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DERMATOLOGY
INSECTS
AND
PARASITES
PEDICULOSIS (LICE)
Nits firmly attached to hair shafts.
Under a microscope, an egg with a developing head louse, attached to a hair shaft.
PEDICULOSIS (LICE)
Pubic louse
Egg and louse ona hair shaft.
LICE TREATMENT
1. KILL THE LICE2. COMB OUT THE
NITS3. CLEAN THE HOUSE
SCABIES
SCABIES
Papules and tan or skin-colored burrows in typical location on the
finger web.
Under microscope, a mite at the end of a burrow with eight eggs
and smaller fecal particles obtained from a papule on the
web space of the hand
HYMENOPTERA
WaspBee Yellow jacket Hornet
Angioedema
FLEAS •Multiple, pruritic, urticaria-like papules at sites of flea bites on knees and legs of a child•Usually 1 cm in diameter and may have a vesicle on the top. •When scratched, they exhibit erosions or crusts
BED BUGS
•Pruritic, urticaria-like papules at sites of bedbug bites on the lower back at the waist. •In previously unexposed individuals, bite sites appear as erythematous, pruritic macules. In sensitized individuals, intensely pruritic papules, urticaria, or vesicles/bullae may arise.
MOSQUITO
BLACK WIDOW SPIDER
BROWN RECLUSE SPIDER
TICKS
CASE STUDY 1
A mother brings in her 7-year-old daughter because she caught
something at school. All day she has been itching her head, and it
looks like she has dandruff flakes in her hair. She tried washing her hair at home, but the problem persists.
CASE STUDY 1
You see the following in her hair.
Treatment: Permethrin
preparations(Nix, Rid)
Decontaminate the home
Wash all clothes, sheets, etc
Hot cycle on dryer for 20 minutes
Vacuum daily Check head for nits &
new hatches daily
Etiology:Pediculosis
CASE STUDY 2
30-year-old male presents to the ER shortly after having gone to bed, unable to sleep because of severe itching. He has a papular rash at the interdigital
web spaces, volar wrists and antecubital fossa. He just started working in a
nursing home last week, and recalls that is when the rash began.
CASE STUDY 2
Etiology:
Diagnosis:
Treatment:
Sarcoptes scabiei
Mineral oil, microscope slidePermethrin, LindaneClothing, bedding, and towels should be
washed with hot water or dry cleaned to prevent reinfection
CASE STUDY 3
A 20-year-old female was gardening, and was stung by a bee. About 5
minutes later she felt light-headed and had dyspnea and felt warm. She
called an Ambulance, who administered oxygen on the way to the ER. Her BP is now 80/46 and her
pulse is 124.
CASE STUDY 3
What happened?
Treatment:
Her 6-year-old son was also in the garden, and was stung as well, but c/o
only local pain.
Treatment:
Anaphylaxis
Epinephrine, pressors, oxygen
Benadryl, topical steroid
CASE STUDY 4
A 24-year-old female just returned from a camping vacation in
Maryland, and complains of flu-like symptoms. She is thankful they
didn’t happen earlier because she went hiking, swimming and rock
climbing on the trip.
CASE STUDY 4
Physical exam is normal except
for the following rash on her back.
What is this rash?
What is the disease and
etiology?
Erythema migrans
Lyme’s disease
Borrelia burgdorferi