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12 Cards in this Set

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What are other names for 'head lice', and what causes it?

Pediculosis capitis or 'nits'




Common condition in children caused by the parasitic insect Pediculus capitis

How is head lice diagnosed?

Fine-tooth combing of wet or dry hair

Management of head lice?

Only treat with medication if live lice are found.




Choices include malathion, wet combing, dimeticone, isopropyl myristate and cyclomethicone

Children with head lice should be excluded from school until treatment has started.




True or false?

False. School exclusion is not advised for children with head lice.

What is scabies caused by, and why is it itchy?

Sarcoptes scabiei - the scabies mite burrows into the skin, laying its eggs in the stratum corneum. The intense pruritis is due to a delayed type IV hypersensitivity reaction to mites/eggs which occurs 30 days after the initial infection.

Features of scabies?

Widespread pruritus


Linear burrows on the side of fingers, interdigital webs and flexor aspects of the wrist


In infants the face and scalp may also be affected


Secondary features are seen due to scratching: excoriation, infection

Management of scabies?

Permethrin 5% is first-line


Malathion 0.5% is second-line


Give appropriate guidance on use - apply to dry, cool skin, entire body with special attention to between fingers and toes, under nails, armpits, skin creases. Allow to dry and leave on for 8-12hrs if permethrin, (malathion for 24h) before washing off. Repeat 7 days later. All close contacts / housemates should be treated too. Wash all laundry, bedsheets etc on first day of treatment.

A 25 year old man has come back to see you, 4 weeks after treatment for scabies - he is still very itchy. Does he need retreating?

No, pruritis is common 4-6 weeks post-eradication of scabies.

In what circumstance would you see crusted (Norwiegen) scabies?


How should it be treated?

Crusted scabies is seen in the immunosuppressed, especially HIV.


Ivermectin is the treatment of choice, and isolation is essential.

A 3-year-old girl is taken to the GP due to a rash on her upper arm. On examination multiple raised lesions of about 2 mm in diameter are seen. On close inspection a central dimple is present in the majority of lesions.


What is the likely diagnosis?

Molluscum contagiosum - common skin infection caused by molluscum contagiosum virus (MCV)


Highly infectious

Describe molluscum contagiosum?

Pinkish or pearly white papules with a central umbilication, which are up to 5 mm in diameter. Lesions appear in clusters in areas anywhere on the body (except the palms of the hands and the soles of the feet).


Spontaneous resolution usually occurs within 18 months. Treatment not usually recommended.

When may referral be required in a case of molluscum contagiosum?

If extensive lesions and HIV +ve.


If associated eye/eye-lid lesions refer to opthalmology.


If ano-genital refer to sexual health.