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PARASITIC INFESTATIONS
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
• Wheals,papules,wheals surmounted by
papules
• Central h’gic punctum
• Pruritic-excoriated,crusted
• Sec. Infection
• Rec. crops
• Site depend on insect
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.
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
• Nodular scabies
• Crusted scabies
• Scabies incognito
• Scabies in clean
• Scabies in infants
• Animal transmitted scabies
• Complications…..
TREATMENT
• Permethrin5%
• GBH 1%
• Benzyl benzoate 25%
• Others-crotamiton 10%, malathion 0.5%
• Oral- ivermectin 12mg tab
PEDICULOSIS
• Pediculus humanus var capitis
• Pediculus humanus var corporis
• Phthirius pubis
• Dorsoventrally flattened
• Head,thorax,abdomen
• Legs-3 pairs with claws
• 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
PEDICULOSIS CAPITIS
• Mainly scalp
• Louse pit
• No- rarely>20
• Nits laid close to scalp
• Itching-sec. Infection&LNE
TREATMENT
• Permethrin 1%
• GBH 1%, .5% malathion
• Repeat 10-14 d later
• Antibiotics esp cotrimoxazole
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
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
MYIASIS
• Infestation of tissues of living vertebrates with
larvae of dipterous flies
• Cutaneous
• Ophthalmic
• Nasopharyngeal
• Intestinal
• Creeping myiasis-hypoderma bovis ,
gastrophilus
• Furuncular/true cutaneous
• Traumatic/ wound
• Rx-furuncular-inscise&pick out,
creeping-+antihelmintics, wound-
use turpentine/chloroform&pick out
PULICOSIS
• By flea
• Human flea-pulex irritans
• Wheal/.papule with a central hgic
punctum
• Grouped lesions
• Where cloth fit tightly
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
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
BLISTER BEETLE DERMATITIS
• Lytta vesicatoria (spanish fly)-cantharadin
• Epicauta solani
• Paederus(rove beetles)-pederin
• 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
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
• LOXOSCELISUM-L reclusa-brown recluse spider
• Necrotic cutaneous loxoscelism-localised type
• Viscero-cutaneous loxoscelism –hemotoxic,
joint pain
• Ice bag,elevation,rest,antibiotics
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
• Burning &itching with diffuse erythema of
face with dryness and follicular scales
• Addl rosacea like lesions
• Benzoyl peroxide,Benzyl benzoate,
permethrin,ppt sulphur
CUTANEOUS LARVA MIGRANS
• Hookworms-A braziliense,A canium, A
ceylonicum
• S stercoralis
• F hepatica
• 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
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
• L tropica-nodule,plaque,ulcer with crust , heal
in 8-12 months with scar
• Rx-sodium stibogluconate, pentamaidine
NEW WORLD leishmaniasis
• L mexicana-chiclero ulcer ..face,
retroauricular areas
• L brasiliensis
• Primary lesion-pruritic nodule.. ulcerate
• 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
• 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
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
THANK YOU

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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
  • 4.
  • 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.
  • 6.
  • 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
  • 8.
  • 9.
  • 10. • Nodular scabies • Crusted scabies • Scabies incognito • Scabies in clean • Scabies in infants • Animal transmitted scabies • Complications…..
  • 11.
  • 12.
  • 13.
  • 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
  • 17.
  • 18. PEDICULOSIS CAPITIS • Mainly scalp • Louse pit • No- rarely>20 • Nits laid close to scalp • Itching-sec. Infection&LNE
  • 19.
  • 20.
  • 21.
  • 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
  • 24.
  • 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
  • 26.
  • 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
  • 34.
  • 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
  • 41.
  • 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
  • 44.
  • 45.
  • 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
  • 50.