1. ECTOPARASITE IN
PALEMBANG’S CHILDREN
Ahmad Ghiffari
Department of Parasitology, Faculty of Medicine,
Sriwijaya University, Palembang, Indonesia
DAAD Summer School Program 2012 IGHEP
24 June-3 July Göttingen Germany

2. CASE REPORT
• First case report in
Palembang
• Twelve years old girl
• Arrival from
Dermatovenereology
Dept
• Prolonged Nasolabial
dermatitis
• Asymptomatic nodule
• Kortikosteroid

3. VIDEO PRESENTATION
• Click Window Media Player

4. Jörg Heukelbach, Hermann Feldmeier, the Lancet 2004.

6. TAXONOMY
 Phylum Arthropoda
 Class Arachnida
 Order Trombidiformes
 Family Demodicidae
 Genus Demodex
 Species Demodex folliculorum (Simon, 1842)

7. MORPHOLOGY
7
 Length : 0,3-0,4 mm,
abdomen striae &
worm movement
 4 pair of legs and 1
pair of short one in the
extremity of1/3
anterior part

8. LIFE CYCLE

9. HISTORY
9
 Permanent Ectoparasite live in pilosebaseus unit
 Feed on sebum using the lipolitik Demodex lipase  hidrolise
trigliserida (irritating fatty acid)
 Localize in:
 Face: forehead, cheek, nose, eye lids & eye brows
 Meibom gland
 Scalp: epidermis/sebaseus gland/hair follicle
 Outer part of ear
 Nipple
 Also incidently found ini several skin disease including
Seborrhoic Dermatitis and tumor skin disease

10. DIAGNOSTIC TEST
o SKIN (and hair)
 Two lessions was clean up with
saline and dried with kassa
 Standard surface area 1 cm2 is
drawn in the deck glass using
waterproof pen
 One drop of cyanoacrylate
((Loctite®) in the object glass is
gently sticked for minute in the
prepared lession & release
 2-3 drops of imersi oil in the
deck glass & sealed

11. Gender Grup of infestation
Gender Frekuensi
n %
Male 17 22,6
Female 57 77,4
Jumlah 74 100

12. Gender Grup of infestation
Gender Frekuensi
n %
Male 5 25
Female 15 75
Total 20 100.0

13. Gender Grup of infestation
A. Ozer et al, 2012. Journal of the Formosan Medical Association 111, 30-33

14. Age grup of infestation
Age grup (years old) Frequent
n %
Children (12-16 y.o) 2 2.7
Adult (17-59 y.o) 72 97.3
Age (> 60 y.o) 0 0
Total 74 100

15. Age grup of infestation
A. Ozer et al, 2012. Journal of the Formosan Medical Association 111, 30-33

16. Total related to Complaint
Frekuensi
Total DF scalp
n %
0 50 81.1
1 11 14.9
2 6 1.4
3 7 2.7
Jumlah 74 100

17. Dermatological Complaint related
to Demodicidosis
Hsu, et all, 2008. American Academy of Dermatology

18. With Anti-acaridal
Hsu, et all, 2008. American Academy of Dermatology

19. Sarcoptes scabiae
Jorg Heukelbach, Ulrich R. Hengge, 2004.

20. HISTORY
• Mites Infestasi S.
scabiei var hominis
• Infestate: School
children
• Risk factor : low
economy, poor nutrition
status, homeless, lack of
hygiene, medical
services
Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

21. LIFE CYCLE
Arlian, 1989. Ann. Rev. Entomol. vol. 34:139-161

22. Gender Distribution
Male
Female 51 orang
(25%)
153 orang
(75%)
Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.
7/14/2012 22

23. Gender Distribution
J Infect Dev Ctries 2009; 3(10):789-783.

24. Age Distribution
persentase
anak pubertas remaja
Kelompok usia
7/14/2012 Grafik 5.2. Distribusi kelompok usia subjek penelitian 24

25. Age Distribution
J Infect Dev Ctries 2009; 3(10):789-783.

26. Predilection Site
Lokasi pemeriksaan Frekuensi mikroskopik Frekuensi dermoskopik
n % n %
interdigitalis manus 9 47,0 8 47,0
palmar manus 1 5,7 1 5,9
wrist joint 4 21,0 4 23,5
Antecubiti 2 10,5 2 11,8
Umbilikus 1 5,3 0 0
Genital 2 10,5 2 11,8
Olivier Chosidow, 2000. THE LANCET • Vol 355.
7/14/2012 26

27. Predilection Site
Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

28. Socioeconomic Variables
 Tabel 5.3 Distribusi frekuensi mandi dalam sehari subjek penelitian
Frekuensi mandi dalam Frekuensi
sehari n %
1 kali 3 1,5
2 kali 195 95,6
3 kali 6 2,9
Total 204 100
Tabel 5.4 Distribusi pemakaian pakaian/handuk bersama subjek penelitian
Frekuensi
Pemakaian pakaian dan
handuk bersama n %
ya 79 38,7
tidak 125 61,3
Total 204 100
7/14/2012 28

29. S.A. Karim et al. Public Health (2007) 121, 923–934

30. Pediculus capitis
Fig. 1. Electronmicrograph of an adult head louse Pediculus capitis
A.M.R. Downs, K.A. Stafford and G.C. Coles, Parasitology Today, vol. 15, no. 1, 1999

31. H. Morsy et al. Travel Medicine and Infectious Disease (2007) 5, 243–246

32. Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

33. Acknowledgements
Moh Hoesin Hospital Sriwijaya University
dr. Afaf Agil Almunawar, SpKK Prof. Charil Anwar, PhD
drh. Muhaimin Ramdja, MSc
dr. Inda Astri Aryani, SpKK