Parasite of Skin Infection 2023

Parasite Infection in Skin
dr. Ayu Sekarani D.P.,M.Biomed

Departement of Parasitology
Medical Faculty Tadulako University
tadulakouniversity @ayusekarani
Skin Diseases-Causing Insect
Class Ordo Family Species Role

Insecta Diptera Cuterebridae Dermatobia Specific Myiasis
hominis
Calliphoridae Chrysomyia Specific Myiasis
bezziana
Sarcophagidae Parasarcophaga Semi specific
megacephala myiasis
Muscidae Musca 1.Accidental
domestica myiasis
2.Mechanic
vector
Siphonaptera Tungisidae Tunga Tungiasis
penetrans
Anoplura Pediculidae P.h. capitis Pediculosis
P.h. corporis
Phthirus pubis
Learning Objective
1. Pediculosis
2. Scabies
3. Myasis
PEDICULOSIS CAPITIS (4A)
DEFINISI
• INFEKSI & INFESTASI KULIT KEPALA DAN RAMBUT MANUSIA YANG

DISEBABKAN KUTU KEPALA (Pediculus humanus capitis)
• BANYAK DITEMUKAN PD ANAK2
• CEPAT MELUAS,MNYEBAR DLM LINGKUNGAN YG PADAT
(ASRAMA/PANTI ASHAN) + KONDISI HIGIENE BURUK (JARANG
MNCUCI RAMBUT+RAMBUT PANJANG)
MORFOLOGI
• KEPALA BENTUK OVOID
• THORAX : 3 SEGMENT
• 3 PASANG KAKI
•SIKLUS HIDUP
CARA PENULARAN
1. Kontak fisik erat dgn kepala penderita tidur bersama
2. Kontak dgn benda yg terinfestasisisir, aksesori rambut/kepala,
bantal
PATOGENESIS
Liur & ekskreta kutu masuk kedalam kulit saat mnghisap darah gatal
di kulit kepalagarukan kelainan kulit
GEJALA
ANAMNESIS
Gatal2 dkepala  reaksi hipersensitivitas thd saliva kutu + feses kutu
Asimptomatik
Faktor risiko :
1. Sosioekonomi rendah
2. Higiene perorangan rendah
3. Prevalensi wanita > pria (terutama anak2)
GEJALA
PEM. FISIK
• Lesi kulit garukan (erosi&ekskoriasi)
• Infeksi sekunder o/ bakteripus dan
krusta, rambut bergumpal +
pembesaran kel.getah bening
regional.
• Ditemukan telur&kututerutama di
area oksipital dan retroaurikuler
• Pem. Penunjang ; -
DIAGNOSIS
• Anamnesis + pem. Fisik + dtemukan telur & kutu dikulit kepala &
rambut
• Diagnosis banding : Tinea kapitis, impetigo krustosa, dermatitis
seboroik
• Komplikasi : kronis infeksi sekunder
PENATALAKSANAAN
• Membunuh kutu dan mengobati infeksi sekunder
• Topikalpedikulosid :
1. Malathion 0,5% / 1% btk lotion / spray (didiamkan 1 mlm)
2. Permethrin 1 % ddiamkan selama 2 jam
3. Gameksan 1 %ddiamkan 12 jam
Pedikulosid sebaiknya jgn dgunakan pada anak < 2 thn

• Infeksi sekunder berat  rambut dcukurdiberikan antibiotik
sistemik&topikalpedikulosid dm btk shampoo
EDUKASI
• MENJAGA KBERSIHAN PERORANGAN

• MENGHINDARI KONTAK ERAT DGN PENDERITA
• MENGHINDARI PENGGUNAAN ALAT (SISIR, SPREI, HANDUK)
BERSAMAAN DGN PENDERITA
• ANGGOTA KELUARGA/ORG DEKATHARUS DIPERIKSA
• PROGNOSIS : BONAM
Myiasis-Causing Flies
DEFINITION
• Myiasis is a parasitic infection of the skin and mucous membranes

determined by the larvae of Diptera insects. Many species of Diptera
may cause larval infection in humans.
Life Cycle
Classification of myiasis
The most satisfactory classification is to group the myiasis-producing flies
by their ovi- or larvipositing habits as:
1. Specific,
2. semispecific,
3. accidental
Myiasis also can be difined by the tissue affected or lesion produced

1. Furuncular myiais
2. Migratory integumomyiass
3. Wound myiasis
Specific – Myasis
• Certain species of flies are obligate parasites and require living tissue
for development. The specific flies deposit their eggs or larvae in or
near the tissues of obligate host and the larvae inevitably become
parasites by invading the skin or atria.
Furuncular myiasis
Furuncular myiasis
• Etiology : Infesting fly

• Human botfly
(Dermatobia hominis)
• Tumbu fly (Cordylobia
anthropophaga)
• Rodent and rabbit
botflies (Cuterebra sp)
The mode of transmission
Dermatobia hominis Cordylobia species
• They are carried to the host by a • The eggs of Cordyla sp are
blood-sucking insect, such as however deposited on the soil or
mosquitoes and ticks wet and soiled clothes hung
• the hatched larvae invade outside for drying.
exposed skin of the trunks, head • The hatched larvae invade
and limbs. unexposed skin (of the buttocks,
trunk, the limbs and penis) in
contact with the wet clothes.
Dermatobia hominis (human botfly)
• Family Cuterebridae
• A large, stout fly, measuring 15 to 18
mm, in length,
• With a yellowish face, a dark bluish-
black thorax,
• and a more or less diamond-shaped
Figure 1. Dermatobia hominis oviposits a batch
of small, elongate ovoidal eggs
abdomen of metallic blue with a violet
tinge.
• When she is ready to oviposit, the
female captures a mosquito or some
other blood-sucking arthropod,
• and glues to the abdomen of the
arthropod a batch of 14 to 25 small,
elongate-ovoidal eggs.
Dermatobia hominis
• The recently hatched first-stage larva is
elongate-cylindrical, tapering somewhat
posterior.
• Within the host’s skin layers the larva
feeds, grows and moults twice.
Larvae • The mature third-stage larva measures
from 18 to 24 mm, in length and is
characteristically inverted flask-shaped.
• It has well-developed oral hooks and a
dark brown anterior cuticle.
• The posterior spiracles lie in a small,
deep cleft and are usually concealed in
Posterior spiracle the shrunken specimen. Each spiracle
plate has 3 somewhat curved slits,
directed ventral .
Puparium of Dermatobia hominis
• Most mature larvae drop

during early morning hours.
• They burrow into upper soil
or debris for about 20 min
and form a hardened
puparium in 2-3 days.
The variation in size and shape of Dermatobia hominis depending on
the stage of development of each larva and when it was removed.
Cordylobia anthropophaga
• Tumbu fly Larva
C. anthropophaga is a large, robust
brownish yellow fly found widely
throughout tropical Africa. It deposits 100–
300 eggs on soil polluted with animal
excrement or on clothing saturated with
perspiration and soiled diapers.
After hatching, the larvae can stay alive

for seven to twenty days, while attached to
contaminated articles and clothing or the
soil. On contact with the skin of man or
other vertebrates they easily penetrate the
skin.
Cordylobia anthropophaga
Life Cycle
Family Calliphoridae
• Several species of the family Calliphoridae are

obligate parasites.
• Adult females lay their eggs around the edges of
wounds, and the larvae invade the wounds and
macerate the traumatized tissue.
• Large numbers of maggots can infest single wound.
• Infestations of the nose can be fatal, and therefore
the maggots should be removed surgically as soon
as they are detected.
Eggs of Calliphoridae
The eggs are white and

sausage-shaped
and are usually laid in
clumps.
Chrysomyia sp
•Flies of genus
Chrysomyia, the Old Word
screwworm, are important
causes of human and
animal myiasis throughout
Asia and Africa.
Larva
•Larvae of these flies
penetrate wounds or
mucous membranes,
Posterior
affecting primarily areas
spiracles
around the eyes, ears,
mouth, and nose.
Semispecific myiasis
• The semispecific flies usually deposit their eggs or

larvae in decaying flesh or vegetable matter and less
frequently as facultative parasites in diseased tissues
or neglected wounds , although a few species have
acquired a purely parasitic habit. These flies may
deposit their larvae in the habitat, on the hairs or
body, or in the wounds and diseased tissue of the
host. Other species develop facultatively in either
living or dead tissues.
Family Sarcophagidae
• Female flies in this

family do not lay eggs
puparium but deposit freshly
hatched first-stage
larvae directly in
wounds, ulcers, or
Larva even on unbroken
skin.
• The feeding larvae
may cause
considerable tissue
Posterior damage.
spiracles
Sarcophaga sp
• Genus Sarcophaga.,
• Its large grayish sized, with
four dorsal longitudinal
thoracic stripes and a light-
and dark-checkered
abdomen.
Accidental myiasis
• The accidental myiasis –producing flies or diverse genera and habits

deposit their larvae in excrement or decaying organic material and at
times in food. Man becomes infested by the accidental ingestion of
the eggs or larvae or by the contamination of external wounds or
atria.
Musca domestica
Posterior spiracle
Clinical presentation & Treament
• Pruritic erythematous papule progressing to tender furuncles with draining

central sinuses
• Furuncle : a localised suppurative condition occuring in a hair follicle
• Complication:Transient sharp pain, regional lymphadenopathy,CNS
• Treatment: Apply animal fat to promote larva exit
Complications
• Complications include cellulitis, abscess formation, osteomyelitis and

tetanus Methods of removing the larva include obstructing the
cutaneous orifice thus suffocating the larva, which forces it to wriggle
out. Substances used include oil, petroleum jelly, butter and liquid
paraffin
Epidemiology & prevention
• Gravid flies oviposit onto a second arthropod. Eggs hatch when the phoeretic
arthropod lands upon a human host. The resulting larvae enter the human
skin via the phoretic arthropod`s bite wound or by directly perforating the
skin
• Prevention. Insect repellent and nocturnal mosquito netting
Scabies
Sitti Rahmah Umniyati
SCABIES
Sarcoptes scabiei (itch mites)
• Phylum: Arthropoda
• Class: Arachnida
• Order: Acarina
• Family: Sarcoptidae
• Genus: Sarcoptes
• Species: Sarcoptes scabiei
Life Cycle
Form
3 days a lateral branch
First nymph
male
Burrows
Into the
skin 2nd nymph
Female
2to3 mm
at night
For people without previous exposure of the disease, incubation period is
around two to six weeks.
People who have been previously infested may develop symptoms earlier,
usually within 1-4 days after re-exposure.
Mode of transmission
• Scabies usually spreads

through direct contact with
an infected person.
• Clothing and bedding may
also carry the mite and
transmit the disease.
• Scabies burrows • Scabies rash on the
between the fingers hands. Burrows are
visible.
•
A patient who was infested with scabies
shows the typical pruritic shows the typical pruritic

red papules in the red papules in the finger
interdigital spaces of hand
A nursing home patient who was infested
with scabies
shows the typical pruritic shows scabies infestation on the
red papules in the axilla. flexural wrist
• Scabies with inflamed • Scabies with flexural
lesions in periumbilical wrist involvement
distribution
Diagnosis
• Diagnosis can be confirmed by picking up adult female mites at the ends

of their borrows or by scraping the affected skin lightly covered with
mineral oil.
• The srapings are then examined under a microscope to search for
immature or adult mites or for eggs
• Other methods that have been proposed for obtaining specimens are the
use of cellophan tape and various synthetic glues.
Differential diagnosis
• Impetigo • Scabies
Differential diagnosis
• Scarlet Fever • Scabies
Pathogenesis
• Infection begin when fertile female mites are transfered from
infected individuals by direct contact
• Female, usually at night , burrows into the skin, progressing at the
rate of about 2-3 mm per day.
• The burrow is confined to the corneous layer of the skin
• Lesions appear as short, sinous, or slightly raised , cutaneous
burrows
• Thread-like lesions or vesicles may be seen on the skin
• Itching and skin eruption are usually delayed for several weeks.
• The typical scabies rash appears on various part of the body
represent a generalized response to the allergen.
• Minute vesicular swelling , posibbly produce by the iritating fecal
deposits or excretions
PENATALAKSANAAN
–Emulsi benzil-benzoas (20-25%)
• Efektif thd semua stadium
• Diberikan setiap malam selama 3 hari
• Sulit diperoleh, sering menimbulkan iritasi, dan kadang makin gatal setelah dipakai
–Gamma Benzena Heksa Klorida (gameksan=gammexane) 1%

• Krim atau losio
• Obat pilihan  efektif thd semua stadium, mudah digunakan, jarang iritasi
• Tidak dianjurkan untuk wanita hamil  karena toksik thd SSP
• Pemberiannya cukup sekali  bila masih ada gejala  diulang seminggu kemudian
PENATALAKSANAAN
– Krotamiton 10%
• Krim atau losio
• Obat pilihan  punya 2 efek  antiskabies dan antigatal
• Harus dijauhkan dari mata, mulut, dan uretra
– Permethrin 5%
• Krim
• Kurang toksik dibandingkan gameksan
• Efektivitasnya = gameksan
• Aplikasi hanya sekali dan dihapus setelah 10 jam  bila belum sembuh  ulangi setelah
seminggu
• Tidak dianjurkan untuk bayi usia <2 bulan
THANK YOU

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Parasite Infection in Skin

dr. Ayu Sekarani D.P.,M.Biomed

Class Ordo Family Species Role

• INFEKSI & INFESTASI KULIT KEPALA DAN RAMBUT MANUSIA YANG

• Membunuh kutu dan mengobati infeksi sekunder

Pedikulosid sebaiknya jgn dgunakan pada anak < 2 thn

• MENJAGA KBERSIHAN PERORANGAN

• Myiasis is a parasitic infection of the skin and mucous membranes

Myiasis also can be difined by the tissue affected or lesion produced

• Etiology : Infesting fly

• Most mature larvae drop

After hatching, the larvae can stay alive

• Several species of the family Calliphoridae are

The eggs are white and

• The semispecific flies usually deposit their eggs or

• Female flies in this

• The accidental myiasis –producing flies or diverse genera and habits

• Pruritic erythematous papule progressing to tender furuncles with draining

• Complications include cellulitis, abscess formation, osteomyelitis and

• Prevention. Insect repellent and nocturnal mosquito netting

• Scabies usually spreads

shows the typical pruritic shows the typical pruritic

• Diagnosis can be confirmed by picking up adult female mites at the ends

• Scarlet Fever • Scabies

–Gamma Benzena Heksa Klorida (gameksan=gammexane) 1%

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