Clinical and parasitological study on scabies in Sirte, Libya

The present work aimed to determine the risk factors, clinical and parasitological skin lesion features and effective drug regimens. Study was carried out on 200 patients referred to dermatology outpatient clinics in Sirte-Libya. Each was subjected to detailed questionnaire, dermatological skin examination, parasitological skin scraping test [SST], burrow ink test [BIT], drug administration and follow up. Results revealed that females 59%, children 37.5% and military personnel 18% of immigrant families were particularly prone to scabies infestation. Effective risk factors included overcrowding, bed sharing, low hygienic and education levels. Commonest skin lesions included erythematous papules 93%, excoriated papules 77.5%, burrows 66%, pustulation 3 1%, vesicles 21.5 and nodules 3%. Predilection lesion sites were hand 86%, wrist 82%, abdomen 56%, male external genitalia 64.5% and female breast 28%. Specific SST was positive in 67.3% of cases, particularly sensitive in early cases with short itching duration. BIT was positive in 62%. Topical permethrin proved more effective than precipitated sulpher with cure rates of 100% and 85.3% in 21% and 75% of cases, respectively. Ivermectin was 100% effective in 4% of cases

Emerging cutaneous leishmaniasis in Sirte-Libya: epidemiology, recognition and management

The present work aimed to determine the risk factors, lesion pattern and effective therapy of emerging ZCL in Sirte-Libya. The study was carried out on 163 patients referred to health centers of Al-Gadaheya and Al-Hisha villages in the years 2006 and 2007. Methods consisted of a predesigned questionnaire [personal and demographic data], clinical examination of lesions, and parasitological examination by slit smear, treatment and follow up. Results showed an annual incidence of 0.95%, with onset peak during autumn months. Important local risk factors included: increased occupational exposure of farmers and construction worker to infection from fat sand rat burrows, facilitated by lack of prevention knowledge and prophylactic measures; close association of bad-ventilated animal shelters to houses, and increased soil moisture by warm spring ponds. The majority of lesions were multiple [73%] located on legs, arms, and face 66.8%, 52.1% and 41.1%. Most lesions were active 1-2 month duration and 1-3 cm size, ulcerative type [77.3%], and papulo-nodular [21.5%]. Giemsa slit smear proved quite reliable for active lesions, confirmed 79.5% of lesions. The majority of lesions [60.1%] were treated by intra-lesional Pen-tostam. Systemic route was restricted to facial, over-joint, multiple or large lesions producing good response in 31.9%. Cryotherapy and oral Fluconazole gave satisfactory response in 5.5% and 2.5% of cases