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DERMATOLOGY. INSECTS AND PARASITES. PEDICULOSIS (LICE). Under a microscope, an egg with a developing head louse, attached to a hair shaft. Nits firmly attached to hair shafts. PEDICULOSIS (LICE). Egg and louse on a hair shaft. Pubic louse. LICE TREATMENT. KILL THE LICE
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DERMATOLOGY INSECTS AND PARASITES
PEDICULOSIS (LICE) Under a microscope, an egg with a developing head louse, attached to a hair shaft. Nits firmly attached to hair shafts.
PEDICULOSIS (LICE) Egg and louse on a hair shaft. Pubic louse
LICE TREATMENT • KILL THE LICE • COMB OUT THE NITS • CLEAN THE HOUSE
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 Bee Wasp Yellow jacket Hornet Angioedema
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 FLEAS
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.
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.
Treatment: CASE STUDY 1 • 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 You see the following in her hair. 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 slide Permethrin, Lindane Clothing, 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 What is this rash? What is the disease and etiology? Erythema migrans Physical exam is normal except for the following rash on her back. Lyme’s disease Borrelia burgdorferi