SCABIES - a parasitic skin disease caused by mite from the group of itch itchy. In recent years, on the territory of Russia is common.
Pathogen - Sarcoptes scabiei; its development cycle (from egg to adult) is 10-14 days. The life of the female mite is about 2 months. Only she takes part in the development of the pathological process in scabies. The male, having fertilized the female on the surface of the human skin, soon dies. The fertilized female digs into the stratum corneum of the epidermis, where, slowly moving parallel to the skin surface, she creates scabby passages, in which she lays eggs. Later on, the larvae develop. Coming to the surface of the skin, the larvae invade the mouth of the hair follicles and under the scales of the stratum corneum of the epidermis, where their maturation occurs. Ticks and their larvae do not tolerate boiling and ambient temperatures below 0 °; a pronounced acaricidal effect has a 3% solution of carbolic acid.
Infection occurs through close contact with a patient with scabies or things and objects that were used by him (underwear and bed linen, clothes, towels, cleansers, books, gloves, money, etc.); possible infection through sexual contact; You can become infected in a bath, shower, dormitory, hotel, as well as in transport if they do not comply with the sanitary regime. The crowding and insufficient hygienic skills of the population contribute to the spread of scabies.
The incubation period is from 1 to 6 weeks. The first clinical symptom of the disease is itching, aggravated at night (the period of the greatest activity of the tick). Mainly affected areas of the body with thin skin, exposed to friction, such as interdigital folds of the hands, lateral surface of the palms, flexion surface of the wrist joints, the front wall of the armpits, scrotum, head and back of the penis, around the nipples of the mammary glands in women; navel and buttocks, especially the gluteal folds; extensor surface of the elbow joints. In children, the lateral surface of the feet near the ankle, heels and soles are also affected. At the height of the development of the disease in adults is characterized by damage to the anterior surface of the body, starting from the armpits and to the middle of the thighs; while the face, neck, back are not affected (in infants, they are often involved in the process). In these places are found scabby moves, having the form of grayish winding rollers, lines 3 - 5 mm long, or pink strips - scratches, one of which can detect a whitish point (female) or a bubble with serous contents; small, often paired, papulovesicular rashes, crusts, and linear scratching are also visible. Often scabies complicated by folliculitis, boils, eczematized.
The diagnosis is made on the basis of clinical data and the detection of ticks. To identify scabby moves using a solution of aniline dye or alcohol solution of iodine; after applying them to the skin, the scabby moves are more clearly visible. To detect itch mites, a 10% solution of alkali is applied to the affected skin for 2 minutes, then macerated epidermal flakes are scraped with a scalpel on a glass slide into a drop of water and examined under a microscope.
Treatment is usually carried out on an outpatient dermatologist. For complicated scabies, prior treatment of complications is necessary. Before treatment of uncomplicated scabies, the patient washes. Apply a 20% suspension of benzyl benzoate, sulfur ointment (20% for adults, 5–10% for children). The Demianovich method is the accelerated method of treating uncomplicated scabies: the patient rubs 60% sodium thiosulfate solution into the lesions for 10 minutes, then repeats the procedure 2 times, then 3-4 times 6% aqueous hydrochloric acid solution is rubbed. Later
1 hour after rubbing, the patient puts on clean linen and after 3 days washes. If necessary, repeat the procedure. Control examinations of cured spend every 10 days for 1.5 months.
Prevention consists in observing the rules of personal and public hygiene, possibly early detection and treatment of patients with scabies, examination of persons who have been in contact with the patient (every 10 days for 1.5 months). In an epidemic outbreak it is necessary to disinfect bed and underwear, towels by boiling in 1 - 2% soda solution or laundry detergent for 10 minutes. Outer clothing on both sides, including pockets, is steamed with a hot iron. Coats, fur coats, leather goods can be disinfected in the open air for 5 days. Current disinfection is done daily.
2 times: wet cleaning of floors and wiping furniture with a hot 1-2% soap and soda solution.