction of cartilage ….tapir nose deformity

48. • POST KALA AZAR leishmaniasis
• Following visceral leishmaniasis
• In india 2yrs later
• Ery. bat wing rash over face
• Hypopigmented….then nodular
• May involve mucosa
• May resemble LL

49. LYMPHATIC FILARIASIS
• By Wuchereria bancrofti, Brugia Malayi, Brugia timori.
• Rec. episodes of lymphangitis and lymphadenitis occur.
• Lead to elephantiasis - Skin thickened, subcutaneous
tissue hypertrophic. Fissuring, nodular and papillomatous
to verrucose changes also occur.
• Mainly lower limbs.
• Rx. - DEC, ivermectin

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