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Scabies Lice and HPV PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Scabies, Lice, and HPV".

This medical PowerPoint presentation talks about scabies, lice, and HPV, types of skin conditions caused by different organisms.

Scabies: Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei. The mite burrows into the skin, causing intense itching and a red, pimple-like rash. Scabies is typically spread through prolonged skin-to-skin contact with an infected person. Treatment typically involves topical creams or lotions that kill the mites.

Lice: Lice are small, wingless insects that live on the scalp and feed on human blood. There are three types of lice that infest humans: head lice, body lice, and pubic lice (also known as "crabs"). Lice are typically spread through direct contact with an infested person or their belongings. Symptoms include itching, red bumps, and visible lice or eggs (nits) on the hair shafts. Treatment typically involves topical or oral medications that kill the lice and their eggs.

HPV: Human papillomavirus (HPV) is a sexually transmitted infection (STI) caused by the human papillomavirus. There are many different types of HPV, and some can cause genital warts or certain types of cancer, including cervical cancer. HPV is spread through skin-to-skin contact during sexual activity. Symptoms may not appear for months or years after infection, and there is no cure for HPV. However, vaccines are available to protect against certain types of the virus that can cause cancer. Treatment typically involves managing symptoms, such as genital warts, and regular screening for cervical cancer in women.

Tags : Scabies, Lice, HPV, Dermatology, Dermatology PowerPoint presentation

Published on : Mar 31, 2023 | Views : 869 | Downloads : 2

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SCABIES, LICE AND HPV Michael E. Hagensee, M.D. Ph.D. Associate Professor Department of Medicine Section of Infectious Disease LSUHSC
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DISCLOSURE I have no financial interests or other relationship with manufacturers of commercial products, suppliers of commercial services, or commercial supporters. My presentation will not include any discussion of the unlabeled use of a product or a product under investigational use.
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STDs AND OTHER GYNECOLOGIC INFECTIONS Objectives: To be able to diagnose and treat scabies To be able to diagnose and treat pubic lice To know about the disease that HPV cause and how to treat/prevent them
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SCABIES
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SCABIES
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SCABIES A. Etiology: Sarcoptes scabiei-human itch mite B. Epidemiology: 1. More than 100 million cases per year 2. Itching due to excretions from burrowing mites 3. Increase spread by close contact, crowding 4. Medical practitioners are at high risk C. Clinical manifestations: 1. Itching increases at night and after a hot shower 2. Burrows-dark wavy lines ending in small bleb 3. Usual sites wrists, fingers, elbows and on penis 4. Usually 15 mites per person
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SCABIES
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SCABIES
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SCABIES 5. Norwegian scabies: (crusted) - thousands to millions of mites per person - seen only in immunosuppressed (HIV) individuals - erythema, thick keratotic crusts and dystrophic nails D. Diagnosis: Find mite of eggs in scraping vs empiric E. Treatment: 1. 5% permethrin cream 2. 1% lindane (not in pregnant women) 3. Anti-pruritics as needed
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LICE
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LICE A. Etiology: 1. Pediculus humanus var. capitis - head lice 2. P. humanus var. corporis - clothing 3. Pthirus pubic - pubic hair B. Epidemiology: 1. Lice feed on human blood once a day 2. Saliva of lice produce an irritating rash 3. Transmitted by close contact, shared combs, clothing
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LICE
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LICE C. Clinical manifestations: 1. Intensely pruritic lesions 2. 2-3 mm blue macules (maculae cerulae) at bite sites D. Diagnosis: Find nits or adult lice in hair or clothing E. Treatment: 1. 1% permethrin 2. 0.5% malathion 3. 1% lindane - more toxic and must apply a second dose 1 week later - does not kill nits - not in pregnant women 4. Comb out nits after treatment
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HUMAN PAPILLOMAVIRUS (HPV) Papovavirus Most common viral STD ds DNA virus of 7.9 kB Entire DNA sequence is known
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HPV TYPES 1,2 - plantar and common warts 6,11 - condylomata and laryngeal warts 16,18, and others - anogenital malignancies Defined by 10% difference in DNA sequence (L1 gene)
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METHODS TO DETECT HPV INFECTION Clinical diagnosis: Genital warts Epithelial defects See cellular changes caused by the virus: Pap smear screening Directly detect the virus: DNA hybridization or PCR* Detect previous infection: (Research Only) Detection of antibody against HPV* * Done in the Hagensee Laboratory
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GENITAL WARTS
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GENITAL WARTS
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HPV EPIDEMIOLOGY GENITAL WARTS Usually caused by HPV 6 or 11 Prevalence has increased 2-10x over past 30 years Most often found on penile shaft and anus in men, vulva in women Spontaneous regression seen in 20% of cases
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GENITAL WARTS
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GENITAL WARTS
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GENITAL HPV INFECTION DIFFERENTIAL DIAGNOSIS CONDYLOMA LATUM-SYPHILIS MOLLUSCUM CONTAGIOSUM FIBROEPITHELIOMA AND OTHER CANCERS LICHEN PLANUS OTHER-HSV, LGV, CHANCROID, GRANULOMA INGUINALE
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GENITAL HPV INFECTION TREATMENT OBSERVATION -20% spontaneous regression CRYOTHERAPY -70% cure rate PODOPHYLLIN/ TCA -30% cure rate SURGERY -laser-85% cure rate INTERFERON ALPHA -intralesional and systemic IMIQUIMOD -induces local interferon alpha production CIMETIDINE (Tagamet) – non-specific immune booster
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HPV EPIDEMIOLOGY ANOGENITAL MALIGNANCY Caused by high risk HPVs-16, 18, 31 and others Occurs mainly in older women-average age 54 years Associated with increased number of sexual partners, smoking, and immune suppression
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HPV IS ASSOCIATED WITH ANOGENITAL MALIGNANCIES HPV DNA is found in 50-98% of tumors depending on location Oncogenic genes (E6 and E7) of high-risk types are expressed in tumors E6 and E7 of high-risk types are oncogenic in-vitro Support from many epidemiologic studies
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CERVICAL CANCER CIN II
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CERVICAL CANCER 2nd most common malignancy of women worldwide More than 500,000 cases per year # of cases declining in USA Over 13,000 cases in US in 1998 Over 35% mortality
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CERVIX - ANATOMY
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CERVIX - ANATOMY
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CERVIX - ANATOMY
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COLLECTION OF A PAP SMEAR CONVENTIONAL NOW MOST CLINICS HAVE MOVED TO LIQUID-PAP SMEARS (Thin Prep, SurePath) - preserve the morphology of the cells better
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HPV DIAGNOSIS – PAP SMEAR Normal, ASCUS – Atypical Squamous Cells of Unclear Significance
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HPV PAP SMEARS Pap smear: Normal ASCUS – atypical cells of unclear significance: repeat Pap vs test for HPV DNA LGSIL – low grade squamous intra-epithelial lesion: colposcopy with biopsy HGSIL – high grade squamous intra-epithelial lesion: colposcopy with biopsy and treat Cervical biopsy: CIN I – mild dysplasia – usually spontaneously regresses CIN II – moderate dysplasia - treat CIN III – severe dysplasia – treat Carcinoma – in-situ – treat Invasive cervical cancer – treat
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CERVICAL CANCER SCREENING METHODS HPV DNA Testing for questionable cases: Normal PAP smear - usual follow up ASCUS - may be cost-effective LGSIL - most regress HGSIL - refer for colposcopy and biopsy
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CERVICAL CANCER SCREENING METHODS REFLEX TESTING USING HYBRID CAPTURE II Collect a cervical swab for DNA testing from all women and store them Only those women with ASCUS (or LGSIL) – the swab is sent for HPV DNA testing HCII – positive for high-risk HPV – then refer to colposcopy negative for high-risk HPV – then routine yearly screening
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SCREENING METHODS
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CERVICAL CANCER SCREENING METHODS
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HIGH-RISK HPV INFECTION TREATMENT OBSERVATION CRYOTHERAPY-LASER CONE BIOPSY-SURGERY RETINOIDS??
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PROPHYLACTIC VACCINES AGAINST HPV Utilizing in-vitro capsid production: (VLPs – Virus-Like Particles) Co-discovered by: Zhou et al, Virology 185:251, 1991 Kirnbauer et al, PNAS 89:12180, 1992 Hagensee et al, J. Virology 67:315, 1993 Particles made in the laboratory identical to in-vivo down to a resolution of 5 microns No infectious potential Can be made in vaccinia virus, baculovirus, yeast and bacterial expression systems
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HPV VLPs HPV capsids – EM and 3-D Reconstruction
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PROPHYLACTIC VACCINES AGAINST HPV
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ACIP Recommendations Routine vaccination with 3 doses of quadrivalent HPV vaccine for females 11–12 years of age Can be started in females as young as 9 years of age Catch-up vaccination for females 13–26 years of age not previously vaccinated or who have not completed the full vaccine series Ideally, vaccine should be administered before potential exposure to HPV. Each dose of quadrivalent HPV vaccine is 0.5 mL, administered intramuscularly. Quadrivalent HPV vaccine is administered in a 3-dose schedule. The second and third doses should be administered 2 and 6 months after the first dose. Quadrivalent HPV vaccine can be administered at the same visit at which other age-appropriate vaccines are provided, such as Tdap, Td, and MCV4.* Advisory Committee on Immunization Practices (ACIP). ACIP recommendations for the use of quadrivalent HPV vaccine. Available at: http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf. Accessed December 19, 2006. *NOTE: Per the Prescribing Information, co-administration of GARDASIL with these vaccines has not been studied.
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ACIP Recommendations (cont.) Current recommendations for cervical cancer screening have not changed for females who receive quadrivalent HPV vaccine. Females who have an equivocal or abnormal Pap test, a positive Hybrid Capture II high-risk test, or genital warts can receive the quadrivalent HPV vaccine. Recipients should be advised that the vaccine will not have therapeutic effect on existing Pap test abnormalities, HPV infection, or genital warts. Vaccination would provide protection against infection with vaccine HPV types not already acquired. Lactating women can receive quadrivalent HPV vaccine. Immunocompromised females can receive quadrivalent HPV vaccine. However, the immune response to vaccination and vaccine effectiveness might be less than in females who are immunocompetent. Quadrivalent HPV vaccine is contraindicated in people with a history of immediate hypersensitivity to yeast or to any vaccine component. ACIP. Recommendations for the use of quadrivalent HPV vaccine. Available at: http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf. Accessed December 19, 2006.
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ACIP Recommendations (cont.) Quadrivalent HPV vaccine is not recommended for use in pregnancy. Individuals should report any exposure to the vaccine during pregnancy to the vaccine pregnancy registry. Quadrivalent HPV vaccine can be administered to females with minor acute illnesses. Vaccination of people with moderate or severe acute illnesses should be deferred until after the illness improves. ACIP. Recommendations for the use of quadrivalent HPV vaccine. Available at: http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf. Accessed December 19, 2006.