摘要
疥瘡是由疥蟲感染所引起的皮膚病，具有高度的傳染性，疥瘡常會在醫院、長期照護機構爆發或流行，對於老年人和醫療工作者都有很高的致病率。流行病學研究調查顯示25%的長期照護機構在一年內曾有疥瘡的感染。疥瘡的潛伏期約2-4星期。典型的成人疥瘡患者呈現的是癢、皮膚疹和隧道狀病灶。老年人疥瘡呈現的可能只是非特異性的癢和皮膚疹的非典型表現。有失智、失能、免疫功能缺損、使用類固醇的老年病患可能出現挪威疥或角化型疥瘡，因感染性甚高，是長期照護機構疥瘡流行最常見的原因。診斷疥瘡主要是依據病史，詳細的皮膚理學檢查和疥蟲、蟲卵或糞便的證據。疥瘡的治療包括5% permethrin cream、1% lindane lotion、crotamiton、benzyl benzoate和口服的ivermectin。疥瘡患者應早期診斷，徹底治療，並確實隔離，跟患者有密切接觸的醫療工作人員和家屬需同時治療。造成長期照護機構疥瘡的爆發或流行包括挪威疥、未能早期診斷、治療失敗和未有妥善的預防措施，因此瞭解和預防疥瘡的措施是絕對需要的。
關鍵字
疥瘡並列摘要
Scabies is a highly contagious skin disease caused by the parasite mite Sarcoptes scabiei. A significant source of morbidity in nursing home residents and workers, scabies has been frequently documented in long term care facilities. Statistics from a related study indicates that as high as 25% of the surveyed long term facilities reported scabies within a period of one year. The incubation period of scabies is 2-4 weeks. Its clinical manifestations include: itching, skin lesion and burrow. In elderly patients, scabies may appear in the form of nonspecific pruritic plaques and patches. Debilitated, demented or immunocompromised patients may suffer Norwegian or crusted scabies that is highly contagious and is one of the most frequent sources of scabies outbreak in long term care facilities. Diagnosis of scabies is based on patient history, physical examination, and demonstration of mites, eggs or scybala on microscopic examination. Scabies can be attended with topical treatment including 5% permethrin, 1% lindane lotion, crotamiton, benzyl benzoate and oral ivermectin. In an outbreak of scabies in a nursing home, residents, staff and frequent visitors should all be treated. It is important to isolate suspected cases immediately and prevent the spread of infection by rapid and sensitive diagnosis, treatment, disinfection, good hygienic procedures and infestation control in long term care facilities.
被引用紀錄
延伸閱讀
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