Professional Documents
Culture Documents
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Pruritus: Overview of management European Dermatology Forumguideline Chronic Pruritus Management. Current Opinion in Allergy and Clinical Immunology Sept 2011
Pathophysiology of Itch and New Treatments Ulrike Raap; Sonja Stnder; Martin Metz
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La frecuencia en el trpico de escabiosis es alta no debemos sobre diagnosticarla haciendo un correcto diagnstico diferencial La Gran imitadora
Recordemos la epidemiologia , buscamos la signologa Usamos las herramientas de auxilio para el diagnstico: lupa y microscopio
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Erradicamos la ectoparasitosis
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Reino:Animalia Filo:Arthropoda Subfilo:Chelicerata Clase:Arachnida Subclase:Acarina Superorden:Acariformes Orden:Astigmata Suborden:Psoroptidia Superfamilia:Sarcoptoidea Familia:Sarcoptidae Subfamilia:Sarcoptinae Gnero:Sarcoptes Especie:S. scabiei
Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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Latn Scabererascar..
Escarificacin de un surco 400X
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ACAROS
Prostigmados
Mesostigmados
Sarcoptes spp.
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Most of the contributors accept pruritus and itch to be synonymous. Following the International Forum on the Study of Itch (IFSI). Vlida 2011 Pruritus / itch is a sensation that provokes the desire to
scratch.
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Dermatolgica, II Sistmica, III Neurolgica, IV Somatoforma, V Mixta VI otras (Stnder S, Weisshaar E et al 2007).
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1Criteria of Arnold et al for Pyschogenic Excoriation 2Descriptor and Affective Scales of Yosipovitch et al for a Patient with Pruritis 3Emotional Descriptors from the Eppendorf Itch Questionnaire 4Modified Sleep Impact Scale of Yosipovitch et al for a Patient with Pruritis 5Paraneoplastic Pruritus
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En la atencin primaria , centros de salud rurales y urbanos que atienden poblacin pobre es muy frecuente la escabiosis Muchas veces se presenta eczematizada
En nuestro pas se sobre diagnostica Se confunde con lesiones eczematosas , xerticas pruriginosas, lesiones secundarias al grattage sistematique
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Imitador clnico sus manifestaciones imitan cualquier lesin dermatolgica Prurito persistente La picazn de los 7 aos Nios Adultos sexualmente activos( genitales masculinos , arolas femeninas Inmunocomprometidos, leprosos Escabiosis costrosas
Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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Epidemias institucionales, prisiones, pobreza . Varios miembros de la familia. Partner sexual ( pareja , esposa) Los sujetos que comparten una habitacin. Habitacin rural,
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A typical linear burrow on the flexor forearm. Courtesy of Kenneth E. Greer, MD.
A subtle linear burrow accompanied by erythematous papules on the sole of the foot in a child with scabies. Courtesy of Kenneth E. Greer, MD.
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Surcos: en zonas donde la piel es ms fina, lo que facilita la penetracin del caro: - Surcos de las palmas. - Caras laterales de los dedos. - Cara anterior de las muecas. - Genitales masculinos.
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Surco o galera Estos son grises o color piel. Miden 5 a 15 mm. de largo.
Los caros hembras despus de depositar sus huevos mueren en el surco. Su tumba se le conoce como, la eminencia acariana.
Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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Erythematous papules and papulovesicles on the flexor wrist. Courtesy of Kenneth E. Greer, MD.
Papules rarely contain mites and most likely represent a hypersensitivity reaction. Papules are common on the shaft of the penis in men and on the areolae in women.
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Scabietic papules on the penile shaft and scrotum. Courtesy of Kenneth E. Greer, MD.
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Unlike adults, who rarely present with facial and neck involvement, this presentation is fairly typical in children. In very young children and infants, a widespread eczematous eruption primarily on the trunk is common.
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In neonates unable to scratch, pinkish-brown nodules may develop and range in size from 2-20 mm. Mites are rarely found within the nodules. Infants may have 1 to 3-mm papules, vesicles, and pustules on the palms and soles.
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Hallazgos Excoriaciones, Crostas melicricas, Hiperpigmentacin postinflamatoria, Eritrodermia, Prurigo nodularis Pioderma.
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Diagnostico diferencial..
Impetiginizacin: Stafiloccus aureus y el Streptococo pyogenes :pstulas mielicricas y crostas. Lesiones por grattage sistemtico.
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Acropustulosis of Infancy Asteatotic Eczema Atopic Dermatitis Bedbug Bites Chickenpox ontact Dermatitis, Allergic Contact Dermatitis, Irritant Dermatitis Artefacta Dermatitis Herpetiformis Dermatologic Manifestations of Renal Disease Dyshidrotic Eczema
Eosinophilic Pustular Folliculitis Erythroderma (Generalized Exfoliative Dermatitis) Folliculitis Gianotti-Crosti Syndrome (Papular Acrodermatitis of Childhood) Id Reaction (Autoeczematization) Insect Bites
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Kyrle Disease Lice Lichen Planus Neurotic Excoriations Papular Urticaria Parapsoriasis Prurigo Nodularis
Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
Psoriasis, Guttate
Psoriasis, Pustular Seabather's Eruption Syphilis Urticaria, Cholinergic Vesicular Palmoplantar Eczema
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Alta especificidad Poca sensibilidad, Pequeo nmero de caros sobre todo si ya hubo rascado
Raspar Montar lamina KOH 10% , examinar con lentes de bajo aumento
Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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PCR
Test intradermicos Deteccin de anticuerpos
Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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Toma de muestras piel Raspado ( Scrapping) Lamina, aceite mineral una gota Agregar KOH 10% para remover keratina en exceso Cubre objeto
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Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513
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In routine scabies, a single mite is seen. Eosinophilic spongiosis may be present (hematoxylin and eosin; original magnification, 400X). In crusted scabies, sections show multiple mites within the hyperkeratotic stratum corneum. The epidermis is spongiotic.
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Permethrin 5% cream is the drug of choice, especially for infants >2 mo and small children. More effective than crotamiton in treating symptoms and reducing chances of secondary bacterial infection. Even after successful treatment, postscabietic nodules and pruritus may persist for months.
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Binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death. Half-life is 16 h; metabolized in liver. Available in 3- and 6mg tab.
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Tel
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Gracias
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