Foods to avoid if you have Scabies
Scabies. (Hoechst-Roussel Pharmaceuticals) Figure 21-1. Scabies. (Hoechst-Roussel Pharmaceuticals) Figure 21-2. The female of the mite Sarcoptes scabiei. The small, oval, black body near the anal opening is a fecal pellet. Proximal to it is a vague, much larger, oval, pale-edged mass an egg. (Dr. H. Parlette) Scabies is usually more prevalent in a populace ravaged by war, famine, or disease, when personal hygiene becomes relatively unimportant. However, there are unexplained cyclic epidemics of this parasitic infestation. In the 1970s and 1980s such a cycle plagued Americans. In normal times scabies is rarely seen except in schoolchildren, among the elderly in nursing care centers, or in poorer populations under crowded conditions. It can be a sexually transmitted disease.
Fig 35-9 see Fig 22-1). This disease is usually transmitted through prolonged personal contact with infected people and less often by clothing The burrow is a skin-colored, tortuous, elevated line of 1 to 1.5 cm in length. They are usually found in the finger webs, flexor surface of the wrist, nipples, and elbows. In children, they are common in the palms and soles. The diagnosis is confirmed by a potassium hydroxide (KOH) preparation of the skin and the identification of the parasite. For treatment, permethrin 5 solution, one 8-hour application at night, is considered the standard treatment today. The gamma isomer of hexachlorobenzene (Lindane), 1 in a vanishing cream, was used for years, but it is used less commonly today because of its toxicity and should not be used in pregnant women and infants. With both medications a second application is made after 1 week. Note that this application should cover the entire body very thoroughly. A 6 sulfur precipitate in Vaseline...
As an epidemic in a nursing home, scabies can be a difficult management problem. The elderly, especially if mentally confused, present a challenge for basic hygiene. When they itch, this itch is usually attributed to dry skin or senile pruritus. Only when several residents in the nursing home, and the personnel, begin to itch does one think of scabies as a cause. Then the therapy is difficult because so many persons are affected (and for personnel, possibly their families) that a basic simple therapy becomes a major management problem. All persons affected must be treated at the same time.
Buntin DM, Rosen T, Lesher JL, et al. Sexually transmitted diseases viruses and ectoparasites. J Am Acad Dermatol 1991 25 527. Centers for Disease Control. Scabies in health-care facilities Iowa. Arch Dermatol 1988 124 837. Goddard J. Physician's guide to arthropods of medical importance, ed. 2. 1996.
Senile pruritus is a resistant form of generalized pruritus in the elderly patient. It can occur at any time of the year and may or may not be associated with dry skin. There is some evidence that these patients have a disorder of keratinization. This form of itch occurs most commonly on the scalp, the shoulders, the sacral areas, and the legs. Clinically, some patients have no cutaneous signs of the itch, but others may have linear excoriations. Scabies should be ruled out, as well as the diseases mentioned under the next form of pruritus to be considered, essential pruritus.
Parasitic infection should always be included in the differential diagnosis of patients with perianal pruritus. Pinworms (Enterobius vermicularis) are the most common cause of perianal itching in children. The diagnosis can be made by microscopically evaluating perianal skin samples collected on cellulose tape. It is imperative that other family members be evaluated so they can be treated and recontamination does not occur. The symptoms usually occur in the evening, when these 6-mm-long parasites migrate to the perianal skin. Scabies, a contagious skin infestation due to the mite Sarcoptes scabiei, can elicit severe pruritus. Although usually found on the finger webs or sides of the fingers, these lesions can often be identified in the perianal region. The diagnosis of scabies can be confirmed by demonstrating the mite or its products, such as ova or feces, from scrapings prepared on a slide with one drop of 10 potassium hydroxide. Lesions appear initially as vesicles as the mite...
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