Scabies presents as an intensely pruritic rash that predominantly involves hairless and thin skin such as web spaces of the hands and skin creases. Sensitization to mite products is responsible for the itch and therefore symptom onset is usually delayed by weeks in the first infection. Secondary bacterial infection with Staphylococcus aureus and Streptococcus pyogenes is responsible for significant morbidity. Crusted scabies, the most severe form of scabies, presents as a hyperkeratotic rash. Lesions are loaded with mites and such patients are highly infectious. Direct skin-to-skin contact is the most important mode of transmission. Parasitological diagnosis is difficult and therefore clinical diagnosis is usually relied upon, although new diagnostic methods are under development. The most commonly used treatment of choice is topical permethrin cream applied to the whole body. Ivermectin, administered orally, is increasingly being used, including for mass drug administration.

"This chapter is divided into three sections. The first provides the reader with a historical perspective of Australian Aboriginal and Torres Strait islander peoples, the impact of colonisation and contemporary access to mental health care. The second section is written from a remote rural mental health nurse perspective, providing insight into some of the concerns and challenges of working in often far distant places, away from acute care services, to provide mental health care to Indigenous people within Australia. The last section comes from our colleagues in New Zealand, exploring the bi-cultural nature of mental health care in that country. This section offers insights into how care can be provided within a culturally safe and inclusive manner. " -- taken from the introduction to the chapter.

None available.