How to Kill Scabies ? - Everything to Know

1. Aims and Objectives of Presentation What the scabies mite looks like A little about their history What signs and symptoms to look for And understand the difference between ‘normal’ scabies and ‘crusted’ scabies How to apply treatment That you do not want to catch them – ever • Presented by: http://www.drscabies.com

2. Sarcoptes Scabiei (Scabies) • Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes Scabiei. • Direct skin-to-skin contact is the mode of transmission • A severe and relentless itch is the predominant symptom of scabies • However, It can affect any individual irrespective of social class, caste, age , gender or race • Presented by: http://www.drscabies.com

3. The Scabies Mite • Presented by: http://www.drscabies.com

4. History of Scabies • Scabies has been seen in humans since ancient time. Archeological evidence from Egypt and the Middle East suggests scabies was present as early as 494 BC • It is suspected that some biblical “leprosy” (Hansen’s disease) was actually scabies • Aristotle (384-323 BC) mentioned "lice in the flesh" that produced vesicles • Greek physician Celsus is credited with naming the disease "scabies" and describing its characteristic features. • Presented by: http://www.drscabies.com

5. Some Stats About Scabies • World wide there are an estimated 300 million cases a year • Immunocomprimised people more likely to develop Norwegian (crusted) scabies. • 7% of people will develop nodular scabies (nodules can last for several months) • Presented by: http://www.drscabies.com

6. Life Cycle of the Scabies Mite • Presented by: http://www.drscabies.com

7. Population of Scabies Mites • Numbers of adult mites (burrows) build up slowly • Symptoms only start after several weeks • The number of active females increases until • Immune response inhibits increase • Scratching eliminates many burrows • Presented by: http://www.drscabies.com

8. Adult Female Mite (Mother of Scabies) • Adult female mites form burrows in the stratum corneum (dry horny layer of skin) • They cut into the cells using sharp “elbow” joints on the front pair of legs and secrete a skin dissolving enzyme • Usually only have 10 – 15 live mites on the body • Obligate parasite (lives its entire life on the host) • Presented by: http://www.drscabies.com

9. Adult Female Mite (Mother of Scabies) • Newly matured females form a short burrow and wait for a male to find them • Males and females mate in the burrow • Males then wander off – in search of other females • They lay eggs, defecate (scybala), and die in the burrow • The female enlarges the burrow and stays there for the rest of her life – burrows about 2-5mm per day (nodular scabies if she goes too deep)? • Larva makes its way to skin surface • Female may live for 60 days • Can lay 150 – 180 eggs • Can ‘travel’ 10 – 15 cm under the skin • Presented by: http://www.drscabies.com

10. Presented by: http://www.drscabies.com

11. How is Scabies Transmitted • Direct skin-to-skin contact is the mode of transmission • They can only live off of a host body for 24-36 hours under most conditions • sharing bedclothes that had mites in them the night before. • Sexual physical contact,  • Presented by: http://www.drscabies.com

12. Signs and Symptoms of Scabies • Can be up to 6 – 8 weeks before first symptoms develop: • Unfortunately, these signs are often overlooked, long term can result in eczema and dry areas • Infants often develop pustules on hands and feet • Presented by: http://www.drscabies.com

13. Some Random Pictures of Scabies Scabies on Wrist and Hand • Presented by: http://www.drscabies.com

14. Webbing (between fingers) • Presented by: http://www.drscabies.com

15. Diagnosis of Scabies aka Seven Year Itch • Scabies is a great masquerader that mimics other skin problems, e.g. impetigo, vasculitis, insect bites, psoriasis, all of which complicate diagnosis • Removing a mite from a burrow with a needle or skin scraping. Examined under a microscope to confirm the presence of mites or eggs   • Presented by: http://www.drscabies.com

16. Precautions for Treatment of Scabies • Although mites may only burrow in certain places juveniles may be found over the whole body • Wearing gloves and a disposable apron, apply cream or lotion to cool dry skin to all skin surfaces from head to toe (study): • including under nail ends – is especially important for infants and elderly • awkward places such as the back, soles of the feet, between fingers and toes, and the genitals. • Pay special attention to the areas where mite burrows most commonly occur, the front of the wrists and elbows, beneath the breasts, the armpits, and around the nipples in women. • Repeat treatment after 7 days • If you wash your hands before end of treatment - reapply • Presented by: http://www.drscabies.com

17. Scabies Treatment Drugs • Dr. Scabies • Made-up of natural extracts • Eliminates contagious scabies mites and eggs rapidly • Highest Concentration Formula • Contains Permethrin • Presented by: http://www.drscabies.com

18. Scabies Treatment Outbreak in a Nursing Home • Resident Staff Member Yes Affected No No Yes Affected Unaffected family members Staff Family Unaffected member family member Staff D1 Permethrin Permethrin Permethrin Permethrin Permethrin Permethrin No treatment D7 Permethrin No Treatment, monitor over the next 7 days Permethrin Permethrin No Treatment No Treatment but monitor Monitor & retreat if necessary using a topical + Ivermectin D14 Monitor & retreat if necessary If signs & symptoms are evident begin treatment N.B. The itch of scabies continues for 2 weeks or more following treatment. Relieve the itch with Eurax or calamine. In severe cases of crusting using an emollient to help remove crusts will enable treatment to work more effectively. A 2nd Ivermectin dose + topical may be needed in cases of severe crusted scabies D21 • Presented by: http://www.drscabies.com

19. Environmental Precautions • Patients clothing should be placed into soluble bags • Hoover bags should be discarded after each use into a plastic bag and tied immediately • Clothes, towels, and bed linen should be machine washed at 50°C or above after the first application of treatment. This kills the scabies mites. • Keep any items of clothing that cannot be washed, in plastic bags for at least 72 hours to contain the mites until they die • Pressing clothes with a warm iron, dry cleaning, or putting items in a dryer on the hot cycle for 10–30 minutes is also effective

20. Norwegian (Crusted Scabies) • Highly contagious due to the large number of parasites embedded in the crusts possibly close to 1 million mites! • Crusted scabies is more easily transmitted through contact with towels, bedding and upholstery • Presented by: http://www.drscabies.com

21. Points to take Care • Notify the Health Protection Unit (HPU) of outbreak (two or more residents affected) • Do liaise with the local infection control team or HPU for support and advice • temporarily close to admissions / respite patients until completion of the first • Follow the outbreak care • All GPs should be informed of the problem • Staff who have had one treatment can return to work • Presented by: http://www.drscabies.com

22. Credits • Presentation by Dr. Scabies • A well known name of Scabies Remedy provider • Please visit http://www.drscabies.com/ for more info • Follows us ……. • Facebook: https://www.facebook.com/DrScabies • Google+: https://plus.google.com/+Drscabies • Tweet: https://twitter.com/DrScabies