Derinin Paraziter Hastalıkları
Özet
Uyuz ve pediküloz, dünya genelinde önemli halk sağlığı sorunları olmaya devam eden, yaygın ve bulaşıcı ektoparaziter enfestasyonlardır. Uyuz, Sarcoptes scabiei var. hominis tarafından oluşturulur ve başlıca uzun süreli deri teması yoluyla bulaşır. Tipik olarak şiddetli gece kaşıntısı, ekskoriye papüller, nodüller ve karakteristik tüneller ile seyreder. Kabuklu uyuz, özellikle immünsüprese ve yaşlı bireylerde belirgin şekilde artmış akar yükü ile ilişkili, oldukça bulaşıcı bir formdur. Tanı esas olarak klinik bulgulara dayanır; dermatoskopi, mikroskopi ve diğer görüntüleme yöntemleri tanıyı destekleyebilir. Topikal permetrin birinci basamak tedavidir; oral ivermektin ise özellikle seçilmiş veya şiddetli olgularda önemli bir sistemik tedavi seçeneğidir. Pediküloz, kan emici bitlerin neden olduğu bir enfestasyon olup pedikülozis kapitis, korporis ve pubis olmak üzere üç klinik formu içerir. Klinik bulgular etkilenen bölgeye göre değişmekle birlikte sıklıkla kaşıntı, ekskoriasyonlar ve sekonder ekzematizasyon veya enfeksiyon görülür. Tanı, canlı bitlerin veya canlılığını koruyan sirkelerin gösterilmesiyle konur. Tedavide topikal pedikülisitler, mekanik temizleme, uygun hijyen önlemleri ve seçilmiş dirençli olgularda sistemik tedaviler kullanılabilir. Her iki enfestasyonun başarılı yönetiminde tedavinin doğru uygulanması, gerektiğinde yakın temaslıların eş zamanlı tedavisi ve yeniden enfestasyon ile bulaşın önlenmesine yönelik uygun çevresel önlemler önemlidir.
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