Scabious lymphoplasia or nodular scabies is a highly contagious parasitosis with a skin lesion that causes a microscopic subcutaneous tick of the species Sarcoptes scabiei, leading an active life in the human epidermis, gnawing the "tunnels" and laying eggs in them. We will tell you about the signs of the disease and the treatment of nodular scabies( scabious skin lymphoplasia) in adults and children, show her photos and share tips with you.
Disease The latent course of the pathology lasts from 3 to 14 days. Nodular form of scabies develops as a hyperergic( especially pronounced) immune reaction of the body to allergens, which are saliva, feces, egg shells, glandular secretions.
The reaction is characterized by the so-called hyperplasia of lymphoid tissue, which is an abnormal growth of cells in the lymphatic tissue of the skin. Externally, it manifests itself in the form of dense small red-brown knots on the skin, which intensively itch.
It has been confirmed that the main s
ource of allergens that cause hyperplasia are wastes and segregations of unfertilized zudnev females that do not lay eggs and do not make holes in the upper zone of itch moves. The absence of such apertures limits the penetration of anti-scabic agents from the surface of the skin into the tick-duct. For this reason, nodular scabies are difficult to treat.
About stages of skin disease, nodular scabies, we will tell below.
Scabiotic lymphoplasia, nodular scabies( photo)
Scabiotic lymphoplastic stages
Studies and statistics prove that nodular lymphoplasia is a consequence of a long-running scabies of a typical form that has not been treated or treated incorrectly. In fact, this is a typical scabies( not to be confused with Norwegian, cleanliness and others) in a very neglected stage, when all anti-catabolic( anti-malignant) drugs already have little effect on the lymphatic growths, under which the mites hide.
Nodular formations, pruritus with nodular scabies often persist up to 3 - 5 weeks( often up to 2 - 3 months) already after correctly conducted therapy. Female zudna retain vitality up to one and a half months, so after treatment, patients still suffer from itching for a long time. The course of the process is often very long( up to several years).
The root cause of nodular lymphoplasia is an itch mite that lives beneath the human stratum corneum.
The main causes of hyperplasia of lymphatic tissue and the formation of a nodular form of scabies:
- prolonged ignoring of signs of usual scabies;
- relapses of pathology due to excessive use of anti-catabolic drugs;
- parasite resistance to an incorrectly selected acaricidal agent;
- secondary infection with pruritus.
The dense itching nodes that appear with the nodular form of scabies are distinguished by their high resistance to acaricidal( anti-scratch) preparations, since the curative substances are unable to penetrate the dense skin formations to the habitat of the parasite. For this reason nodular scabies are difficult to treat, and the healing process is delayed.
In addition, a very common error in the treatment of scabies, leading to lymphoplasia is the excessive use of antiparasitic medicines, which leads to the development of so-called post-scabic dermatitis. This happens when the patient has completed treatment, and it continues to be troubled by itching and individual rashes. The patient( and sometimes the doctor) makes a false conclusion that the drug is ineffective, and repeats the course of treatment or uses another means.
A persisting itch is actually a response of the immune system to toxins and secretions of the killed pruritus and does not require further treatment. If you repeat the course, itching often grows, and there are additional rashes, which indicates the development of post-skyscraper dermatitis - an allergy to excess medications.
The main signs of nodular scabies:
- A few, highly itchy round or oval seals on the skin of 2-20 mm in size are dark red, brown and cyanotic pink with a characteristic spread in the following places:
- scrotum and inguinal folds;
- inner thighs;
- buttocks, axillary folds and buttocks;
- area around the anus;
- areoles around the nipples.
- Scallop ducts located on the surface of the formed nodules.
- Severe itching, leading to combs in the areas where ticks are introduced.
Diagnosis of lymphoid hyperplasia is based on:
- of external manifestations in the form of a nodular rash in size from pepper to beans in characteristic places;
- patient complaints of painful itching.
- frequent detection in the blood of an infected person with developed nodular scabies increased lymphocyte count.
Nodular scab is confirmed after laboratory analysis for the detection of pruritus, larvae, eggs, membranes, excrement in skin scrapings on the sites of rashes.
Extraction of the
mite. First, open the end of the tick-duct at the spot where the dark spot( the tick-borne female) is seen by the needle. When the needle is advanced along the canal, the mite often clings to the needle, so removing it does not cause difficulties. After this, the itching is examined under a microscope.
Thin section or scraping
A sharp razor cuts the stratum corneum with a tick-like channel very thinly. Fabric pour alkaline solution, leaving for 5 minutes. Or on a nodule, a crust, a tick duct, lactic acid is applied to loosen the epidermis and after 5 minutes the tissue is scraped off until the appearance of blood from the capillaries.
The material of scraping or cutting is examined under a microscope. These methods allow us to consider not only Zudna, but also larvae, eggs, membranes, excreta.
The night manifestation of nodular and other forms of scabies will be described in her video by Elena Malysheva:
Differential diagnosis of
Nodular scabies are differentiated from other acariases( diseases caused by subcutaneous parasites):
- pseudosarcoptosis( scabies of animals) developing upon penetration of skin scalesman ticks from birds and animals;
- cereal scabies, which causes a pot-bellied tick, living in rotting straw;
- thrombidiosis, which provokes larvae of mites living on plants.
It is compulsory to compare lymphoid hyperplasia with neurodermatitis and pruritus( itchy dermatoses belonging to the group of cutaneous pathologies of neurogenic-allergic origin).About treatment of scabies of a nodular at the person in house conditions national agents and traditional we shall tell below.
The treatment of nodular scabies is significantly hampered for two reasons:
- is the density of nodules on the skin that interferes with the penetration of the drug to the "mite" habitat;
- development of dermatitis in overuse of medicines.
It should be remembered that the causative factors of the development of the nodular form of scabies are: lack of treatment in general or wrong treatment. Lymphoplasia is often observed with a long course of the disease and excessive use of acaricidal drugs. For example, the use of an emulsion of benzyl benzoate for 4 to 7 consecutive days. Or therapy with one remedy, and then a long( up to 7 - 10 days) use of another.
Studies and patient observations confirm that all antisabiotic agents are effective against mites if they are treated correctly. Major errors in treatment leading to the development of scabious lymphoplasia:
- unreasonable repeated conduct of the course of acaricidal medicines against the background of the development of pruritus and dermatitis, which are not related to the activity of ticks, but are the reaction of the organism to the anti-drug preparations themselves;
- disregard of therapy in the presence of nodular scabies;
- non-simultaneous treatment in a group of people living or working together( family, office, children's groups in schools and gardens);
- is an unreasonably high concentration of acaricidal medication used in the treatment of a child.
Anti-acne therapy is performed only after confirmation of the diagnosis. It is necessary to be convinced, that external displays on a skin and an itch are signs of a nodular scabies, and not one of forms of a dermatitis.
About what ointment, remedy and lekasrva from nodular scabies are best help, we will tell below.
Treatment is carried out in a complex manner. The following groups of medicines are used:
- Emulsion( 20%), ointment Benzyl benzoate ( 20% and 10% for children) is effective, convenient, the only drawback is a faint smell. Treatment is carried out on days 1 and 4, twice a day, treating the skin( up to 10 minutes) and not flushing the medicine for 12 hours.
- Sulfur, sulfur-tar paste - proven reliable means, but the fatty vaseline base often spoils clothes. Apply to the entire body of the course in 5 - 7 days. More often these funds are used for the purpose of "curing" scabious lymphoplasia in certain areas. A particularly good result is observed when the sulfuric ointment is combined with corticosteroid agents, which remove inflammation and itching from scabious dermatitis. Applied in the morning hydrocortisone ointment( 1%), in the evening - sulfuric ointment( 33%) for 7-10 days.
- Permethrin cream( 5%) is a French acaricidal preparation. Effective and low toxicity.
- Aerosol Spregal .The product is convenient to use. Disadvantage - the possibility of absorption into the blood, the development of allergies by inhalation of scattered drops, high cost.
- Lindan ( 1% lotion, cream, powder, shampoo and ointment 1 - 2%) is applied once on the whole body without washing off for 6 hours. Processing on days 1 and 4 is desirable.
- Crotamiton( eurax) is used in the form of lotion, ointment and 10% cream, rubbing it into the skin twice a day after washing. A day later, another treatment is carried out. You can use 2 consecutive days with 4 one-time treatment after 12 hours.
Corticosteroid and antihistamines
These are necessary for the parallel treatment of dermatitis that develops after or during the application of acaricidal agents. Uses:
- Calcium preparations, zinc ointments - with a common rash.
- Weak hormones that relieve itching and inflammation - hydrocortisone ointment 1%, Sinaflan.
- Antiallergic - Suprastin, Loratadine, Fexofenadine, Tavegil, Zodak, Cetrin, Erius. Dosage and form( tablets or injections) depend on the severity of the process.
- Antibacterial and antiseptic medicines.
In case of complication of scabies by the development of pyoderma( pustular skin lesion) when infection is introduced into the places of scratching, these phenomena are stopped with the help of antibacterial and sulfanilamide preparations, antiseptics - Fucocin( Fucaseptol), disinfectant ointments of the type of Gyioxysone.
- After the correct treatment of scabies and the introduction of glucocorticosteroids and antiallergic agents, itching lasts no longer than 10 to 14 days, gradually fading in the case of uncomplicated scabious lymphoplasia.
- Despite the treatment, running nodular scabies often lasts long enough - more than a month( sometimes longer).Therefore, the patient is examined every 7 to 10 days. This is necessary to accurately distinguish the signs of post-scabic dermatitis from residual manifestations of scabies. The patient is explained the danger of prolonged or repeated use of antiparasitic medicines for the purpose of "guarantee".
- 14 days after completion of therapy, the parasitologist performs control tests.
On how to cure nodular scabies with folk remedies, this video will tell:
Prevention of disease
Methods of disinfecting clothes and clothes:
- boiling in detergent, soda solution 1 - 2%( mites die immediately, but boil for 5-7 minutes).
- ironing with a red-hot iron( especially in the area of warehouses and pockets) of garments;
- temporary( for 5 - 7 days) packing clothes, shoes, books, toys in tightly closed plastic bags;
- hanging clothes, pillows, linen in the open air( for 2 - 3 days).
Rules for the prevention of scabies:
- Carry out the current disinfection of linen, clothes, pillows, blankets.
- Active detection of adults and children with scabies( examinations in schools, children's institutions, camps, sports organizations, when going to a polyclinic, admission to a hospital).
- Detection of foci of infection and their elimination. Identified infected people are sent for treatment, healthy one-time preventive treatment with any acaricidal drug. In order to avoid repeated invasion by the tick, the treatment of infected people and the treatment of healthy ones are carried out simultaneously.
The most common complications:
- allergic dermatitis, urticaria;
- microbial eczema.
In addition, due to severe itching and active combing of the skin( especially by children) in places of bites, pathogenic bacteria often enter the tissue with the development of pyoderma - skin lesions in the form of multiple pustular lesions. Without treatment, this condition causes:
- post-streptococcal glomerulonephritis( renal damage);
- development of rheumatic heart disease;
- abscesses with lymphadenitis;
- ecthim - ulcerative lesion of the dermis with streptococcus with affection of deep layers;
- pyogenic pneumonia( severe form of pneumonia caused by pyogenic bacteria);
- panaritium( purulent inflammation of the tissues of the fingers);Erysipelas;
- septicemia( acute sepsis with severe toxicosis);
- regional lymphadenitis, internal abscesses.
- in infants and young children, infection of places of scratching can lead to infection of the blood( sepsis).
Prognosis for nodular scabies
Treatment of scabious lymphoplasia is protracted, but the prognosis is favorable. The main reasons for overly prolonged therapy with relapses of the disease are: incomplete cure of the patient due to non-observance of the recommendations of the parasitologist, the lack of disinfection of linen, household items, shoes and clothes, re-infection from infected persons in the outbreak.
Recovery control is performed every 7 to 10 days for the entire duration of therapy. The criterion of complete cure of the patient is the absence of external manifestations, itching and laboratory signs of pathology.
On how to distinguish scabies from scabies, this video will tell: