The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

First record of ectoparasites (Phthiraptera and Acari) from the Andean condor (Vultur gryphus) in Colombia.

Several species of ectoparasites, including chewing lice and mites are closely associated with their hosts. The Andean condor (Vultur gryphus) is globally listed as vulnerable by the IUCN and its population has been steadily declining in recent decades suggesting a potential extinction of associated entomofauna. The purpose of this study was to record the species of ectoparasites infesting three individuals of Andean condor found dead in the 'Páramo del Almorzadero' Santander Department, Northeastern Colombia. One juvenile (male) and two adults (male and female) Andean condors received for necropsy were carefully examined for ectoparasite infestation. Specimens were collected and preserved in ethanol (70%) for taxonomic studies. Morphologic identification and morphometric records were made under light microscopy. Some specimens were also prepared for scanning electron microscopy and others were subjected to DNA extraction to amplify and obtain sequences of the cytochrome-C oxidase subunit I (COI) gene for phylogenetic analyses. Lice were collected from the juvenile condor and the adult female and identified as Falcolipeurus assesor (Phthiraptera: Ischnocera) in the juvenile condor (8 females, 19 males and 8 nymphs) and the adult (1 female); Colpocephalum trichosum (Phthiraptera: Amblycera) in the juvenile (19 females, 24 males and 1 nymph) and the adult (2 females, 2 males and 3 nymphs); and Cuculiphilus zonatus (Phthiraptera: Amblycera) in the juvenile (40 females, 43 males and 15 nymphs) and the adult (1 male and 2 nymphs). Moreover, one mite collected from the juvenile condor was identified as Ancyralges cathartinus (Acari: Astigmata) (1 female). Morphometric data was obtained for the adult stages of F. assesor (6 females and 13 males), C. trichosum (9 females and 9 males) and C. zonatus (10 females and 10 males). We obtained the first DNA sequences of COI for F. assessor, and C. trichosum, where phylogenetic tree analysis showed that F. assessor is more closely related to Falcolipeurus marginalis, and C. trichosum to Colpocephalum kelloggi. This represents the first record of parasites in Andean condor from Colombia and contributes to the knowledge of chewing lice and mites associated with an endemic and endangered bird species. Further studies on Andean condor ectoparasites should be focused on documenting host-parasite interactions and potential health impacts in these wild birds.

Varias especies de ectoparásitos, incluidos piojos masticadores y ácaros están estrechamente asociados a sus hospedadores. El cóndor andino (Vultur gryphus) está catalogado por la UICN como una especie vulnerable y su población ha ido disminuyendo constantemente en las últimas décadas, lo que sugiere una posible extinción de la entomofauna asociada. El propósito de este estudio fue registrar las especies de ectoparásitos infestando a tres individuos de cóndor andino encontrados muertos en el Páramo del Almorzadero, Departamento de Santander, Noreste de Colombia. Un cóndor andino juvenil (macho) y dos adultos (macho y hembra) recibidos para necropsia fueron examinados cuidadosamente para detectar infestación por ectoparásitos. Los especímenes fueron recolectados y preservados en etanol (70%) para estudios taxonómicos. La identificación morfológica y los registros morfométricos se ejecutaron bajo microscopía óptica. Algunas muestras también se prepararon para microscopía electrónica de barrido y otras se sometieron a extracción de ADN para amplificar y obtener secuencias del gen de la subunidad I (COI) del citocromo­C oxidasa para análisis filogenéticos. Los piojos recolectados del cóndor juvenil y de la hembra adulta se identificaron como Falcolipeurus assesor (Phthiraptera: Ischnocera) en el cóndor juvenil (8 hembras, 19 machos y 8 ninfas) y en el adulto (1 hembra); Colpocephalum trichosum (Phthiraptera: Amblycera) en el juvenil (19 hembras, 24 machos y 1 ninfa) y en el adulto (2 hembras, 2 machos y 3 ninfas); y Cuculiphilus zonatus (Phthiraptera: Amblycera) en el juvenil (40 hembras, 43 machos y 15 ninfas) y en el adulto (1 macho y 2 ninfas). Además, un ácaro recolectado del cóndor juvenil fue identificado como Ancyralges cathartinus (Acari: Astigmata) (1 hembra). Se obtuvieron datos morfométricos para los estadios adultos de F. assesor (6 hembras y 13 machos), C. trichosum (9 hembras y 9 machos) y C. zonatus (10 hembras y 10 machos). Secuencias de ADN basadas en COI para las especies F. assesor y C. trichosum son reportadas por la primera vez, donde el análisis filogenetico mostró que F. assesor está más estrechamente relacionado con Falcolipeurus marginalis y C. trichosum con Colpocephalum kelloggi. Este representa el primer registro de parásitos en cóndor andino de Colombia y contribuye al conocimiento de los piojos masticadores y ácaros asociados a una especie de ave endémica de los Andes y en peligro de extinción. Otros estudios sobre los ectoparásitos del cóndor andino deberían centrarse en documentar las interacciones hospedador­parásito y los posibles impactos en la salud de estas aves silvestres.

An update on Epstein-Barr virus-and human T-lymphotropic virus type-1-induced cutaneous manifestations. CME Part II.

The Epstein-Barr virus (EBV) is a DNA virus that infects 90% of the human population, is responsible for certain cutaneous lymphomas (extranodal NK/T-cell lymhoma, hydroa vacciniforme lymphoproliferative disorder, lymphomatoid granulomatosis, others), and can be associated with a variety of cutaneous manifestations (eg, infectious mononucleosis, severe mosquito bite allergy, chronic active EBV disease, Gianotti-Crosti syndrome). EBV-related skin disorders are frequent in certain populations (South and Cental America, Africa, Asia, and Oceania) and can be diagnostically challenging. The human T-lymphotropic virus type-1 is a retrovirus, which is known to be associated with adult T-cell leukemia/lymphoma, neurologic disorders, but also cutaneous non-neoplastic manifestations (infective dermatitis, infections, and infestations). We performed an updated revision of the clinical dermatologic and histopathologic findings associated with the cutaneous non-neoplastic and preneoplastic disorders occurring in association with the EBV and human T-lymphotropic virus type-1.

Delusions of parasitosis and delusions of parasitosis by proxy in a mother and her children.

Delusions of parasitosis by proxy is an uncommon entity wherein an individual projects a delusional belief onto another person who lacks capacity to hold the same belief. We report a case of delusions of parasitosis by proxy in a mother who believed that she was infested with scabies and projected her fixed, delusional belief of scabies infestation onto her children. She subjected her children to numerous home remedies and medical treatments as well as removing them from school in an effort to cure them of the supposed infestation. Child maltreatment can be a concern in such cases with a low threshold for involving child protective services if harm to the children is suspected.

Disseminated cysticercosis with multi-system involvement in a child.

We report a rare case of disseminated cysticercosis in a 7-year-old Indian girl with recent onset seizures treated with antiepileptics for 2 months. When she presented to dermatology clinic, she had multifocal subcutaneous and submucosal nodules. The subsequent diagnostic workup revealed extensive neurocysticercosis as well as orbital and myocysticercosis.

Comparison of sulfur ointment and permethrin treatments in scabies.

Scabies is a contagious, parasitic skin disease that adversely affects the quality of life and, can cause systemic complications if it is not properly treated. Sulfur ointment and permethrin cream are among the most used topical agents in the treatment of scabies. In this study, we aimed to compare the efficacy of sulfur ointment and permethrin cream in the treatment of scabies. In this single-center study, patients who were diagnosed with scabies in the dermatology outpatient clinics of Karabuk University Training and Research Hospital between April, 2021 and September, 2021 were investigated retrospectively. Age, gender, date of diagnosis, topical agent used for scabies treatment, and response to the treatment at the control examination in the second week were recorded. The patients were divided into two groups those receiving 5% permethrin cream or 10% sulfur ointment, and the treatment efficacy of both agents was compared. This study showed that 10% sulfur ointment was significantly more effective in treating scabies than 5% permethrin cream (p < 0.001). Moreover, younger patients with scabies responded better to both treatments. 10% Sulfur ointment can be considered a safe and effective topical option in the treatment of scabies. The resistance to 5% permethrin cream, which is the most commonly used agent for scabies, can be a concern as an unexpected low success rate was obtained in this study.

Dual treatment of cutaneous leishmaniasis with topical amphotericin B and photodynamic therapy in a pediatric patient.

Cutaneous leishmaniasis is a parasitic infection that can result in scarring, contributing to significant morbidity when a cosmetically sensitive area is involved. We report a case of a 13-year-old boy with cutaneous leishmaniasis involving the face and arm. He was treated with a combination of photodynamic therapy as well as topical amphotericin with a cosmetically satisfying outcome. This combination of noninvasive treatment regimens has not been reported to our knowledge and merits further study in the pediatric population.

Laboratory life cycle of Ornithodoros puertoricensis (Ixodida: Argasidae) collected in the Colombian Caribbean.

Three studies on the biology of Ornithodoros puertoricensis are available in the literature, using different hosts and incubation temperatures. In a previous study, we identified O. puertoricensis in the Colombian Caribbean. The aim of the present work was to analyze life cycle data along one generation from these specimens under laboratory conditions. Eggs of O. puertoricensis were collected in between fragments of bahareque material in a rural dwelling in the municipality of Planeta Rica (Córdoba Department, Colombia), and transported to the laboratory. All post-egg stages (i.e., larvae, nymphs, and adults) were incubated at 27 °C and 85% RH and fed on laboratory mice (Mus musculus). Sixteen engorged larvae were obtained to start a laboratory colony. Average feeding period for larvae was 4.6 days (4-5). The first nymphal instar (N1) did not require feeding and the subsequent nymphal stages (N2, N3, and N4) and adults had feeding periods ranging from 55 to 75 min. Average pre-molting period in nymphs was 15 days (10-21). Most of the N3 molted to males and all N4 molted to females. Two gonotrophic cycles were recorded: the first had a preoviposition period of 12 days (7-18) and produced 190 eggs (171-223), the second lasted 6.6 days (6-7) and produced 146 eggs (104-201). The mean life cycle duration (from parental eggs to F1 eggs) was 70.7 days (58.7-82.7) without fasting periods. The collected data agree with previous studies even with differences in hosts and maintenance conditions.

Treatment practices in the management of scabies in infants younger than two months.

BACKGROUND/OBJECTIVES: Efficacy and safety data of scabies treatments in infants are limited. Although topical permethrin is used in the treatment of scabies in adults, it is not approved for use in infants younger than 2 months of age in many parts of the world. This study aimed to describe treatment practices in the management of scabies in infants younger than 2 months. METHODS: An online survey was developed and distributed to physicians worldwide through the Society of Pediatric Dermatology and the Pediatric Dermatology Research Alliance. Data collected included demographics, medication availability, experience using medications, deterrents to medication use, medication administration preferences, perceived and experienced medication side effects, and preferred treatment agent in this population. RESULTS: In total, 57 physicians from seven countries responded. The majority of respondents were board-certified in pediatric dermatology (48/57, 84.2%) and resided in the United States (44/57, 77.2%). Respondents had experience using permethrin (47/57, 82.5%) and precipitated sulfur (35/57, 61.4%) most frequently. Most (38/57, 66.7%) preferred permethrin as their treatment of choice. Among those who did not use permethrin, potential side effects (8/10, 80%) were most frequently reported as a deterrent from its use. However, only 4.3% (22/47) of those who used permethrin reported side effects, including itching, erythema, and xerosis. CONCLUSIONS: Permethrin is frequently used in the treatment of infants younger than 2 months with scabies. Furthermore, our results demonstrate that permethrin is the preferred treatment agent among sampled dermatologists for infants younger than 2 months. Few side effects were reported, and none were serious.

Modification of footed pajamas to confirm arthropod bites: The Modified Onesie Biting Bug Assessment suit.

When children present with features of bed bug bites, many parents are reluctant to accept the diagnosis. Furthermore, standard methods to detect arthropods in or around one's home can be expensive, time-consuming, and frustrating. We developed a simple, inexpensive way to provide evidence that the lesions are in fact due to arthropod bites. The Modified Onesie Biting Bug Assessment (MOBBA) suit utilizes simple alterations to a full-body onesie-type footed pajama, exposing some body surfaces to insect predators while protecting other areas.

Understanding Dermatologic Concerns Among Persons Experiencing Homelessness: A Scoping Review and Discussion for Improved Delivery of Care.

There is a paucity of information surrounding dermatologic care for persons experiencing homelessness (PEH). This scoping review aims to map existing literature and provide a summary of the most common cutaneous manifestations among PEH, risk factors for dermatologic disease, describe any reported interventions, as well as identify research gaps for future studies. Search strategies developed for MEDLINE and hand searching yielded 486 articles. Out of the 486 articles screened, 93 articles met the inclusion criteria. The majority were cohort studies, cross-sectional studies, and case-control studies concentrated in North America and Europe. Excluding the pediatric population, the prevalence of dermatologic conditions ranged from 16.6% to 53.5%. Common skin conditions described in PEH were: acne, psoriasis, seborrheic dermatitis, atopic dermatitis, and lichen simplex chronicus. There were no studies comparing the extent or severity of these cutaneous diseases in PEH and the general population. PEH have a higher prevalence of skin infections and non-melanoma skin cancers. This scoping review has direct implications on public health interventions for PEH and highlights the need for evidence-based interventions to provide optimum and safe dermatologic healthcare for PEH. We propose several recommendations for improved care delivery, including addressing upstream factors and comorbidities impacting skin health, providing trauma informed care, reducing barriers to care, preventing and managing skin conditions, as well as including PEH in the planning and implementation of any proposed intervention.

Massive Tick Bites Causing Spotted Fever Rickettsial Infection: A Hazard in a Tea Plantation, Sri Lanka.

Tea plantations in Sri Lanka cover the central hills of the island, where spotted fever group (SFG) rickettsial infection is common. In most cases, the history of tick bite is obscure and eschars are not present. A 45-y-old female experienced massive tick bites while working in her tea plantation. She developed fever 2 d after exposure, but the diagnosis of SFG infection was not considered until a skin rash appeared on the eighth day. She had a very high titer of antirickettsial antibodies detected by immunofluorescence assay and responded to doxycycline. Here, we highlight the high risk of exposure to ticks and tick bites within tea estates and its causal relationship to SFG infection, which is increasing in Sri Lanka. Active case detection, notification, surveillance, and community awareness are imperative. Possible preventative measures for tick bites have to be introduced. There is a need to explore the effectiveness of local remedies currently in use.

Acute inflammatory Demodex-induced pustulosis in an immunocompetent patient related to topical steroid use.

Demodex spp. mites are a common colonizer of sebaceous adult skin. Though usually clinically insignificant, demodicosis may be associated with a wide spectrum of skin diseases in immunocompetent hosts, such as erythematotelangiectatic and papulopustular rosacea, Demodex folliculorum, and blepharitis. We present a case of a healthy 9-year-old boy with an exuberant, inflammatory, Demodex-associated pustular eruption of the face, induced by the use of a high-potency topical steroid and successfully treated with oral ivermectin.

Caterpillar dermatitis: A brief report.

A 3 year-old boy presented to our clinic with a 3-day history of itchy rash involving the face and limbs and recent contact with a caterpillar. A diagnosis of caterpillar dermatitis was suspected. This condition has rarely been reported and may be underestimated in the pediatric population who may suffer more systemic symptoms associated with caterpillar contact.

Cutaneous myiasis in a traveler returning from Argentina.

Myiasis is a common travel-associated dermatosis. We describe a 52-year-old Italian man who acquired Dermatobia hominis when bitten by a mosquito during a visit to Argentina. He had a painful nodular lesion on the left cheek that had been present for about 3 weeks. The complete removal of the larva is the goal of medical treatment. Prescription of antibiotics to avoid secondary infections is not recommended. For psychological reasons and due to the failure of previous therapies, the lesion was excised. Travelers to endemic areas should be informed of preventive measures to reduce mosquito bites and transmission of the infestation.

Prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Waghimra zone, Ethiopia.

BACKGROUND: Intestinal parasitic infestations triggered considerable gastrointestinal morbidity, malnutrition, and mortality worldwide. In particular, young children in developing countries affected most. Helminthiasis infestation accounts for 10-20% of prevalence on preschool children worldwide. Unfortunately, small children below 5 years are uniquely susceptible to intestinal parasitic infestations in poor communities. This is because of children's behavior like playing with soil and putting hand -to- mouth habit. Thus, the aim of this study was to assess the prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Ethiopia. METHODS: A community-based cross-sectional study was carried out on 378 preschool children in Sekota town from February 15 - March 10/2019. Stool specimens were collected and examined for intestinal parasites using wet mount and formal ether concentration technique. The risk factors of intestinal parasites were assessed using a pretested structured questionnaire. The data were entered and analyzed using Epi-data version 4.2.0.0 and SPSS-version 23 statistical software respectively. Both bivariable and multivariable analysis was carried out, and potential co-linearity was tested for closely similar variables. Variables with P value less than 0.05 in multivariable analysis was considered as statistically significant and reported with 95% CI and odds ratio. RESULTS: The prevalence of intestinal parasitic infestations in Sekota town on wet mount and formal ether concentration techniques was 83(21.9%), (95% CI, 17.7-26.3%) and 113(29.9%), (95% CI, 25.1-34.8%) respectively. In multivariable analysis, not taking medication as periodical deworming (AOR, 95% CI), (2.5, 1.5-4.3), presence of animals in the living room (AOR, 95% CI) (3.1, 1.8-5.3), and being a government employee as an occupation (AOR, 95% CI), (3.4, 1.1-10.0) were increasing the odds of intestinal parasitic infestations. CONCLUSIONS: The prevalence of intestinal parasitic infestations in Sekota town is high, which is a public health problem. The risk factors that contributed to intestinal parasitic infestations in this study were preventable and modifiable. Therefore, the concerned bodies need to emphasis on periodical deworming and keeping animals in separate room.

Non-pruritic bullous scabies in an immunosuppressed pediatric patient.

Bullous scabies is an uncommon subtype of scabies that frequently mimics other blistering skin diseases. Nocturnal pruritus is a hallmark symptom of bullous scabies. We report an unusual case of bullous scabies presenting in the absence of pruritus in an immunosuppressed pediatric patient. It is critical that clinicians consider the diagnosis of bullous scabies in any patient with bullae, irrespective of pruritus symptoms.

Increase of scabies infestations, Norway, 2006 to 2018.

Between October and December 2018, several clinicians in Norway reported an increase in scabies diagnoses. We compared data from the Norwegian Syndromic Surveillance System on medical consultations for mite infestations with scabies treatment sales data to investigate this reported increase. From 2013 to 2018, consultations and sales of scabies treatments had almost increased by threefold, particularly affecting young adults 15-29 years. We recommend to increase awareness among clinicians to ensure timely diagnosis and treatment.

[Scabies in old age]. / Skabies im Alter.

Scabies is a frequent ectoparasitosis the prevalence of which also seems to increase in older patients. Correct and timely diagnosis of scabies in older age is hampered by atypical clinical manifestations, the potential lack of pruritus and a variety of differential diagnoses. Scabies crustosa, a highly contagious subtype due to the presence of innumerable mites, is of particular importance. It predominantly occurs in immunosuppressed patients as well as in mentally or physically disabled persons and is the most important source of scabies outbreaks in residential and nursing homes. This article reviews the diagnosis and treatment of scabies and the strategies for managing outbreaks with special reference to older patients.

Changes in grapes composition during ripening of five Vitis vinifera L varieties as related to Tephritidae and Drosophilidae infestations.

Vitis vinifera (L) is a great economically important crop. However, huge loss in fruits due to destructive pests hinders the improvement of its performance. The study of their biochemical profile, ripening dynamics, and defense mechanisms presents a great scientific interest. In this work, phenylalanine ammonia lyase (PAL), tyrosine ammonia lyase (TAL) activities, proteins, sugar and malondialdehyde (MAD) were investigated during ripening of five grape varieties in Loudaya region (Marrakech, Morocco), three of them are allochthonous while two are autochthonous. The Dipterans infestations by Drosophila suzukii and Ceratitis capitata have been highlighted as a factor that stimulates the defense mechanism in ripeness stage of grapes. Sugars, proteins and MDA have shown a gradual increase in grapes maturation in all varieties. TAL activity decrease in the course of the maturation in contrast to the PAL activity increasing in the ripe grapes. High content of PAL, TAL, and MDA compounds were noted in the ripe infested grapes as compared to the healthy ones. A significant difference (P < 0.05) for all biochemical assays according to varieties, maturity and the condition (damaged/undamaged) were found. A PCA analysis highlighted different biochemical behaviours from the grapes concerning the flies' infestations (79.64% of total variation). The variables that have contributed to the discrimination of the grapes according to their stage of maturities were sugar, proteins and TAL. The higher concentrations of PAL (6.64 ± 0.57 EU), TAL (0.93 ± 0.05 EU) and MDA (58.32 ± 2.55 EU) especially in the injured grapes prove that flies infestation triggered a priming defense mechanism, directly activating defense reactions. The results obtained could be crucial in establishing a database of the Moroccan grapes biochemical defense which provides a foundation for new methodologies in the plants behavior against fruit flies stress.