Scabies ( itch mite ) - Causes, Symptoms and Treatment .MF .
Scabies (scabes) - highly contagious (highly contagious), infectious and parasitic disease transmitted by contact through infected person or infected household items.
Causes of scabies
The causative agent is a mite (Sarcoptes scabiei - Sarcoptes scabiei) very small size, which is almost impossible to see with the naked eye, it is a parasite in the stratum corneum and artificial causes eczema.Tick moves in the skin layer, leaving a track - moves.
Causes mite: unsanitary conditions, violation of health standards, contact with infected (vigilance should be kept and when there is only a suspicion of scabies).
predisposing factor could be diabetes.
Symptoms of scabies
There are the typical clinical symptoms of scabies, which are characteristic of the main forms of manifestation of the disease, but there are deviations from the standards which may be confusing and lead to contamination of the surrounding, especially often happens when self-diagnosis and self.Therefore, when the first
entire clinical picture will depend on the response of the immune system and the degree of maturity has infected individuals.If infected adult female, the symptoms show up during the day when the larvae - that has not yet completed its maturation, and the symptoms manifested by the end of 4 days on average.
And so, with a typical clinical picture appears:
1 - itchy skin, especially growing at night (it is related to the circadian rhythm of the tick - it is active at night).
2 - whitish-grayish straight or curved line of 5-7 mm on the skin with papules or vesicles at the end of the course (as polymorphic rash).
3 - point or linear excoriations (raschёsy).
4 - purulent bloody crusts.
5 - Typical places rashes: interdigital region of brushes, stomach (especially around the belly button), buttocks, breasts - where the skin is thinner.
In clinical form «scabies cleanly» - minimal clinical manifestations, less rash, they are not as pronounced and less concerned about the night itching.
When «nodular scabies» , characterized hyperergic immune response and the main clinical manifestation is the formation of nodules of reddish-brown under the moves, while these formations are resistant to protivoskabioznoy therapy.
«Cortical scabies» due immunodefetsitnym state and manifests the formation of crusts on all body parts.This is the most contagious form, because the crust - is exfoliated itch mites.Guile in this form is that due to the low reactivity of the immune system, almost no clinical symptoms and disease form abortive flow, ie may fall in any of the manifestations (weakly expressed or absent cutaneous manifestations - raschёsy and itching).But there is a bright, mandatory features:
- affected scalp and the hair becomes ash-gray, dry and brittle;
- Corky firmly seated and removing them is painful;
- atypical lesions Places: extensor surfaces (elbows, knees, hands rear surface);
- on the soles and palms hyperkeratosis is formed and this leads to an imaginary contractures (flexion as additional lanes);
- Affects the nail plate (deformed, thickened, change in color, exfoliated).
Scabies.Disseminated papules and excoriations, as well as changes in the flexor surfaces.
Scabies.Papules, pustules, crusts and excoriations on the sole.
Scabies.Ekskoriirovannaya papule with a typical localization on the wrist.
Itch move on the nodular elements
typical localization of scabies, itch moves between the fingers
survey of suspected scabies
Necessary tests: for the definitive diagnosis of suspected scabiesit is necessary to carry out laboratory diagnostics - microscopy of scrapings from the field rashes in these scrapes detect mite larvae and its waste products.
The earliest reference to the doctor is necessary for the timely start of treatment, in order to prevent further widespread infection and secondary bacterial complications.
Common laboratory tests, we will not give any response, just did the KLA (CBC) may show an increase in eosinophils (indicating sensitization) and the picture of inflammation (if secondary infection).
All contact persons designate causal treatment (ie protivoskabioznye drugs).Current drugs for the treatment of scabies are effective, safe, broad bioavailability, comfortable and effective in relation to the cosmetic (no odor and color, does not pollute the clothes), are relatively cheap.The main groups of drugs used to treat - antiparasitic and antiseptic (there are complex formulations containing in itself both) + antihistamines and / or corticosteroids.
Basically now prescribe aerosol Spregal-complex preparation (it can be for children and irrigates the skin, except for the head, and do not wash within 12 hours (ie ease of use -.. 1 time per day) After that, take a showerwith soap and water. The procedure is repeated for 2 days and 4 minutes for the control. After treatment, linen change. in severe cases, the drug is used 2 times a day).
Permethrin - an analogue of lindane, but is not neurotoxic (it can be for pregnant women and children, and people with neuropathology), so it is the drug of choice in the world.His nanoch applied and washed off in the morning (in infants wash c / o 6 hours).And so in the course of 2 days, Day 4 - control.On the plantar and palmar region formulation is applied also on day 10, because of the thick stratum corneum.
Ivermectin is convenient and effective to use and fast cure comes, but in violation of toxic dosages, so use 200 mg / kg, 1 time per week, repeat until next week.
possible, after rinsing antiparasitic drugs used sulfuric antiseptic ointment (20% for adults and 6-10% for children) - Daily massaging nanoch within 5 days.In hospitals possible to use benzoic acid (but it may cause dermatitis) Lindane (if no violations of the peripheral nervous system).
When "cortical itch" to start to apply the ointment keratolytic, dissolving crusts (salicylic acid), and after - a common treatment.You also need to pass immunogram to determine the cause anergy (low response of the immune system).Be sure to use antinistaminnyh drugs (or suprastin or tavegil or tsitirizin
Citrine -. Tsitirizina analogue, but can not help, because it is a structural formula is changed).
treatment is carried out for an average of 4 days, and monitored for 2 weeks.
- processing drugs not only the affected areas of the skin, but also the entire surface of the skin.
- After treatment, itching may be enhanced due to the mass death of scabies mite, so drugs are used under the supervision of a doctor - he appoints antihistamine therapy.
- Only a symptomatic treatment (antihistamines or corticosteroids) does not destroy the pathogen, but only reduces the itching, but it can do much harm not only to the infested (because of side effects), and others.
Folk remedies scabies
From the principles of nutrition at the time of infection of the features there, because there is such a massive destruction of the system (but perhaps a little sweet and limit the use of vitamin complexes).
Postinfective rehabilitation will be to restore the buffer function of the skin - the use of baths with the addition of oils, soothing creams, continued use of vitamin complexes.Treatment of folk remedies is better not to use, because the area of herbal medicine is not sufficiently developed and there is no confidence in the integrity of manufacturing products manufacturers;improvement may occur only symptomatically.But it is absolutely harmless can be considered the use of baths with chamomile broth.
Possible complications of scabies:
secondary infection of (pyoderma, microbial eczema), urticaria, dermatitis, pseudolymphoma (especially in children during the first months of life).
necessarily appeal to a dermatologist, because the disease can masquerade as many other eczema, atopic dermatitis, pruritus, syphilitic papules, parasitic prof.zabolevaniya, flebodermiya, dermatoses of pregnancy, psevdosarkoptoz.
Prevention of scabies:
personal hygiene, heat treatment underwear and bed linen (required proglazhivanie), disinfection of laundry can be conducted additionally spray A-PAR.
Doctor's consultation on scabies:
Question: "Is it possible infestation with scabies from animals?»
answer is no, because the animals are not carriers.From them, you can only catch psevdosarkozom and that will be enough use of antiseptic solutions, because the human body these parasites do not live and leave behind only a small bites and itching.
Question: "Do I need to use antiparasitic ointment after 3 days, if the itching subsides ? »
Answer: No, because the effect of drugs protivoskabizoynyh not dose-dependent and can cause an overdose.In such cases, antihistamines and laboratory control in 7-10 days.
Question: "Are antiparasitic drugs on the scalp?"
answer is no, Degtev soap used.
Question: "How often should I change clothes during scabies?»
answer after each use / flushing / application of the new drug.At the same time, clothes should be boiled and then iron.
therapists Inna Shabanova