SCABIES

Group Name
Yarianti
Nur Insani
Imiey Eleena
Efrem
Dwi Putri Mentari
Dian Fahmi
Uka
Fitriani
Fani Yusnita
Nur Asti
PATIENT IDENTITY
Name : Musa HL
Gender : Male
Age : 46 years old
Marital Status : Married
Religion : Muslim
Address : Kel.Apeea Kec.Abuki
Kab.Konawe,Unaha
Job : -
Admission Date : 30
th
May 2014
Medical Record Number : 670163
History Taking
Anamnesis : autoanamnesis
Chief complaint : papule all over the body
Further Anamnesis :
papule all over the body, especially in the groin area,
accompanied by itching since 1 year ago. Initially the
papule appeared only in the groin area then appears
on the neck, head and then entire body. The itching
was perceived continuosly, especially at night.
Initially the papule was red then become blackish
spots.








Treatment history : had been treated by
hospital with scabimite, first it diminished but
then reappears.
Family History with the same complaint :
Family at home are also experiencing the same
complaints. Initially only daughter who lived in
the dorm, complained of itching all over the body
and then spreads to the other family.
History of allergy : -




History Taking
Current Status
Consciousness : Conscious (E4M6V5)
General Condition : Medium
Hygiene : Medium
Nutrition : Medium
Vital Sign
BP : 140.80mmHg
PR : 83x/minutes
RR : 24x/minutes
T : 36,9 C

Physical examination
Anemic (-), icterus (-), cyanoses (-)
Cor/ Pulmonal: S1 S2 normal, reguler,
Rh-/- Wh-/-
Abdomen: Normal, peristaltic (+)
Extremities: Edema (-)
Lymph nodes: Enlargement (-)

DERMATOLOGY STATUS
Location : Regio Generalisata
Efflorescence :Papule
hyperpigmented scale.
Location : Dorsum pedis dextra
Efflorescence :Lichenification,crust,
Papule hyperpigmented, scale
Before treatment
After treatment
Laboratory Result
RBC : 3,20 (10
6
/uL)
WBC : 6.34 (10
3
/uL)
HB : 8,9 (g/dL)
HCT : 29,3 (%)
PLT : 272 (10
3
/uL)
Ureum : 57 mg/dl
Creatine : 1,25 mg/dl
SGOT : 23 U/I
SGPT : 62 U/I



Resume
Patients 46 years complain there was
papule. papule all over the body,
especially in the groin area,
accompanied by itching since 1 year
ago. Initially the papule appeared only
in the groin area then appears on the
neck, head and then entire body.
The itching was perceived continuosly,
especially at night. Initially the papule was
red then become blackish spots.

Effects itching diminished but reappeared
later.
Family at home are also experiencing the
same complaints. Initially only daughter who
lived in the dorm, complained of itching all
over the body and then spreads to the other
family
DERMATOLOGY STATUS
Location : Regio Generalisata
Efflorescence :Papule
hyperpigmented scale.
Location :Dorsum pedis dextra
Efflorescence :Lichenification,crust,
Papule hyperpigmented, scale
DIAGNOSIS
- Skabies
DIFFERENTIAL DIAGNOSIS
- Prurigo
- Pedikulosis korporis
- Dermatitis

PROGNOSIS
- Dubia

R/ -Cetrizine 0-0-1
-as. Salisil 3%
-menthol 0,15
-LCD 3%
-Lanolin 10%
-Diflucortolone valerate 20gr
-Vaselin alb as 40 gr

DISCUSSION
Scabies is a skin infestation caused by
penetration of the human parasite Sarcoptes
scabiei var. hominis into the epidermis.
Many factors that support the development
of this disease, among others: the low
socioeconomic, poor hygiene, sexual
promiscuity that is its nature, fault diagnosis,
and the development and ecologic
dermografik
Crusted scabies (formerly called Norwegian
scabies) is found in individuals with
immunocompromised systems are
vulnerable (eg older people, people infected
with HIV, and transplant patients) and those
with decreased sensory functions (such as
patients with leprosy or paraplegia).
Skin disorders can be caused not only by
the scabies mite, but also by patients
themselves due to scratching. Itching is
caused by secretory and excretory
.sensitization against mites which takes
about a month after infestation. At the time
of skin disorders dermatitis resembles the
discovery of papules, vesicles, Urtica, and
others
Allergic reactions are sensitive to the mite
and its products showed an important role in
the development of the lesion and the onset
of itching. Allergic sensitivity to dust mites or
their products seem to play an important role
in determining the development of lesions in
addition to the tunnel, and itching
However, the immunological sequence of
events is unclear and requires further
explanation. Evidence suggests that both
immediate hypersensitivity and delayed type
involved.
The immunological processes that occur are
hypersensitivity reactions and increased
eosinophil IgE triggers that spurred rapid
type hypersensitivity reactions resulting in
itching and manifestations of skin disorders
dermatitis resembles the discovery of
papules, vesicles, utrika, etc.

- Scratching may arise erosion, eskoriasis,
crusting, and secondary infections.
- Clinical symptoms of nocturnal pruritus,
attack humans as a group, there is a tunnel
(kunikulus), and found mites.
- Eliminate the predisposing factors of this
disease can be eradicated and give a good
prognosis.
MANAGEMENT
Topical
1. Sulfur creep (Sulfur Presipitatum) of 4-20%
ointment or cream 3 times a day
2. Emulsion Benzyl-benzoas (20-25%) is given
every night three days
3. Gama Benzene Chloride Hex (1%) in a
cream or lotion is given only once
4. Krotamiton (10%) in a cream or lotion
5. Permethrin (5%) in the form of a cream given
only once

REFERENCE
Handoko, Ronny P. 2010. Ilmu Penyakit Kulit dan Kelamin.
Jakarta : FK UI. pp 122-125
Wolf, Goldsmith, Katz, Gilchrest, Paller, Leffel. 2010.
Fitzpatrick's Dermatology in General Medicine. Eighth
Edition. The McGraw-Hili Companies, United States of
America. pp 2029-2032
Bolognia, Jorizzo, Rapini. 2008. Dermatology 2nd ed.
Habif, Thomas P. 2004. Clinical Dermatology, 4th ed.
Mosby, Inc. pp 498-505
Burns DA. Diseases caused by arthropods and other noxious
animals. In: Rooks textbook of dermatology. 8
th
ed. United
kingdom. Willey-blackwell; 2010. p. 38.36 38.38.

Thank You