DEPARTEMENT OF DERMATOVETENEOROLOGY REFERAT

FACULTY OF MEDICINE AUGUST 2018

HASANUDDIN UNIVERSITY

MANAGEMENT AND EDUCATION OF SCABIES

Hasryani Haluddin C014172140
Selfiana Lani C111 13 702
A. Muhammad fadhil Wardihan C111 12 258
A. Muh. Roem Ashari C014172075

Supervisor : Resident :
dr. Asnawi Madjid, Sp.KK(K), MARS, FINSDV, FAADV dr. A. Nurhaerani Z
DEFINITION
• Scabies is a skin disease caused by the investment and sensitization
of arachnid mite Sarcoptes scabiei variant hominis and its products

Ronny PH. Skabies. Dalam: Adhi D, Mochtar H, Siti A, Editor. Ilmu Penyakit Kulit dan Kelamin Edisi Keenam. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia. 2010; hlm. 122-125.
ETIOLOGY
Sarcoptes scabiei include by filum of arthopoda, class of
arachnida, ordo of ackarima and big family of sarcoptes. In human we
called Sarcoptes scabiei var hominis.
RISK FACTOR
1. Poverty
2. Young children and Elderly
3. Immunocompromised Individuals
4. Malnutrition
5. Institution with the large capacity such as orphanage, islamic cottage,
nursing house and prison
6. Poor hygiene
PATHOPHYSIOLOGY
The most common source of transmission of scabies is prolonged
skin-to-skin contact with an infested individual. It takes 15–20 min of
close contact for successful direct transmission.
There also indirect transmission, for examlpe, sharing bed, towel,
blanket, etc
PATHOPHYSIOLOGY
Life Cycle
PATHOPHYSIOLOGY
The incubation period before symptoms develop can range from days to
months. In first-time infestations, it usually takes 2–6 weeks before the host’s immune
system becomes sensitized to the mite or its by-products, resulting in pruritus and
cutaneous lesions. In contrast, a subsequent infestation often becomes symptomatic
within 24–48 hours. The skin findings are the result of reactions to the mites, their
saliva, eggs, and excrements. Findings include papules and pruritus caused by
delayed type IV hypersensitivity reaction.
CLINICAL FINDING
Predilection Area
CLINICAL FINDING
4 cardinal sign of Scabies infestation :
1. Nocturnal pruritus
2. Attack group of people
3. Burrows
4. Finding mites in the skin
CLINICAL FINDING
CLINICAL FINDING
Variant Scabies
1. Nodular Scabies
Extremely pruritic nodules 2–20 mm
in size are present on the genitalia,
buttocks, groin, and axillary regions.
Nodules are reddish to brown, and
because they do not contain mites, they
are thought to be secondary to intense
hypersensitivity reactions to mite products
CLINICAL FINDING
2. Norwegia Scabies ( Crusted Scabies)
Have thousands of mites on their
skin surface, and live mites can be
recovered in debris from sheets, Scabies
mites usually live 3 days or fewer off a
human host, but those from patients with
crusted scabies may live up to 7 days
by feeding on sloughed skin.
SUPPORTING EXAMINATION
• Skin scarping • Biopsy H.E staining
SUPPORTING EXAMINATION
• Dermoscopy • Burrow ink test
DIAGNOSIS
• Diagnosis of scabies is made by anamnese, physical examination, and
supporting examination (such as skin scarping, epidermal shave biopsy,
biopsy H.E staining, dermoscopy, burrow ink test).
• The diagnosis can be made when two over four cardinal signs are
found.
• The diagnosis of scabies should be confirmed by identifying the mite,
or mite eggs, or nymph, or scybala from scrapings of infested skin or
by identifying the mite burrows
DIFFERENTIAL DIAGNOSIS

Prurigo Pediculosis corporis

TREATMENT
TREATMENT

Salavastru C.M. et all. 2017. European Guideline for the Management of Scabies. European Academy of Dermatology and Venereology. 1248-1253.
COMPLICATION
• Secondary Impetiginization
• Post Streptococcal Glomerulonephritis
• Lymphangitis
• Septicemia
• Bullous pemphigoid
PROGNOSIS
Dubia et Bonam
PREVENTION
• Personal Hygiene Change
• Adhering to a clean and healthy lifestyle
• All family members and close contacts should be treated
simultaneously.
THANK YOU