Itch

Ectoparasitic sexually transmitted diseases: scabies and pediculosis.
Orion E, Matz H, Wolf R.

Dermatology Unit, Kaplan Medical Center, Rechovot, Israel.

Scabies and pediculosis are diagnosed on an almost daily basis in many dermatology offices. Whether the patient seeks medical attention because of the often unbearable itch of scabies or because of the fear of lice infestations, the physician should be on the lookout for these ectoparasitic infestations. Secondary bacterial infection, resistance to medication, and the risk of spread of the infestations to family members and other close contacts may complicate the problem. Patients frequently have to battle the myths, prejudices, and even shame that are associated with such infestations.

PMID: 15596323 [PubMed - indexed for MEDLINE]

Atopic dermatitis: an overview for the nurse practitioner.
Mack S.

Mavena Derma Center, Des Plaines, Illinois, USA. susan_mack@comcast.net

PURPOSE: To provide the primary care provider (PCP) with a review of the clinical presentation, aggravating factors, and basic options for treatment of atopic dermatitis (AD). DATA SOURCES: Selected scientific literature and clinical experiences of the author. CONCLUSIONS: AD is a common, chronic skin condition that is frequently seen in both children and adults. Although AD can be challenging to treat, a number of therapeutic options exist to help alleviate the pruritus and rash that accompany the disorder. IMPLICATIONS FOR PRACTICE: The PCP can manage AD in most patients by prescribing avoidance measures, good skin care, antihistamines, and conservative topical medications. Patients with more severe disease may require aggressive therapies such as phototherapy, balneo-phototherapy, or systemic agents.

PMID: 15543922 [PubMed - indexed for MEDLINE]

Scabies: new future for a neglected disease.
Walton SF, Holt DC, Currie BJ, Kemp DJ.

Menzies School of Health Research, Australia and Charles Darwin University, Darwin, Australia.

Scabies is a disease of global proportions in both human and animal populations, resulting from infestation of the skin with the "itch" mite Sarcoptes scabiei. Despite the availability of effective chemotherapy the intensely itching lesions engender significant morbidity primarily due to secondary sepsis and post-infective complications. Some patients experience an extreme form of the disease, crusted scabies, in which many hundreds of mites may infest the skin causin severe crusting and hyperkeratosis. Overcrowded living conditions and poverty have been identified as significant confounding factors in transmission of the mite in humans. Control is hindered by difficulties with diagnosis, the cost of treatment, evidence for emerging resistance and lack of effective vaccines. Historically research on scabies has been extremely limited because of the difficulty in obtaining sufficient quantities of the organism. Recent molecular approaches have enabled considerable advances in the study of population genetics and transmission dynamics of S. scabiei. However, the most exciting and promising development is the potential exploitation of newly available data from S. scabiei cDNA libraries and EST projects. Ultimately this knowledge may aid early identification of disease, novel forms of chemotherapy, vaccine development and new treatment possibilities for this important but neglected parasite.

PMID: 15504541 [PubMed - indexed for MEDLINE]

Insect bite-like reaction associated with mantle cell lymphoma: a report of two cases and review of the literature.
Dodiuk-Gad RP, Dann EJ, Bergman R.

Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

BACKGROUND: An insect bite-like reaction and exaggerated reactions to insect bites are nonspecific phenomena described primarily in association with chronic lymphocytic leukemia (CLL), but also with other hematological malignancies. Two cases of mantle cell lymphoma (MCL), one associated with an insect bite-like reaction and the other with a true hypersensitivity to mosquito bites, have previously been reported in the English language literature. The pathogenesis of the skin eruption may be related to the release of different cytokines that also trigger an IgE elevation and dermal eosinophils. CASE REPORT: We describe two additional cases of MCL associated with an insect bite-like reaction. One patient had been diagnosed with MCL 4.5 years prior to the appearance of the skin eruption, and in the other patient the skin symptoms preceded the diagnosis of the MCL by 2 years and led to its diagnosis. CONCLUSIONS: Insect bite-like reaction may appear in patients with MCL. It is important to recognize this entity because it may be the presenting sign of MCL.

PMID: 15485536 [PubMed - indexed for MEDLINE]

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