mange - a skin disease caused by the itch mite parasitism (Acarus scabiei) in the surface of the skin sections.
Scabies has long been known.References to it are found in Egyptian parchments.In ancient China, Babylon and the disease was also well known.Ancient Greek Aristotle even brings in his writings Description "tiny animals" blister skin rash sick people.
At present, the most widespread of the disease observed in socially unadapted populations.Outbreaks of its observed in disadvantaged regions of the world, where there is mass migration under the influence of natural disasters and military action.
In affluent regions in this sense as no one is immune from this disease.Thus, the appearance of one infected person in a group united for a while people (from the trip on the bus to an extended stay in the same room - kindergarten, school, boarding school) already suggests the presence of a potential outbreakof the disease.The greatest risk of getting in an age ratio have a youthful age (25-35%).This is because most of the contact activity as the teams during training (school, college, institute), and after it (informal connections, yard, boarding hostel).
increased risk of developing scabies promote active migration of vulnerable groups in the context of globalization of the world.Some risk of carries and mass tourism, especially extreme direction in exotic countries of the world where the disease is quite common.
lifecycle Clinical manifestations of the disease, caused by scabies mites manifestation of the life cycle, so it's worth it to dwell.
The adult female itch mite size of about 1/3 mm.Their photos are on the right.Males are about 1.5 times less and of no importance in the clinical manifestations of the disease are not.
Like all insects, in their development itch mites are the larval and adult stages.After fertilization, the female is introduced into the surface of the skin department (the epidermis).Eating epidermis, it moves, it moves in the paving, which in addition to its waste products leave the eggs.In one course can be identified intraepidermal 3-4 fertilized eggs at different stages of development.Above the laying females bore holes to facilitate the release of progeny to the skin surface.On the skin, the larvae spread around, get into hair follicles (hair roots), a stratum of skin flakes in the different elements of the rash (especially bubble).There they undergo a transformation, bypassing the intermediate stage, just in adults mature individuals tick.pairing occurs on human skin, and then, introduced into the epidermis females and males doctoring combing, separated from the skin and mikrocheshuykami die.The life expectancy of females - 6-8 weeks, during which she lays about 60 eggs.It is estimated that the potential hatching of adult ticks from one female for three months can be up to 150 mln. Individuals.
remote from the skin, in an environment at room temperature, itch mites are about a week to maintain its viability.In less favorable conditions, females live for about three days, and larvae - about two.
Infection healthy person implemented in close contact with the patient or indirectly through his belongings (combs, washcloths, towels, etc.).
typical (classical) form of scabies
From the moment of infection until the first clinical manifestations may take from 8 days to 6 weeks.It all depends on the state of the immune status and the number of ticks intruded.
main feature that attracts attention, is a strong, compulsive itch.Itching is the body's reaction to stimulation products mite activity.This response of the immune system, one of the parts of the external manifestations of which becomes an itching sensation, holding back the unrestrained multiplication of the parasite, the outcome of which could result in death.With great force, sometimes even deprived of sleep, pruritus manifested in the evening and at night.This is the most active female mite at this time.The main occupation in this period it becomes paving intraepithelial moves.
itch moves - this is the most characteristic symptom of scabies.On each turn, the female gnaws one or two branches, performing them in a few outlets.Each of the tribes laid fertile eggs.Then it continues to move in the main course.In the morning until mid-day activity of females drops sharply, and at the same time in all individuals.
When flaking skin old moves gradually found a whitish lines, such as surface scratches left on the skin during the point of the needle.Pictures have their frequency and repetition, which can be seen on the daily movement of the course.
length of diurnal variation is rarely more than 5 mm., And his whole life the female takes about 3-6 cm. Identify the itch moves can theoretically be on any part of the body, but most likely their location in areas with thicker surface epithelium.These areas are the skin of hands and feet.Thickness of the epidermis, are available, allowing the larvae to hatch from eggs long before reject the stratum corneum.Besides, it does not require too high a temperature the skin to maintain life cycle.
reaction to the introduction of the tick becomes as rash in the form of small, towering over the rest of the surface of the skin of red bumps (papules) 1-2 mm in diameter, sometimes with blisters on their top (pustules)filled with fluid.The first eruption of this type can be found on the place of introduction of the tick into the skin.Photo rash scabies you can see on the right.
number of papules, usually depends on the number of mites intruded.The rash may be initially numerous and "pour" after the emergence of new mature individuals.
scabies rash, along with the itch moves can often be found in the interdigital folds of the hands, feet.You can identify them on the flexor surfaces of the wrist joint, at the lateral surfaces of fingers, armpits, front, in the umbilical region, on the inner thighs, buttocks.Alternatively, the location of burrows found in men in the skin of the penis, women - around the nipples.
for children, due to the specific structure of the skin, the most characteristic localization rash moves on the palms and soles.
With strong itching and subsequent scratching a rash, in connection with the accession of infection takes blotchy appearance, with yellow crusts.Connection of inflammatory diseases of the skin, until boils and carbuncles.Connection of erysipelas infection and dermatitis.
Other typical symptoms of scabies
In addition, a long history of observations of scabies possible to identify a number of characteristic symptoms of authors, allowing to differentiate this disease from other diseases of skin appearances:
also regional lymph nodes may be enlarged.
Scabies itch moves without intraepithelial
extremely rare.In these cases, the infection is carried out is not of mature individuals, and on the stage of the tick in the larval stage.The rarity of this form of scabies is due to the fact that to keep the surface of the skin and the introduction of the parasite must have developed biting mouthparts, which are no larvae.Individuals of the same, who were able to resist and to penetrate into the hair follicles - causing a pronounced immune response to a stimulus.There is a strong itch and rash of allergic nature, not only in those places where the larva has taken root, but also throughout the body.Accordingly, until the larva matures into a mature individual females (and sometimes this takes up to two weeks) and not embedded in the epidermis, scabies rash moves in places you can not identify.
is named so because it was first described in Norway in patients with leprosy (leprosy) in the middle of the XIX century.This is the most contagious and malignant in its current form of scabies.It occurs in individuals with stable background suppression of the immune system, for various reasons.For example, after undergoing chemotherapy for cancer, hormone therapy with severe diseases of the corticosteroid.The risk of severe patients have Down's syndrome, HIV-infected people.Violations observed in skin sensitivity paralysis of various etiologies, some other diseases, particularly congenital skin keratinization may also facilitate the transition of the classical form of scabies in Norwegian.
Scabies "cleanly", or scabies "incognito»
Danger patients such kind of form of scabies is that because of their obvious exterior cleanliness and no one sees as the source of outbreaks.Yes, and the infected patient does not feel any disease.
However, complete self-recovery in such cases does not occur, since the maximum yield of mites on the skin takes place at night, when the unsuspecting patient is asleep and customary for yourself does not make ablution.
In this form of the disease is clinical complications in the form of dermatitis, skin boils, erysipelas, abscesses and soft tissue abscesses.Occasionally the disease may take the form of a light urticaria as an integrated response against the foreign antigen.On this basic treatment will be directed.
Accordingly, the disease will occur for a long time, and the patient will retain its danger to others as a constant source of scabies.
manifested rash of small elongated in line nodules (papules), blue-purple color.They appear in the projection of the burrows and the most frequently observed on the inner thighs, on the scrotum, buttocks, elbows on breast cancer in women.These towering above the reddening moves are explained by an allergic reaction know finding in these zones of the lymph nodes.Proof of this is the appearance of this type of rash in the same locations when re-infected with scabies.
This infection itch mites, parasitic on animals only.The difference is that the infection is carried out with larvae rather than adult ticks and the disease manifests itself immediately.Implementation is carried out in the open areas of the skin, due to penetration of the larvae in the hair follicle.Before the hidden areas of the skin, due to the inability to stay on the surface of the parasite does not reach.Upon reaching the age of mature mite or dies, or peeled off from the skin surface.Thus, after a brief itching and rash self-healing occurs.
Besides the classical clinical picture is necessary to confirm the presence of the parasite at different stages of its development.This is achieved by extracting it with a needle.
Furthermore, studied under a microscope the surface of the skin sections (epidermis) and extracted layer method slicing method using rapid diagnosis using 40% lactic acid aqueous solution.
Implemented using Antiscabietic, the choice of which in recent years is large enough.
The difference from the previous generation of such funds was the high speed of onset of therapeutic effect without any side effects.
most commonly used spregal, benzyl benzoate.
Preparations applied to the whole body in the evening, carefully rubbing, especially paying attention to the specific habitat for the parasite.The drug remains on the skin overnight and in the morning the patient is thoroughly cleaned.For better effect it is recommended to repeat this procedure after 2-3 days.
In complicated cases to the described treatment are connected antibiotics, antihistamines and hormonal ointments.In these cases, treatment should take place under the guidance and supervision of a physician.