RTS - Cradle Cap, Threadworms

Question 1

How is cradle cap identified ?

Answer 1

yellow greasy scaly patches on the scalp

usually occurs during a babies first 3 months of life

can last a few weeks or months and usually clears up by 2 years of age

Question 2

What are the symptoms of cradle cap?

Answer 2

yellow greasy scaly patches on the scalp
scales, flakes and yellow crusts on the scalp
affected area of skin appears red

Question 3

Where can cradle cap spread to?

Answer 3

behind the ears
nappy area - groin
nose 
armpits
backs of knees
in areas other than the scalp it is called seborrhoeic eczema

Question 4

What causes cradle cap?

Answer 4

not clear - not contagious
could be linked to overactive sebaceous glands - produce an oily substance called sebum

some babies can retain some of their mother’s hormones in their bodies for several weeks after birth making their glands more active

excess sebum causes the old skin cells to stick to the scalp instead of drying up and falling off

Question 5

What are treatment options for cradle cap?

Answer 5

no specific treatment required

gently washing the baby’s hair may prevent build up of the scale

• to help loose the crust, massage a small amount of baby oil or petroleum jelly into the scalp at night
• use a soft baby brush or cloth to remove any loose particles
• wash the hair with baby shampoo

if this does not work then use a mild shampoo - dentonix cradle shampoo
avoid shampoo that contain ground nut oil or peanut oil for children under 5

Question 6

How to identify threadworms?

Answer 6

affects 20% of community
65% in institutional settings
can reach 100% in certain populations

Question 7

What causes threadworms?

Answer 7

helminth infection - parasitic worms

not water borne

Question 8

How are threadworms spread?

Answer 8

faecal - oral infection
- eggs lodged under nails are digested
retroinfection
- larvae hatch on anal mucosa and migrate back into sigmoid colon

is common in preschool and school-aged children

Question 9

How do threadworms spread in the body?

Answer 9

• eggs are ingested
• duodenal fluids break them down and release larvae into the intestines
• after mating female migrates to anus (night) and lays eggs on the periannal area where she dies
• eggs are infective immediately
• transmission occurs back into the gut and cycles continues

Question 10

What are symptoms of threadworms?

Answer 10

night time periannal itching which can lead to sleep disturbances

threadworms look like thin, white cotton threads

Question 11

How can you test for threadworms?

Answer 11

sticky tape test (am) before wiping or bathing - check tape under microscope

diagnosis is confirmed by observing worms in stool

Question 12

What are complications that can occur due to threadworms?

Answer 12

excoriation - picking, scratching of skin

secondary bacterial infection

Question 13

What are hygiene measures taken can be taken for threadworm?

Answer 13

wash sleep wear, bed linen, towels and toys

• vacuum and damp dust home
• wear close fitting underpants and knickers at night
• shower every morning
• wash hands and scrub under nails first thing in the morning and after each use of the toilet
• avoid biting nails
• avoid sharing towels

Question 14

What are treatment options for threadworms? What should not be given to epileptic patients?

Answer 14

OTC products

• mebendazole tablets = inhibits worms uptake of glucose
• piperazine tablets = paralyses worm so optimises worm clearance and contains Senna which is a laxative and stimulates expulsion of the worms

must treat all family members at the same time and repeat after 14 days

avoid both preparations in pregnancy

anti-histamines should not be given to epileptic patient