Parasitic Infestations, Stings & Bites Part 2 - Another Spine-Tingling Lecture from…

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Parasitic Infestations, Stings Bites Part 2 -
Another Spine-Tingling Lecture from

• KCOM/TX Dermatology Residency Consortium
• Dan Ladd DO

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Loaiasis

• Aka Loa Loa, Calabar Swelling, Fugitive Swelling,
  Tropical Swelling
• Asymptomatic localized subQ swellings, size of a
  hens egg
• Prediliction for loose tissues such as eyes,
  frenulum of tongue, genitalia
• Mango fly Chrysops dimidia or silacea
• Tx Diethylcarbamazine

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Loaiasis
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Onchocerciasis

• River Blindness
• Central South America, Mexico
• Pretibial depigmentation leopard skin
• Thickened skin elephant skin
• May develop into subQ nodules
• Mazzoti test if edema, pruritis, fever
  arthralgias w/ 50mg diethylcarbamazine
• Tx Ivermectin 150mg single dose

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Black fly Simulum
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Leopard skin, Elephant skin
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Trichinosis

• Inadequately cooked pork, bear or walrus meat
• Puffy eyelid edema, red conjunctiva and sometimes
  urticaria, fever, HA, muscle pains, neurologic
  SS.
• 20 have maculopapular rash, very itchy,
  responsive to corticosteroids.
• Diagnosis by muscle biopsy
• Tx Albendazole 400mg bid for 2w.

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Trichinella spiralis muscle bx
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Phylum Arthropoda

• Myriapoda
• Centipede
• Millipedes
• Insecta
• Caterpillar
• Moth
• Arachnidia

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Myriapoda Centipede Stings

• Paired hemorrhagic puncta with erythematous
  swelling progressing to brawny edema or
  lymphangitis and lymphadenopathy.
• Scolopendra species, 15-20cm
• Tx Rub with garlic, local anesthetic injection.