Common Skin Infections

COMMON PARASITIC INFECTIONS

Scabies

This is one of the most itchy rashes around. Diagnostic clues include

• interdigital, penile, peri-umbilical, flexures, axillae
• contact history
• crusted scabies in immobile/immunosuppressed

Clinical Tip: Itch is often out of proportion to what you see on skin - there may not be many obvious burrows etc.

Clinical Tip: nodules on the shaft of the penis are pathognomic for scabies.

Scabies – note linear burrows at typical site of wrist. Feet are commonly involved in children.

Crusted scabies – loads of mites!

Scabetic nodules – commonly seen in genital region

Scabies mite – isolated with needle

Treatment

Scabies - patient Information Leaflet

The Key to Success is to treat both the patient and all close contacts at the same time with two treatments a week apart, using topical Permethrin 5% cream, applied from the neck down and washed off after 12 hours, reapplying if hands are washed.

Ivermectin orally is needed for immunosuppressed or crusted scabies.

Apologies that we have covered so much this week - and even then there are a number of common infections which we have not had the opportunity to cover in depth. HIV infection will be covered later in the course.