Treatment of scabies
This variant of the disease was first described in Norway in the XIX century in patients with leprosy. The disease is also caused by an itch mite, but develops against the background of such conditions:
- Immunosuppressive conditions caused by prolonged intake of cytostatic and hormonal drugs;
- Peripheral sensitivity disorders( due to paralysis, leprosy, syringomyelia);
- Senile dementia, dementia, infantilism, Down's disease;
- HIV infection.
The main manifestations of the disease are the presence of itching strokes, multiple eruptions( papules, vesicles, pustules), as well as erythroderma.Palmar-plantar hyperkeratosis is observed.Norwegian scabies are often accompanied by pyoderma and polyadenopathy, and sometimes by fever.
Hair becomes dull, dry, alopecia can develop, and the nails become bumpy, grayish-yellow, easily crumbling.Sometimes from the patient it is possible to feel the sour smell of the sauerkraut.
Norwegian scabies are extremely contagious, since there may be 200 mites per cm2 of skin.Contact people develop a typical version of scabies.
Symptoms of cereal scabies
This variant of scabies is caused by a pot-bellied mite.After contact with contaminated straw or grain, a vesicle-pustular rash appears accompanied by itching on the skin of the hands, back, and neck.Skin elements are located close to each other on the swollen, red skin.Vesicles can reach the size of a five-kopeck coin.Skin elements eventually open, the contents of the blisters dry up and crusts form.The rashes last for several weeks.After the disappearance of the rash, hyperpigmentation may persist for a long time.With a common rash, the temperature can rise, weakness, lymph nodes increase.
Symptoms of scabious lymphoplasia
The disease is accompanied by the appearance on the skin of a few itchy reddish nodules, up to 2 cm in size. The elements are localized mainly in the area of the external genital organs, inguinal and scrotal, axillary folds, on the inner surface of the buttocks and thighs, the anus, Areola of nipples.Skin thickening is a consequence of the growth of lymphoid tissue, outwardly resemble lymphomas.It is noteworthy that nodules and itching can persist for several weeks and months, despite active treatment.
Symptoms of pseudocysts
This is an itchy dermatosis caused by scabies of animals.A person becomes infected with mites in contact with dogs, horses, pigs, rabbits, sheep, goats, foxes.Already after several hours after contacting the infected animal, the person has an itch.These pincers do not penetrate into the skin and do not form moves.In areas of contact with animals, asymmetric rashes( papules, vesicles, blisters) appear.Man is not transmitted from man to man.
Scabies in children
In children under the age of six months, scabies can be manifested not only papularly-vesicular, but also urticaria eruptions reminiscent of hives.Blisters open, and in their place there is moknutie.It should be noted that in young children scabies rarely occurs with lesions of interdigital spaces and lateral surfaces of brushes.In this case, the face and the scalp are affected, which is never the case in adults.In addition, nail plates can be damaged, as a result of which they become loose.
In children, scabies are often complicated by pyoderma, sepsis.It is worth noting that more often among children there are erased forms of the disease.
The diagnosis is made taking into account human complaints, examination results, epidemiological data, research results. The following diagnostic methods are used:
- Extract the tick from the stroke with a needle for further examination under a microscope;
- Method of thin sections of the skin in the area of the itch;
- Method of layer-by-layer scraping in the region of the blind end of the itch movement until the appearance of blood with further microscopy of the material;
- Express diagnostics using lactic acid;
- Method of alkaline preparation.
Detection of itch moves is a sure sign of scabies.On the iodine-treated skin, the strokes are clearly visualized in the form of brown stripes against a light brown, healthy skin.You can also determine the presence of strokes using a videodermatoscope.
Treatment of scabies
Treatment of patients is aimed at combating the tick.This is under the power of acaricidal drugs. The ideal tool must meet the following specifications:
- Provide an effective effect on both ticks and larvae;
- Have a minimal side effect;
- Minimal toxicity;
- Be easy to use;
- Be acceptable in use: do not spoil clothes and do not have a pungent odor.
Spontaneous scabies do not pass.To eliminate mites and larvae, external skin treatment with the help of sulfuric ointment, Wilkinson's ointment, lysol solution, pure tar, ethylene glycol, benzyl benzoate, crotamiton, spregal, permethrin, ivermectin is sufficient. Regardless of which tool is chosen, the general principles should be adhered to:
- Strictly adhere to the treatment schemes as prescribed by the physician.
- The entire body surface must be treated, except the head( these areas of the body should be treated in young children).Particular attention should be paid to the interdigital spaces, arms, legs, armpits, perineum.
- The product is applied with a thin layer of the hands.
- Carry out treatment in the evening.
- Avoid contact with the antiscalant in the eyes.
- Antiseptics are used to eliminate secondary infection.
- When Norwegian scabies are used with keratolitics, skin areas covered with a crust should be cleaned.It is necessary to isolate the patient.
On the territory of the post-Soviet countries, benzyl benzoate is widely used as ointments and emulsions in 20% concentration for the treatment of adults and 10% concentration for children.This product has undeniable advantages: it is well absorbed, does not leave traces on the body, has a small cost.Among the shortcomings is the burning sensation of the skin.
Treatment plan for 20% emulsion with benzyl benzoate:
- The first day of treatment - a patient in the evening is washed out with soap, then wiped dry.200 ml of benzyl benzoate rub into the skin, wait until the drug dries.Then you should put on clean clothes and replace bed linens.
- Second or third day - you can not take a shower, apply a drug, change bed linen.
- Fourth day - wash with soap, apply.Put on clean clothes and change bed linens;
- The fifth day - to wash away in the soul the remnants of an anti-scab drug, to change the bed linen and bed linen.After each rinsing of the hands, it is necessary to rub the product into the skin of the brushes.
Sulfuric ointment is almost not used in developed countries because of the peculiar smell and coloring of clothing.However, the remedy is still used in post-Soviet countries. Treatment of scabies at home using 33% sulfuric ointment is carried out according to the following scheme:
- The first day - after washing with soap, dry thoroughly.Then you need to rub the ointment into the skin of the body.Do not wash your hands for three hours.Change clothes and bed linens.
- Second or fifth day - should be daily rubbed ointment in the skin of hands, legs, trunk( once a day).
- The sixth day - to wash off the remains of the ointment in the shower, change your underwear.
The sulfur-containing agents are used in the treatment scheme by the Demjanovich method.This method is a sequential treatment of the skin with solutions of sodium thiosulfate and hydrochloric acid.The method is effective, however it takes a lot of time, it is currently used quite rarely.
In most countries permethrin is recommended for the treatment of scabies.Treatment with permethrin begins with the preparation of an aqueous emulsion.To do this, the third part of the vial( 8 ml of 5% solution) must be mixed with 100 ml of boiled water.The resulting mixture should be applied to washed skin.Hand after treatment with permethrin can not be washed for three hours.Then you should rub the emulsion into the skin of the hands after each rinsing of the hands.Replace clothes and bed linen.Such treatment should be done within three days.On the fourth day you need to wash off the remnants of the drug from the body, change your underwear.
Highly effective and safe is the drug Spregal, the active substance of which is esdepaletrin.Treatment with this drug is usually performed only once.After washing it is necessary to apply aerosol to the body from a distance of thirty centimeters, from top to bottom.After that, you should put on clean clothes and replace bed linens.During the day you can not wash yourself, this can be done in the evening the next day.After that, you need to change your underwear.You can use Spregal to treat children.
Control of the cure should be carried out on the third and tenth day after the end of treatment.The disappearance( reduction) of itching, rashes, normalization of sleep are the criteria of recovery.
Grigorova Valeria, medical reviewer