DEPARTMENT OF DERMATOVENEROLOGY OCTOBER 2013

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

EXAMINATIONS AND TREATMENTS ON SCABIES PATIENTS

PRESENTED BY :

Nurul Fajri Syamsuri 110 209 0104

Andi Fajar Apriani 110 209 0106

ADVISOR :
dr. Fitri Kadarsih Bandjar

SUPERVISOR :
Dr. dr. Farida Tabri, Sp.KK(K)

PRESENTING AS A TASK ON CLERKSHIP

DEPARTMENT OF DERMATOVENEROLOGY
MOSLEM UNIVERSITY OF INDONESIA
MAKASSAR
2013
DEFINITION
 EPIDEMIOLOGY
Affects on any races and any social groups worldwide
 ETIOLOGY

Sarcoptes scabiei var hominis

- The mites has 4 legs
- Measures 0,3 mm in diameter
- Oval-shaped, transluscent, white in colour, has no eyes
- 330-450 x 250-350 micron in diameter (female)
200-240 x 150-200 micron in diameter (male)
PATHOGENESIS

3 days

2
week
s

It takes 4 6 weeks after initial

exposure into hosts skin to
develop the itch and
hypersensitivity reaction
Effloresence of Scabies

Classical features of Scabies

PREDILECTIONS
Macro distribution of primer Macro distribution of primer
lesions in adults lesions in children
 DI

2 of 4 Cardinal Sign
Additional test
 CLINICAL FINDING
CARDINAL SIGN

Nocturnal prurit
CLINICAL FORMS
Crusted, hyperkeratotic plaque
 ADDITIONAL TESTS
Skin scrapping
Epidermal shave biopsy
DIFFERENTIAL DIAGNOSIS

Insect bites
 TREATMENT
Education
 Drugs and Topical Agents
DRUG DOSE COMMENT

Permethrin 5% Applied for 8-12 hours at night First-line treatment

cream single dose; could be repeated in 7
days.

Precipitated Applied 24 hours for 3 days Safe in children and during pregnancy
sulfur 2-10%

Benzyl benzoate Applied for 24 h then washed off. Could be cause of dermatitis on excessive
12,5-25 % lotion use

Lindane 1% Applied for 12-24 hours then CNS toxicity, seizure-induced in infants
cream, lotion, gel washed off, Second application is and children
recommended after 1 week of
initial use.
 DRUG DOSE COMMENT

Crotamiton 10% Applied on 2 x a day May not be as recommended as other

cream, lotion consecutive within the antiscabies topicals, because of less efficacy
next 5 days. and its toxicity level

lvermectin, 200 ug/kg Single oral dose, can be Could be used above 5 years old. Side
repeated in 10-14 days, effects include dermatitis and TEN

Monosulfiran 25 % Using daily in 2-3 days

Malathion 0,5 % Use in first 24 hours, Less recommended because of its high
repeated couple days potential side effects
after initial dose
 Special Treatments
Forms Treatments
Norwegian/ - Permethrin, Lindane + Sulphur
Crust scabies - Keratolytic
Nodular - Anti Scabitic agents
Scabies - Steroid
Complication - Antibiotic (e.g : Eritromycin)
Symptomatic - Antihistamine
- Hydrocortison 1% (active lesion on infants)
- Emolient (nonactive lesion on infants)
- Triamsinolon 0,1% (adults)
 COMPLICATION
Secondary impetiginization
PROGNOSIS
PREVENTION
THANK YOU