SCABIES is a parasitic skin disease caused by a tick from the group of scabies. In recent years, in Russia is common.
The causative agent is Sarcoptes scabiei; the cycle of its development (from an egg to an adult) is 10-14 days. The life span of a female tick is about 2 months. Only she takes part in the development of the pathological process with 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 surface of the skin, lays the scabies in which it lays eggs. Subsequently, larvae develop from them. Having come to the surface of the skin, the larvae penetrate the mouth of the hair follicles and under the scales of the stratum corneum of the epidermis, where they mature. Ticks and their larvae do not tolerate boiling and the ambient temperature is below 0 °; pronounced acaricidal action has a 3% solution of carbolic acid.
Infection occurs through close contact with a patient with scabies or things and objects that he used (underwear and bedding, clothes, a towel, washcloth, books, gloves, money, etc.); infection through sexual contact is possible; You can get infected in the bathhouse, shower room, hostel, hotel, as well as in transport if you do not comply with the sanitary regime. Crowding and insufficient hygiene 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, worse at night (the period of greatest tick activity). Mostly affected areas of the body with thin skin are subject to friction, for example interdigital folds of the hands, the lateral surface of the palms, the flexion surface of the wrist joints, the front wall of the armpits, the scrotum, the head and the back surface of the penis, around the nipples of the mammary glands in women; the navel and buttocks, especially the gluteal folds; extensor surface of the elbow joints. In children, the lateral surface of the feet near the ankle, heel and sole is also affected. At the height of the development of the disease in adults, damage to the anterior surface of the body is characteristic, starting from the axillary hollows and to the middle of the hips; while the face, neck, back are not affected (in infants, they are often involved in the process). In these places, itch passages are found, which look like grayish winding ridges, lines 3-5 mm long, or pink stripes - scratches, on one of which it is possible to detect a whitish point (female) or a vesicle with serous contents; small, often paired, papular vesicular eruptions, crusts, linear combs are also visible. Often scabies is complicated by folliculitis, boils, eczematized.
Diagnosis is based on clinical findings and tick detection. To identify scabies, aniline paint solution or an alcoholic solution of iodine is used; after applying them to the skin, scabies are more clearly visible. To detect scabies mites, a 10% alkali solution is applied to the affected skin for 2 min, 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 by a dermatologist on an outpatient basis. With complicated scabies, preliminary treatment of complications is necessary. Before starting treatment of uncomplicated scabies, the patient is washed. Apply a 20% suspension of benzyl benzoate, sulfuric ointment (20% for adults, 5 to 10% for children). An accelerated method of treating uncomplicated scabies is the Demjanovich method: the patient rubbed a 60% sodium thiosulfate solution into the lesions for 10 minutes, then repeated the procedure 2 times, after which he rubbed 6% aqueous hydrochloric acid 3-4 times. After
1 hour after rubbing the patient puts on clean linen and after 3 days washes. If necessary, repeat the procedure. Control examinations of the cured are carried out 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 people who were in contact with the patient (every 10 days for 1.5 months). In the epidemic focus, it is necessary to disinfect bed and underwear, towels by boiling in a 1 - 2% solution of soda or washing powder for 10 minutes. Outerwear on both sides, including pockets, is steamed with a hot iron. Coats, fur coats, leather goods can be disinfected outdoors for 5 days. Routine disinfection is done daily
2 times: wet floor cleaning and furniture wiping with a hot 1-2% soap-soda solution.