1 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 2Department of Pediatrics, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract: Scabies, caused by the Sarcoptes scabiei var. hominis mite, is a common and highly contagious skin infestation that manifests with symptoms of intense itching and a generalized pruritic papular eruption. Crusted scabies, a severe form of the infestation, is more commonly seen in immunocompromised individuals. Scabies can affect individuals of all ages and is typically transmitted through close and prolonged skin-to-skin contact. Diagnosis relies heavily on clinical examination, with scabies preparation at multiple sites guided by dermoscopy. Management involves both treating the condition and preventing its spread to others, with the primary treatment being the application of topical scabicide medications to the entire body. Environmental decontamination measures are crucial in controlling the spread of scabies. Prompt diagnosis and treatment are essential to prevent complications and transmission to others.
A large range of prevalence exists with scabies and scabies is not reportable in Canada. It disproportionately affects individuals living in poverty and crowded conditions.
A definitive diagnosis of scabies can be made through visualization through microscopy of skin scrapings and tape samples or through dermoscopy.
Treatment of patients and close contacts and environmental measures must be taken to prevent further spread and infestation.
In scabies infestation, the female mite burrows under the skin and triggers a hypersensitivity reaction with symptoms of pruritus and inflammation.
Classic scabies is more common, while crusted scabies is rarer and more severe.
First-line treatment is topical 5% permethrin cream head to toe including the scalp in infants and young children and from the neck down in adults with retreatment in one week.
Environmental decontamination is important to preventing reinfestation.
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Common Skin Conditions among Older Adults in Long-Term Care
Teaser:
Foy White-Chu, MD, Geriatric Fellow, Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA. Madhuri Reddy, MD, MSc, Department of Medicine, Director of the Chronic Wound Healing Program, Hebrew Rehabilitation Center; Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA; Director, Wound Healing Clinic, Lahey Clinic, Burlington, MA, USA.
The skin of older adults undergoes intrinsic aging and is susceptible to multiple ailments. Both comorbidities and environmental issues increase the risk for particular skin diseases among older adults who live in long-term care facilities. This article looks at four common skin conditions frequently found among older adults living in long-term care facilities, and reviews methods of treatment and prevention. Key words: skin, wound, skin tear, scabies, incontinence dermatitis.
Chamandeep Thind, MRCP, Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK. Simone Laube, MD MRCP, Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Skin and soft tissue infections are an important cause of morbidity and mortality in older adults. Decreased immunity, changes in skin anatomy, and comorbidities contribute to an increased susceptibility to infections. Methicillin-resistant Staphylococcus aureus is an increasingly common problem in both the community as well as hospitals. Clinical features and management of some common skin infections encountered in this population are reviewed here. Local microbiological guidelines and drug susceptibilities should be taken into account in the treatment. Key words: bacterial skin infections, cellulitis, MRSA, fungal infection, scabies.
