Last week a mother and her two teenage children came to the clinic complaining of intensely itchy skin. I took one look at the lesions especially in the interdigital areas of the hands and feet to quickly diagnose it as scabies, a skin disease caused by tiny mites burrowing into the skin.
The mother immediately said that the three of them came 10 days earlier and were told that it was kudis buta, a Malay word for scabies. They were prescribed with an emulsion to be applied to the body and one of the sons was also given an injection but the conditions have not subsided and in fact it worsened in one of her sons causing him intense discomfort and unable to sleep at night due to the itchiness.
They looked exasperated and the mother said "Please give us injections and strong antibiotics to get rid of this skin problem!". I noticed that the son with the most lesions and purulent vesicles had a strange looking palms, dry and scaly and whitish And when asked how the palms came to be in such an appearance, the mother related that the boy had been applying the emulsion everyday at least two, three times to get rid of the itchiness for the last 10 days!
Obviously this family has not been informed about this skin condition as to its cause and how to prevent its recurrence and the proper use of the emulsion (Benzyl Benzoic).
I told them about the mite and its disease history and even showed them the pictures of the mites on Google and stressed upon them the need to sterilise their clothes and beddings and keep their house clean to get rid of the mites . And the emulsion is not to be used for days, in fact it is only for 2 to 3 overnight whole body applications. Chronic use of the emulsion can be poisonous or detrimental to health.
The mother looked perplexed and I had to explain to her several times that the condition would recur if she did not do anything to remove the mites in her house. The mites are not killed by antibiotics because they not bacteria ( the concept she found hard to understand in the first place).
After spending a good 15 minutes talking about the skin condition, the mother at last said " I have never known about how the condition is caused and now we will do as you say". It is sad when doctors don't explain to patients properly resulting in so much morbidity and in this case the two children had not gone to school for more than a week as their conditions looked embarrassing beside difficulty holding a pen to write.
Some doctors only know how to diagnose and prescribe but the prevention part is not explained. This happens due to perhaps their being too busy, failure to think that it is important or taking things for granted. To me patient-doctor interaction should always be educational in order to have a greater impact on patient's health.
The mother immediately said that the three of them came 10 days earlier and were told that it was kudis buta, a Malay word for scabies. They were prescribed with an emulsion to be applied to the body and one of the sons was also given an injection but the conditions have not subsided and in fact it worsened in one of her sons causing him intense discomfort and unable to sleep at night due to the itchiness.
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| The teenage patient's palms, note the pus-filled blister |
Obviously this family has not been informed about this skin condition as to its cause and how to prevent its recurrence and the proper use of the emulsion (Benzyl Benzoic).
I told them about the mite and its disease history and even showed them the pictures of the mites on Google and stressed upon them the need to sterilise their clothes and beddings and keep their house clean to get rid of the mites . And the emulsion is not to be used for days, in fact it is only for 2 to 3 overnight whole body applications. Chronic use of the emulsion can be poisonous or detrimental to health.
The mother looked perplexed and I had to explain to her several times that the condition would recur if she did not do anything to remove the mites in her house. The mites are not killed by antibiotics because they not bacteria ( the concept she found hard to understand in the first place).
After spending a good 15 minutes talking about the skin condition, the mother at last said " I have never known about how the condition is caused and now we will do as you say". It is sad when doctors don't explain to patients properly resulting in so much morbidity and in this case the two children had not gone to school for more than a week as their conditions looked embarrassing beside difficulty holding a pen to write.
Some doctors only know how to diagnose and prescribe but the prevention part is not explained. This happens due to perhaps their being too busy, failure to think that it is important or taking things for granted. To me patient-doctor interaction should always be educational in order to have a greater impact on patient's health.
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