La Escabiosis Prurito en el Trópico La Gran Imitadora.pptx

7/29/2019 La Escabiosis Prurito en el Trpico La Gran Imitadora.pptx

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Diagnstico Diferencial del Prurito ,

Mecanismos

Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022, 8882-551308/02/2013

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New !

Anotaciones clnicas sobre la Gran Imitadora .


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Anotaciones Clnicas para nuestrosMdicos de Atencin Primaria y

especialistas.La Gran Imitadora La Escabiosis.

Entomologa Mdica, Taxonoma ,especies de Nicaragua.

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Demasiadas lesiones sondiagnosticadas erroneamente

atribuidas a la ectoparasitosis

Ver piel seca del anciano

Dermatitis atpica del nio.


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http://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theater


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Pruritus and SystemicDisease

Brachioradial Pruritus

DermatologicManifestations ofScabies

Atopic Dermatitis News&

Pruritus: Overview ofmanagement

European Dermatology

ForumguidelineChronic PruritusManagement.

Current Opinion in

Allergy and ClinicalImmunology Sept 2011

Pathophysiology of Itch and New Treatments UlrikeRaap; Sonja Stnder; Martin Metz


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http://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1355312-overviewhttp://emedicine.medscape.com/article/1109204-overviewhttp://emedicine.medscape.com/article/1109204-overviewhttp://emedicine.medscape.com/article/1109204-overviewhttp://www.medscape.com/resource/atopicdermhttp://www.medscape.com/resource/atopicdermhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.medscape.com/index/list_4760_0http://www.medscape.com/index/list_4760_0http://www.medscape.com/index/list_4760_0http://www.medscape.com/index/list_4760_0http://www.medscape.com/index/list_4760_0http://www.medscape.com/index/list_4760_0http://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.box.com/s/j179xh5p49ql7zqkn8tyhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.uptodate.com/contents/pruritus-overview-of-managementhttp://www.medscape.com/resource/atopicdermhttp://www.medscape.com/resource/atopicdermhttp://www.medscape.com/resource/atopicdermhttp://emedicine.medscape.com/article/1109204-overviewhttp://emedicine.medscape.com/article/1109204-overviewhttp://emedicine.medscape.com/article/1109204-overviewhttp://emedicine.medscape.com/article/1355312-overviewhttp://emedicine.medscape.com/article/1355312-overviewhttp://emedicine.medscape.com/article/1355312-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overviewhttp://emedicine.medscape.com/article/1098029-overview


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La frecuencia en eltrpico de escabiosis

es alta no debemossobre diagnosticarlahaciendo un correctodiagnsticodiferencial

Recordemos laepidemiologia ,busquemosatentamente lasignologa

Usemos lasherramientas deauxilio para eldiagnstico: lupa ymicroscopio


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Erradicamos la

ectoparasitosis

Pero el pruritopersiste

Ver eczema y lasobreinfeccin

Comomanejamos el

contagio visual


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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


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http://es.wikipedia.org/wiki/Reino_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Animaliahttp://es.wikipedia.org/wiki/Filohttp://es.wikipedia.org/wiki/Arthropodahttp://es.wikipedia.org/wiki/Cheliceratahttp://es.wikipedia.org/wiki/Clase_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Arachnidahttp://es.wikipedia.org/wiki/Acarinahttp://es.wikipedia.org/wiki/Acariformeshttp://es.wikipedia.org/wiki/Orden_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Orden_(biolog%C3%ADa)http://es.wikipedia.org/w/index.php?title=Astigmata&action=edit&redlink=1http://es.wikipedia.org/w/index.php?title=Psoroptidia&action=edit&redlink=1http://es.wikipedia.org/w/index.php?title=Sarcoptoidea&action=edit&redlink=1http://es.wikipedia.org/wiki/Familia_(biolog%C3%ADa)http://es.wikipedia.org/w/index.php?title=Sarcoptidae&action=edit&redlink=1http://es.wikipedia.org/wiki/G%C3%A9nero_(biolog%C3%ADa)http://es.wikipedia.org/w/index.php?title=Sarcoptes&action=edit&redlink=1http://es.wikipedia.org/wiki/Especiehttp://es.wikipedia.org/wiki/Especiehttp://es.wikipedia.org/w/index.php?title=Sarcoptes&action=edit&redlink=1http://es.wikipedia.org/wiki/G%C3%A9nero_(biolog%C3%ADa)http://es.wikipedia.org/w/index.php?title=Sarcoptidae&action=edit&redlink=1http://es.wikipedia.org/wiki/Familia_(biolog%C3%ADa)http://es.wikipedia.org/w/index.php?title=Sarcoptoidea&action=edit&redlink=1http://es.wikipedia.org/w/index.php?title=Psoroptidia&action=edit&redlink=1http://es.wikipedia.org/w/index.php?title=Astigmata&action=edit&redlink=1http://es.wikipedia.org/wiki/Orden_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Orden_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Acariformeshttp://es.wikipedia.org/wiki/Acarinahttp://es.wikipedia.org/wiki/Arachnidahttp://es.wikipedia.org/wiki/Clase_(biolog%C3%ADa)http://es.wikipedia.org/wiki/Cheliceratahttp://es.wikipedia.org/wiki/Arthropodahttp://es.wikipedia.org/wiki/Filohttp://es.wikipedia.org/wiki/Animaliahttp://es.wikipedia.org/wiki/Reino_(biolog%C3%ADa)


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Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022,8882-5513


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Del griego

Sarx ( ) carne

Koptiein , cortar

Latn

Scabererascar..


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Escarificacin de un surco 400X


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Acariformes

Prostigmados

Mesostigmados

Astigmados

Enfermedad:Sarna

Sarcoptes spp.


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Artropodos, araas, acaros, sarcoptes,

Todos tienen ocho patas

Los insectos tiene seis patas inclusolas cinches de cama , bed bugs

Cimex lectularius esteproblema ser tratado en otra charlavista las epidemias que enfrentamos


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CICLO TIPO DE SARCOPTES


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CICLO TIPO DE SARCOPTES


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Comentarios de relevancia

Entomologa mdica y Veterinaria

Demos la palabra al Entomlogo

Jean Michel Maes


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JeanMichelMaes

Museoentomolgicode Len.

08/02/2013 19Clnica de Asma y Alergia, Managua, Nicaragua. Tel 22781169,22703359, 88825513,

8946 5022
http://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.htmlhttp://www.bio-nica.info/topic/index.html


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Sarcoptes

scabiei

J-M. MaesClase Acaridaen PDF

FAMILIA

SARCOPTIDAE Acaros causantes de

sarna de humanos yanimales

domsticos. Sarcoptes scabiei ssp.

hominis.

Sarcoptes scabieissp. hominis. sarnahumana.

08/02/2013Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022, 8882-5513 20
http://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfjhttp://www.box.com/s/vc06874op4sgvve7vhfj


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Especies fisiolgicas Comunmente asumimos que si

nuestros perros tienen sarna y uno denuestros familiares presenta una lesineczematosa damos de manera casirefleja tratamiento, a nuestrospacientes.

Usamos tpicos como el benzoato debencilo y hoy se difunde el uso deivermectina por va oral ( Caalox) , enhumanos


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Most of the contributors accept pruritus and itch to besynonymous. Following the International Forum on the Studyof Itch (IFSI). Vlida 2011

Pruritus / itch is a sensation that provokes the desire to

scratch.

Sensacin que provoca

el deseo de rascarse.


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Lectio magistralis J.C Ivancevich
http://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theaterhttp://www.facebook.com/photo.php?fbid=300805989942759&set=a.241104292579596.57878.240944549262237&type=3&theater


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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 PyschogenicExcoriation

2Descriptor and Affective Scales ofYosipovitch et al for a Patient with Pruritis

3Emotional Descriptors from theEppendorf Itch Questionnaire

4Modified Sleep Impact Scale ofYosipovitch et al for a Patient with Pruritis

5Paraneoplastic Pruritus08/02/2013

Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022,8882-5513 29
http://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.05.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.05.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.05.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.04.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.02.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.03.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspxhttp://www.medal.org/visitor/www/ch21/ch21.34/ch21.34.01.aspx


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En la atencin primaria , centros de saludrurales y urbanos que atienden poblacinpobre es muy frecuente la escabiosis

Muchas veces se presentaeczematizada

En nuestro pas se sobre diagnstica

Se confunde con lesiones eczematosas ,xerticas pruriginosas, lesiones secundariasal grattage sistematique


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Imitador clnico sus manifestacionesimitan cualquier lesin dermatolgica

Prurito persistente La picazn de los 7 aos

Nios

Adultos sexualmente activos( genitalesmasculinos , arolas femeninas

Inmunocomprometidos, leprososEscabiosis costrosas


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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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Primo-infestacin

Recada- reinfestacin.

Hipersensibilidad retardada al caro,heces , huevos ( prurito)pocas

horas despus..


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Lesiones primarias

Ppulas

Vescculas

Surcos

Lesiones secundarias

Resultado del

rascado, delpellizcamiento,

Impetigo

Eczema


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Ppula vesccula, punto negro

Labiosmayoresppulas


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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 msfina, 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 depositarsus huevos mueren en el surco.

Su tumba se le conoce como,la eminencia acariana.


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Papules rarelycontain mites andmost likely represent

a hypersensitivityreaction. Papulesare common on theshaft of the penis in

men and on theareolae in women.


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Erythematous papules andpapulovesicles on the flexor wrist.Courtesy of Kenneth E. Greer, MD.


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Scabietic papules on the penile shaftand scrotum. Courtesy of Kenneth E.Greer, MD.


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Unlike adults, whorarely present withfacial and neckinvolvement, this

presentation is fairlytypical in children.

In very young childrenand infants, awidespread

eczematous eruptionprimarily on the trunk iscommon.


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In neonates unable toscratch, pinkish-brownnodules may develop

and range in size from2-20 mm.

Mites are rarely foundwithin the nodules.Infants may have 1 to

3-mm papules,vesicles, and pustuleson the palms andsoles.


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Nodular scabies.Courtesy of KennethE. Greer, MD


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Rascado einfeccionessecundarias.

Respuesta inmunea l caro, heces.

Reacciones dehipersensibilidadTipo IV

Hallazgos

Excoriaciones,

Crostas melicricas,Hiperpigmentacinpostinflamatoria,Eritrodermia,

Prurigo nodularis

Pioderma.


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Diagnosticodiferencial..

Picaduras de insectos.

Eczema.

Dermatitis porcontacto

Eczematizacin:rascado, provocavescula con erosin ycostra.

Impetiginizacin:

Stafiloccus aureus y elStreptococo

pyogenes :pstulasmielicricas y crostas.

Lesiones por grattagesistemtico.


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Impetigo

Ayuda del

microscopio

Buscar lesionestpicas


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Impetigo ( impetere)

Staphylococcusaureus

StreptocccusGABHS(pyogenes)


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Surco

Colorear tintachina

Azul de metileno

Algunosmarcadores


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Busque laeminencia acarina..

Microscopio Huevos , ninfas, en

foliculos pilferos


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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 RenalDisease Dyshidrotic Eczema

Eosinophilic PustularFolliculitis

Erythroderma (Generalized

Exfoliative Dermatitis) Folliculitis Gianotti-Crosti Syndrome

(Papular Acrodermatitis ofChildhood)

Id Reaction

(Autoeczematization) Insect Bites


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09935-overviewhttp://emedicine.medscape.com/article/1109935-overviewhttp://emedicine.medscape.com/article/1109935-overview


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Kyrle Disease

Lice

Lichen Planus

NeuroticExcoriations

Papular Urticaria

Parapsoriasis Prurigo Nodularis

Psoriasis, Guttate

Psoriasis, Pustular Seabather's Eruption

Syphilis

Urticaria, Cholinergic

VesicularPalmoplantar Eczema


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Microscopia

Aplicar aceitemineral a la lesin

Raspar

Montar laminaKOH 10% ,

examinar con lentesde bajo aumento

Alta especificidad

Poca sensibilidad,

Pequeo nmerode caros sobretodo si ya hubo

rascado


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Dermatoscopa

Patologa, noepecfica

PCR

Test intradrmicos

Deteccin deanticuerpos

S. scabiei genes

Ver notas

exmenes noprcticos

IgE y eosinofiliafrecuentes


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Toma de muestraspiel Raspado( Scrapping)

Lamina, aceitemineral una gota

Agregar KOH 10%para removerkeratina en exceso

Cubre objeto

X 40

Test de la tinta, paradelinear los surcos

Tetracycline ylmpara de wood


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In routine scabies, asingle mite is seen.Eosinophilic spongiosismay be present(hematoxylin and

eosin; originalmagnification, 400X).

In crusted scabies,sections show multiple

mites within thehyperkeratotic stratumcorneum. Theepidermis is spongiotic.

08/02/2013Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022,8882-5513 66


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Scabies mite in the stratum corneum.Courtesy of William D. James, MD.


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(Lyclear, Elimite) Scabisan

Permethrin 5% cream is thedrug of choice, especiallyfor infants >2 mo and smallchildren.

More effective thancrotamiton in treatingsymptoms and reducingchances of secondarybacterial infection. Evenafter successful treatment,postscabietic nodules and

pruritus may persist formonths.

View full drug information

Lindane (Kwell)Hexaclorociclohexano.

In 1% lotion or cream. Stimulatesnervous system of parasite,

causing seizures and death.Previously standard treatmentfor scabies, but now consideredsecond line, to be used if otheragents fail or are not tolerated.

Not very safe in children orneonates because oftranscutaneous absorption

leading to neurotoxicity. Overall,permethrin is a safer choice.

Precipitated sulfur in petrolatumIn 6% concentration.

View full drug information

http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/lindane-topical-343501http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503http://reference.medscape.com/drug/nix-elimite-permethrin-topical-343503


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View full druginformation

Crotamiton (Eurax)

A 10% cream or lotionfor treatment ofscabies. Mechanism of

action unknown.

View full druginformation

Ivermectin (Stromectol)

Binds selectively withglutamate-gatedchloride ion channelsin invertebrate nerveand muscle cells,causing cell death.Half-life is 16 h;metabolized in liver.

Available in 3- and 6-mg tab.

http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/stromectol-ivermectin-342657http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500http://reference.medscape.com/drug/eurax-crotamiton-topical-343500


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Gracias ! A todos los especialistas que

enriqueceran el debate,corregiran

los errores. Por ltimo no menos importantes ,

gracias!, a los que formularn, laspreguntas sencillas , que muchasveces no respondemos , estasincentivan nuestra investigacin.



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Managua , Nicaragua

Email:[email protected]

Tel2278 1169 , 2270-3359

8846-50228882-5513

Dr. Juan Herrera Salazar Tel 2278-1169, 2270-3359, 8946-5022,8882-551308/02/2013 72
mailto:[email protected]:[email protected]


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La Escabiosis Prurito en el Trópico La Gran Imitadora.pptx

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