The problem of parasitic skin diseases is one of the most serious in public health. This is explained by the fact that, despite the fact of the highest prevalence of different types of scabies among people leading an antisocial lifestyle, the level of infection in all layers of the population is very high. About how to treat scabies in humans, how it looks in children, how to identify and recognize scabies in the home - all this you will learn from this article.
Features of the pathology
General information on the typical form of scabies
Scabies are acute, highly contagious( highly infectious) and widespread dermatosis caused by the scabic subcutaneous tick Sarcoptes scabiei, also called pruritus. Specificity of the disease - a strong itching, itch moves, a special localization on the skin of a variety of rashes.
All manifestations of pathology( pruritus, papules, nodules), in fact, are allergic reactions of the body to saliva, excrement, excreta, metabolic waste of the pathogen. Th
e intensity of pruritus, the amount and degree of rash manifestation in the form of red papules( knots) and translucent pink vesicles( vesicles) is associated not only with the number of mites that have penetrated the stratum corneum, but the degree of human sensitivity to tick-borne toxins and the response immune response, which is manifested inthe power of itching.
Scabies is complicated in half of the patients combing the highly itchy areas. It is easy to introduce pyogenic bacteria, causing pyoderma. Then the skin, except for itching, is covered with abscesses. Especially often, such cases of complications occur in children who are severely affected by itching and actively combing the skin, damaging it.
Scabies, the first signs( photos)
The course in children
In infants up to six months, manifestations of scabies resemble hives( large merging edemas of bright pink color, similar to blisters from nettle burn).The picture of the disease often makes it difficult to diagnose, because it resembles the symptoms of eczema. But eczema is not cured by pharmacological drugs commonly used in scabies.
In younger children, up to 3 - 4 years, rashes very rarely appear on the sides of the fingers and in between. Sometimes the disease affects even the marigolds of small children. Nails crack, become loose and thick.
A characteristic feature of the manifestation of the disease in children is the defeat of the whole skin of the body, head, face, which is not observed in adults. About the types and stages of scabies in humans will be described below.
From this video you will learn how to distinguish scabies from psoriasis and other such diseases:
There are two main stages in the course of the disease:
- The latent period of during infection lasts approximately from 2 to 5 weeks, but more often 12 to 18 days. Its duration is related to the rapidity of the reaction of the defense system to the introduction of a foreign agent, with the number of mites that managed to penetrate the epidermis. The more ticks infiltrated under the skin, the shorter the incubation stage. During this time, the parasite develops new areas under the skin for reproduction and feeding, and the immune system is turned on, starting to react to the pathogenic microorganism and its toxins. A short incubation stage, from 5 to 12 days, is usually characteristic for the variant of infection of the carrier with mature tick-borne females, which immediately begin to eat up subcutaneous courses. In the case of infection, only tick-larvae require about 14 days, so that the process of their transformation into active individuals under the stratum corneum occurs.
- After the latent period of is over, reddish papules( erythema) begin to appear on the skin. There are separate nodules scattered around the skin or merged into large spots. After a few days, the papules turn into bubble vesicles. Then they burst with the formation of blood crusts. Purulent crusts mean that the pathology was complicated by an infection that penetrated the places of scratching.
If repeated kleshchevaya attack occurs, the reaction of the body to parasites, their isolation and waste manifests itself much faster - in a few hours. Immunity on Sarcoptes scabiei does not develop, but re-infection is usually difficult, and the number of mites is much less.
Classification and forms of
External skin signs of scabies often differ, and the classification of forms enables the specialist to quickly diagnose and develop a therapy program. Such kinds of scabies are considered:
- typical form;
- pseudosarctosis( false scabies);
- scabies of "cleanliness"( "incognito");
- Norwegian scabies;
- disease without tick movements;
- pathology complicated by infection;Sciabian skin lymphoplasia.
A typical form, less problematic in treatment, is most common. It is characterized by typical skin reactions: acute itching, tick movements, papular and vesicular eruptions.
With a typical form of the disease, a certain equilibrium state is formed between the parasites and the immune system, in which the organism exists without serious complications and acute allergies. This kind of scabies, usually, does not cause difficulties in diagnosing and developing therapy.
The active spread of the itch of Sarcoptes scabiei, which survives only in the human body, is determined by specific causes:
- develops and passes only "from skin to skin" among humans;
- itchy itching - it's permanent( living only on the host) parasites;
- modes of transmission contribute to high infectiousness: direct contact( when intimacy, touch, handshake) or mediated( through dishes, bedding, telephone tubes, toys, stair rails, personal belongings);
- high degree of crowding of people;
- severe sanitary conditions of life, underdeveloped hygienic habits;
- high migration;
- illiterate self-treatment.
A hotbed of infection with scabies in medicine is considered a group of closely communicating individuals, among whom there is at least one ill. In addition, there are a number of specific conditions for the transmission of the parasite:
- close and frequent physical contact with the sick, including direct transmission of the tick through a shared bed( in almost 50% of cases, infection occurs through intimate contact);
- family ties, especially - in the presence of small children, when the most likely direct route of transmission of the tick during communication and care of the baby.
In addition, cases of infection occur:
- when caring for a patient, massage( rarely);
- in close contact groups( kindergartens and houses of babies, schools, courtyards "collectives"), where the disease is easily transmitted indirectly during games at the contact of children, through soft toys and bed-clothes, books, shoes and clothes;
- in the transmission of parasites occurring in trains, dormitories, shared showers and baths, sanatoriums under unsatisfactory sanitary conditions. Since up to the day the zudene remains viable outside the human body, it quickly transfers to the "master" when it comes in contact with handrails, toilet paper, towels, bed linen.
On how scabies are manifested in children and adults, we will tell below.
To quickly and correctly diagnose scabies, it is necessary to remember its three basic symptoms so as not to confuse the disease with insect bites or allergies.
Usually, the following symptoms of the typical form of scabies occur:
- intensifying the intensity of itching in the evening and at night. This is an important feature that is determined by the precise life-cycle of female scabby pruritus, which show the main activity by evening and at night, when they eat up the courses;
- elements of various types of rashes( papules, vesicles, crusts) are usually localized in known areas. Typical places:
- almost all( except children) - skin on the sides of fingers and between them;
- in half of cases - wrist area;
- in half of men - the head of the penis;
- every tenth sick woman - skin around the nipples;
- approximately in 20 - 25% of cases - rashes are fixed on the buttocks, feet, abdomen, arms and legs, on the skin in the flexural folds of the joints, hollows under the knees.
- involvement in the pathological process of the wrists, hands and fingers is a special sign of scabies. This manifestation is not observed only if the person is clean, if the infection, for example, occurred during intimate contact, and the mites have not yet reached the brushes;
- is a very important characteristic - group itching. That is, if in a close team at night people begin to itch, this is a characteristic symptom of scabies.
Scabies that are eaten by female mites are not always detected, but their presence is a reliable symptom. They look as sinuous or straight to 10 - 15 mm, protruding under the skin are narrow dirty-gray scratches.
Knowing the symptoms of scabies in children and adults, let's talk about its treatment and diagnosis.
About the symptoms of scabies will tell this video:
For precise definition of the diagnosis of scabies it is quite enough to find tick movements, but they do not always appear.
- It is very easy to detect badly visible pathways of movement with iodine. When iodized with suspicious areas of the skin, strokes in the form of brown strips are clearly visible against the background of the skin, which is colored in a light brown hue.
- Modern diagnostic technology - videodermatoscopy - a method of early diagnosis of skin diseases, in which it is easy to identify tick movements at a magnification of six hundred times.
- The most famous method for rapid confirmation of a diagnosis is a skin scraping, which is often performed using 40% lactic acid, which does not irritate the skin and prevents possible festering. The acid is applied to any papule, nodule, tick progress, waiting for 5 minutes, until the softening of the stratum corneum. Then a piece of the stratum corneum is scraped off and analyzed under a microscope in a lactic acid medium.
- An even simpler method is extracting the itch from the vial at the end of the tick progress with a medical needle with further examination under a microscope.
About the medicine and preparations for scabies, folk remedies and methods of treating it in children and adults, we will tell below.
Basic rules of
Basic rules for the treatment of scabies:
- All infected from the same infectious focus( family, sexual partners, kindergarten group, school class, office employees, sports team) are treated at the same time.
- Any means should be rubbed into the skin with unprotected palms, as the wrists and wrists are paralyzed first.
- Nails should be cut for adults and children, because under them combing can get eggs or Sarcoptes scabiei larvae.
- It is necessary to disinfect clothes and clothes qualitatively, otherwise the surviving mites can re-enter the skin repeatedly. The tick dies in 100% of cases after 10 minutes of boiling the laundry in water with soda or detergent. It is allowed to iron all objects of linen and clothes with a hot iron. Or use an effective way for the lazy: the clothes are hung in the air( preferably in the sun) or folded for 5 days in a plastic bag. Ticks outside the human body die very quickly. On average, after a few hours( from 1 to 24).Therefore, 5 days in the air and under the sun - quite enough for 100% disinfection.
Many drugs are used to treat scabies, differing in cost and quantity of treatments. The most effective and inexpensive anti-scabic( anti-scratch) agents are discussed below.
Ointment, emulsion Benzyl benzoate( 20% of the formulation is used for adults, 10% in pediatrics).To get rid of parasites, only 2 treatments are required. The product is well absorbed, leaving no residue on the laundry. But Benzyl benzoate acts only on mature individuals, without destroying larvae and eggs, therefore treatment is carried out for 2 times.
Treatment begins in the evening( due to night activity of the parasite) as follows:
1 day( first treatment): washing with soap to rinse it and loosening the skin so that the medicines penetrate deeper into the stratum corneum. Palms actively rub emulsion or cream into the body, excluding the head and face. Children are treated completely, because they have pincers penetrate the skin on the head and face. Washing is allowed after 12 hours, but more effective - do not take a shower before the end of treatment.
Day 4( second treatment): a repetition of the treatment procedure to surely destroy new prurines hatched from eggs. After 12 hours, they again vigorously wash and change all the linen.
- Permethrin is a highly effective antisabiotic agent in the form of a spray, cream, lotion, ointment. The most common treatment is 5% cream with two treatments.
- Aerosol Spregal( France).Costly, effective, odorless, kills eggs and larvae. But its vapors are not allowed to inhale, because the drug contains poisons that affect mites and do not improve human health. The instruction recommends a one-time treatment, however, domestic dermatologists advise to spend 2 times a day with an interval of three days for reliability and prevention of relapse.
- Ordinary sulfuric ointment( for adults 20 - 33%) is often used as a proven, harmless and reliable remedy. Rubbed every day for a week. Disadvantages: odor, fatty base, soiling.
For the treatment of children, any remedy is used in a concentration that is half that of adults. Use antiscabiotic agents in the form of liquid, sprays and creams.
- The non-toxic 3 - 5% sulfuric ointment is considered the safest for children under 5 years old.
- Newborns up to 2 months with scabies appoint only sulfuric ointment.
- For infants from 2 months to a year, it is allowed to use Spregal and a 10% emulsion of benzyl benzoate.
- Children older than one year - Permetrin.
On the prevention of scabies in children and adults we'll talk further.
Prevention of the disease
Preventive measures to prevent infection with scabies include:
- detection of cases and treatment;
- detection of foci of epidemic of scabies and their elimination;
- registration and clinical examination of patients in all layers of the population;
- establishment of precise criteria for determining the cure of patients;
- identification of children's institutions, organizations with a scabies outbreak, ongoing disinfection of toys, clothes, bed linen, shoes with A-Par spray;
- all healthy individuals in families with scabies, in organized collectives, as well as persons with intimate contacts outside the epidemic focus, carry out compulsory one-time treatment with any anti-scratch drug to prevent possible infection.
With continued scabies, improper treatment develops:
- dermatitis, microbial eczema, pyoderma( extensive pustular lesions), capable of passing into furunculosis, ectymium( deep inflammation of the skin with streptococcal lesions), staphylococcal impetigo, folliculitis;
- nervous exhaustion and psychological disorders associated with prolonged intense itching, interrupting night sleep and complicating a full-fledged active life. Especially dangerous are neural complications in childhood;
- destruction in children of nail plates, where the female tick likes to multiply, as in a soft, but protected place.
In some cases( with increased susceptibility of the organism to secretions of itchy itching, frequent allergy manifestations, bronchial pathologies), the process can be complicated by the development of urticaria, Quinck's edema, and in some cases - allergic shock;
The prognosis for the typical form of scabies is maximally favorable - provided that the treatment is started and fully conducted in accordance with the recommendations of the dermatologist.
Even more useful information about scabies of a typical form will be given in this video by Elena Malysheva: