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DU PA Creepy Crawler

Duke PA Human Ectoparasites (Dermatology)

what does CRAB stand for Cutaneous Reaction to Arthropod Bite
hallmark lesion of arthropod bite papular urticaria
2-8 mm erythematous, papulovesicular lesion usually arranged in clusters on exposed skin-most often caused by fleas, mosquitoes, and bedbugs papular urticaria
most common spider bites are from what type of spider black widow, brown recluse
extremely toxic, a potent neurotoxin whose site of action is neuromuscular junction black widow venom
serious reaction associated with black widow venom systemic symptoms: muscle cramping (abdomen, chest, and thighs. severe autonomic symptoms include hypertension and tachycardia
if your shoes have been left outside for a while you might find this spider inside brown recluse
effect of brown recluse venom platelet aggregation and infiltration of site by neutrophils, dermal necrosis (can lead to large necrotic wounds), possible systemic effects.
generalized treatment for spider bites RICE, update tetanus immunization, analgesics, antibiotics if needed for secondary infection
in traumatic injuries the C in RICE stands for compression. In spider bites what does the C stand for cephalosporin
what is the antivenom status for black widows, and brown recluses antivenom is available for black widow bites but is usually reserved for those with severe hypertension/tachycardia, no antivenom is currently available for brown recluses
local effects of scorpion sting immediate burning/stinging followed by paresthesias
systemic effects of scorpion stings greater than local effects, the venom is a potent neurotoxin
tunnels into epidermis, eggs and feces are found in tunnels scabies
those at risk for scabies young, sexually active adults, bed-ridden patients, children
scabies can live as long as __hours 48
scabies rash characteristic serpiginous, intensely pruritic, found in areas of thin skin (finger webs, flexor aspects of wrist, elbows, axillae, penis, external genitalia, feet and ankles)
babies get __ scabies (couldn't resist)
heavy infestation with severe crusting, hundreds to thousands of mites, variable pruritis, affected patients usually have underlying immunodeficiency (AIDS common) Norwegian Scabies
how do you make the diagnosis of scabies look for burrows, place mineral oil over burrow and scrape of with a #15 blade (or a glass slide), examine under oil-immersion objective (100x) look for mite, eggs or feces
treatment for scabies 5% permethrin cream, 1% lidane lotion (banned in california due to neurotoxicity). apply overnight from neck down and wash off in am. single application is usually curative
how to treat pruritis associated with scabies antihistamines
what do you do about family members of patients affected with scabies treat them, even if asymptomatic (especially if they share a bed)
sites of predilection for chiggers ankles, backs of knees, groin, axillae
treatment for chiggers immediate bath in hot soapy water, antihistamines and topical steroids
classic bull's eye lesion (at least 5mm induration) erythema migrans
erythema migrans from a tick bite does not mean that a patient has lyme disease
erythema migrans lasting longer than 4 weeks erythema chronicum migrans
single 1-5cm bluish nodule, develops in response to antigenic stimulation, at the site fo bite or remote (earlobe, areola, neck) lymphocytoma cutis (European borreliosis)
bluish erythem accompanied by edema, if untreated can lead to atrophy of all layers of skin, more likely to affect middle-aged persons, seen most in patients of european descent acrodermatits chronica atrophicans
nocturnal arthropods that can cause painful bites, bites are usually in shape of chevron centipedes
treatment for centipede bites analgesics, antihistamine, systemic symptoms are rare
harmless, don't bite but secrete an oily substance from glands located on body segments that cause brownish discolorations of skin (can also cause burning and blistering), can last for months and has been mistaken for child abuse millipedes
three forms of louse body, head, pubic
classic presentation of body lice small erythematous papules (papular urticaria), in axillae, neck, shoulders, hemorrhagic puncta and linear excoriation also common. maculae ceruleae, vesicles
body lice is a vector for bartonella quintana (typhus and trench fever)
group most often affected by head lice caucasion children
treatment for head lice removal of nits/lice with fine toothed comb, wash all bedding, clothing, hats and combs, pediculicides (1% permethrin OTC, 5% permethrin, 0.5% malathion)
pediculides are good for killing adult lice however they are not __ ovacidal-must retreat in 1 week
presentation of pubic lice 1-2mm lice are often visible, small erythematous papules may be visible at feeding sites and blood specks may be visible in underwear, inguinal adenopathy, sometimes in eyelashes
treatment for pubic lice linane lotion or 5% permethrin
presentation of bedbugs, and kissing bugs painless bites at nite usually on exposed areas, lesion is classic papular urticaria but may be vesicular, eczematous
how do you get rid of bed bugs get a new bed
Asp caterpillar/flannel moth/puss caterpillar sting presentation intense pain, train-track pattern of purpura
when to expect flea bites warm months in patients with grouped, pruritic lesions on extremities with history of pet contact
peggy's #1 rule about oral prednisone (or other steroid) no dose packs-give one dose, in the morning, with food
systemic reactions from bees and vespids diffuse urticaria, anaphylaxis, angioedema and shock, usually begins in 10-20 minutes
treatment for bee and vespid stings remove stinger, RICE, antihistamines (questionable-use first generation), oral steroids for severe local reactions
Created by: bwyche