Scabies( scabies) - Causes, symptoms and treatment. MF.

Scabies - a highly contagious( highly contagious) infectious-parasitic disease transmitted by a contact through a sick person or infected household items.

Causes of scabies

The causative agent is a tick( scabies itch - Sarcoptes scabiei) of very small size, which is almost impossible to see with the naked eye, it parasitizes the stratum corneum and causes artificial eczema. The tick moves in a layer of skin, leaving behind itself paths - courses.

Scabies mite

Causes of tick appearance: unsanitary conditions, violation of hygienic norms, contact with the infected( vigilance should be maintained even when there is only a suspicion of scabies).

Predisposing factor may be diabetes.

Symptoms of scabies

There are typical clinical symptoms of scabies that are typical for the main forms of the manifestation of this disease, but there are deviations from the standards that can lead to confusion and lead to contamination of others, especially this often happens during self-diagnosis and self-treatment. Therefore, with the first symptoms described below, you need to contact a dermatologist to prevent contamination of your immediate environment and not only.

The entire clinical picture will depend on the degree of response of the immune system and on the degree of maturity of the infected individual. If an adult female has infected, the symptoms will manifest within 24 hours, if the larva is not yet matured, and the symptoms will appear at the end of 4 days on average.

And so, with a typical clinical picture appears:

1 - skin itch, especially worse at night( this is due to the daily tick rhythm - it is active at night).
2 - whitish-grayish straight or curved lines 5-7 mm on the skin with papules or vesicles at the end of the stroke( as a polymorphous rash).
3 - point or linear excoriation( calculus).
4 - purulent-bloody crusts.
5 - Typical sites of rash: interdigital areas of the hands, abdomen( especially around the navel), on the buttocks, mammary glands - where the skin is thinner.

In the clinical form of "scabies of cleanliness" - minimal clinical manifestations, fewer rashes, they are not so pronounced and night itch less worries.

With "nodular scabies" , which is characterized by a hyperergic immune response and the main clinical manifestation will be the formation of reddish-brown nodules under the passages, while these formations will be resistant to anti-scabic therapy.

"Cortical scabies" is caused by immunodeficiency state and manifests by the formation of crusts on any parts of the body. This is the most contagious form, because the crusts are descended itch itch. The insidiousness of this form lies in the fact that, because of the low reactivity of the immune system, there are practically no clinical symptoms and the form of the disease is abortive, that is, any of the manifestations( mild or no skin manifestations - itching and calculi) can fall out. But there are also bright, mandatory features:

• affects the scalp and the hair becomes ashen-gray, dry and brittle;
• The cakes sit tight and their removal is painful;
• Places of damage are atypical: extensor surfaces( elbows, knees, back surfaces of brushes);
• Hyperkeratosis forms on the soles and palms and this leads to imaginary contractures( as additional folding bands);
• Nail plates are damaged( deformed, thickened, changing in color, sluschivayutsya).

Photo of symptoms of

Scabies. Disseminated papules and excoriations, as well as changes on flexural surfaces.

Scabies. Papules, pustules, crusts and excoriation on the sole.

Scabies. Exercised papule with a typical localization on the wrist.

Scabrous passage on the

nodular element Typical localization of scabies, itchy fingers between the fingers

Survey for suspected scabies

Necessary tests: for the final diagnosis for suspected scabies, it is necessary to conduct laboratory diagnostics - microscopy of scrapings from the sites of rash, these scrapings are detected by mites, its larvae and the products of life.

The earliest treatment is necessary for timely treatment, in order to prevent further widespread infection and secondary bacterial complications.

General laboratory tests will not give us any answer, just can the OAK( general blood test) show an increase in eosinophils( which indicates sensitization) and a picture of inflammation( with secondary infection).

Treatment of scabies

All contact persons are prescribed etiotropic therapy( i.e., antiscabiotic drugs).Modern preparations for the treatment of scabies are effective, safe, have wide bioavailability, are comfortable and effective in cosmetic terms( there is no smell and color, do not contaminate clothes), are relatively cheap. The main groups of drugs used for treatment are antiparasitic and antiseptic( there are complex drugs containing both) + antihistamines and / or SCS.

In general, Spragal is now used as an aerosol( it can also be used for children.) Irrigate the skin, except the head, and do not flush for 12 hours( that is, the convenience of application - once a day).soap. The procedure is repeated for 2 days and on the 4th for monitoring. When the drug is applied, the clothes are changed. In severe cases, the drug is used 2 times a day).

Permethrin is an analogue of Lindane, but it is not neurotoxic( it can be pregnant and children, also people with neuropathology), therefore it is a drug of choice in the whole world. It is applied nanoch, and washed off in the morning( the babies are washed off for 6 hours).And so within 2 days, 4 day - the control. On the plantar and palmar regions, the drug is applied even on day 10, because of the thick stratum corneum.

Ivermectin is convenient and effective in application and quickly comes to cure, but is toxic when the dosage is disturbed, so apply 200 mg / kg once a week, repeat only next week.

If possible, after washing off the antiparasitic drugs, use an antiseptic sulfuric ointment( 20% for adults and 6-10% for children) - daily rubbing of the nanocream for 5 days. In hospitals, the use of benzoic acid( but it can cause dermatitis), Lindan( if there are no violations from the periphery of the nervous system) is possible.

For "cervical scabies", keratolytic ointments that dissolve the crusts( salicylic acid) should be applied first, and afterwards - general treatment. Also it is necessary to pass an immunogram for finding out the reason of anergy( low response of the immune system).It is mandatory to use antinistamine drugs( or suprastin, or tavegil, or cytirizine.)

Citrine is an analogue of cytirizine, but it may not help, because the structural formula has been changed).

Treatment is carried out on average for 4 days, and is monitored for 2 weeks.

Features of treatment:

• treatment with medicines not only affected areas of the skin, but also the entire surface of the skin.
• After treatment, itchy skin can become worse due to mass death of itch itch, so drugs are administered under the supervision of a doctor - he prescribes antihistamine therapy.
• Only symptomatic therapy( antihistamines or GCS) does not destroy the pathogen, but only reduces the degree of itching, and this can harm not only the most infected( due to side effects), but also the surrounding.

Folk remedies for scabies

On the part of the principles of nutrition at the time of infection, there are no special features, because there is no massive systemic damage( but perhaps a small restriction of sweetness and the use of vitamin complexes).

Post-infection rehabilitation will consist in restoration of the buffer function of the skin - the use of baths with the addition of oils, softening creams, the continued use of vitamin complexes. Treatment with folk remedies is better not to use, because the phytotherapy area is not developed enough and there is no confidence in the conscientiousness of manufacturing the drugs by the producers;improvement can only occur symptomatically. But absolutely harmless can be considered the use of baths with chamomile broth.

Possible complications of scabies:

secondary infection( pyoderma, microbial eczema), urticaria, dermatitis, pseudolymphoma( especially in children in the first months of life).

An appeal to a dermatologist is obligatory, because this disease can be masked under many others: eczema, atopic dermatitis, pruritus, syphilitic papules, parasitic diseases, phleboderma, dermatosis of pregnant women, pseudoraportosis.

Prevention of scabies:

personal hygiene, heat treatment of bed linen( necessarily ironing), disinfection of laundry can be carried out additionally with A-PAR aerosol.

Doctor's consultation on scabies:

Question: "Is it possible to infect scabies from animals?"
Answer: no, because animals are not vectors. From them you can get infected only with pseudo-sarcosis and then, it will be enough to use antiseptic solutions, because on the human body these parasites do not live and leave behind only bites and a slight itch.

Question: "Do antiparasitic ointments need to be used after 3 days, if the itching does not subside ?" »
Answer: No, because the effect of antisquash preparations is not dose-dependent and can cause an overdose. In such cases, antihistamines and laboratory control are needed after 7-10 days.

Question: Do antiparasitic drugs apply to the scalp?
The answer: no, apply an oiled soap.

Question: "How often do I need to change clothes during the treatment of scabies?"
Answer: after each application / rinsing / applying a new preparation. In this case, the laundry should be boiled and after ironing.

Physician Therapist Inna Shabanova