Scabies: Symptoms and Treatment in Children andadults

Scabies is an infectious skin disease (pruritic dermatosis),
caused by scabies itch. Similar mites parasitize and
animals, but only this species can reproduce in human skin.
Scabies is extremely contagious.
(contagious) and is ubiquitous. Children especially younger
age, become infected more often.

Scabies is a strictly anthroponotic disease, then
there is a man is the only carrier and master of this
mite in nature. The transmission mechanism of scabies – pin and
contact and household. Infection can occur through touch,
handshakes when using infected objects and clothing. AT
This article will tell you about scabies, symptoms and treatments, types of
this skin disease.

Epidemiology of scabies

Itchy pruritus is intradermal blood-sucking
parasites, they feed on human blood, are small,
and poorly distinguishable to the naked eye. Females are twice as big
males – the length of their body reaches 0.3-0.4 mm. The body has them
domed, resembles a turtle shell, covered
numerous small needles.

Tick ​​males do not play a clinical role, as they die immediately.
after mating. The fertilized female attaches to the skin and
penetrates deep areas of the upper horny layer, leaving
place of introduction scabby moves. Then she moves with speed
0.1 – 5 mm per day parallel to the skin surface, leaving
S-shaped moves.

On the abdominal surface of the body of female ticks there is a transverse
the gap through which they lay eggs (2-3 per day). Of them
in 3-4 days the larvae come out, having 3 pairs of paws. They leave
the main itch and rise to the upper layers of the epidermis,
where molt, turning into a nymph with four pairs of paws. 2-3 after
Day nymph sheds again, turning into an adult tick.
The life expectancy of scabies itchy is 2-3
of the month.

ATероятность передачи возбудителя зависит от следующих факторов:
Чесоточный клещ

  • The presence of direct contact with the patient (for example,
    infected family member, sexual partner)
  • Contact duration
  • A large number of pathogens at the source of infection
  • Diabetes mellitus can be an additional factor
    accelerates the reproduction of parasites
  • Contact with a person who is itchy skin should
    be watchful

It is believed that the main cause of tick in humans –
failure to comply with hygiene standards, unsanitary living conditions. it
so only in part – the tick can not “appear” because of unsanitary conditions
or violation of hygiene standards. There is an epidemiological process:
the carrier — the transmission mechanism — is a susceptible organism. With scabies
either a carrier or a susceptible organism can be any
person. People can get sick for years and not be treated by spreading
pathogen. Impossible to prevent infection even when observed
all sanitary and epidemiological norms. If the tick hit the skin, then
this is fraught with the development of clinical symptoms. And unsanitary conditions,
certainly contributes to the spread of any contagious
diseases.

ATозможна также передача клеща через бытовые предметы и одежду.
At an air temperature of 8–14 ° C, the mite can live in the environment to
three weeks, and at 18-20 ° C – only 3-4 days. Natural
susceptibility to scabies infection is high.

Who has scabies most often?

Absolutely anyone has the risk of contracting scabies, however
high risk of infection in the following categories of the population:

  • People in custody and other specials. institutions
  • Persons leading an active sex life
  • Дети в дошкольных institutions
  • People living in cramped conditions

Симптомы чесотки у adults и детей

Period from infection to the development of a characteristic clinical picture
It is 1-2 weeks, but it cannot be considered as
incubation, because after contact with the skin, the female mite immediately
starts digging moves and laying eggs.

When a person becomes infected for the first time, the first symptoms of scabies can
It will appear a month after the tick hits the skin, with secondary
infection – symptoms appear much earlier. Most
obvious, basic and typical signs of scabies are as follows:

  • Unbearable itching (more often at night)
  • Rash, blisters, small pimples
  • Because of scratches appear suppuration, sores
  • The hallmark of the disease is the occurrence
    scabby moves up to 7 mm in length (convoluted strips of grayish,
    whitish color), such curved passages end with vesicles
    or papules are mite mites, in which the female lays 10-25
    eggs

The development of symptoms of scabies is due to the following factors:

  1. The activity of the tick itself;
  2. Allergic reaction of the delayed type;
  3. The appearance of characteristic changes due to itching.

Characteristic first symptom of scabies with which patients
Seeking a doctor is a severe itch. Its intensity and time
appearances are individual. Increased activity of the pathogen in the dark
time of day is accompanied by a significant increase in itching, which may
cause development neuropsychiatric disorders.

A strong burning sensation leads to the fact that patients often
combing the affected areas, which leads to the formation
multiple abrasions and hemorrhagic crusts. ATследствие этого
scabies может осложняться пиодермией и микробной экземой. Pockets
lesions have clear boundaries, a large
the number of pustules.

AT месте проникновения клеща на коже обнаруживается маленький
a bubble. From it begins scabby move – winding dotted
a line of grayish color, slightly distinguished on the surface of the skin.
It does not always appear. For scabies is characteristic appearance on
skin scattered and paired rash, which is characteristic
polymorphism.

Most often, the end of the moves in the form of papules or vesicles are visible (with
microscopic examination can be found in them tick).
These elements are arranged in pairs at a distance of the length of the scab
course, often covered with hemorrhagic crusts (due to scratching).

The distribution of scabies on the skin is not accidental. Beloved
locations of scabies mites are body parts with
well developed thick horny layer: Как выглядит scabies

  • The lateral surfaces of the fingers, interdigital spaces;
  • Wrist flexion, back of hand;
  • The extensor surface of the elbows and knees;
  • Anterolateral parts of the body, lower back;
  • The area of ​​the navel, waist, armpits, mammary glands,
    penis;
  • The front surfaces of the legs (legs, thighs).

Scabies in children, the symptoms of which may differ slightly
due to the nature of the organism, it can be manifested by rashes in
atypical locations: Симптомы чесотки у детей

  • on the soles of the palms
  • face, scalp

У школьников scabies иногда маскируется под экзему, детскую
pruritus, pyoderma. Valuable diagnostic symptoms of scabies in
adults:

  1. Symptom Sesari (probing scabies);
  2. Symptom Ardi-Gorchakov (dry scales, crusts and pustules
    found on the elbows);
  3. Michaelis symptom (hemorrhagic crusts in the interyagic
    crease).

Can I see a scabies mite?

Even though usually in an adult person infected
itch mite, there are 10-12 individuals on the body, see them
almost impossible. The largest female is no larger than
0.4 mm and looks like a little black dot, but you can see the male
impossible at all. But when you pass the skin scraping under the microscope
it’s easy to see both eggs and ticks and their products
life activity.

Scabies classification

With scabies, симптомы и лечение зависят от формы заболевания,
кроме классической, существуют атипичные формы и псевдоscabies.

Типичная scabies

Как выглядит scabies? Типичная scabies начинает свое клиническое
manifestation most often with interdigital folds, navel area, folds
elbows, buttocks, further without treatment, the process can
spread to any part of the body. Characteristic itchy skin usually
intensifies at night, as the tick is most active at night.
Atypical symptoms of typical scabies: Чесотка: симптомы и лечение

  • Itching does not always accompany scabies – in individuals with reduced
    immunity is observed only peeling skin without a characteristic itch
    (у детей на голове, у adults на подошве, ладонях).
  • У грудничков scabies поражает ушные раковины, лицо, ладони,
    sole, scalp
  • In blacks, the disease looks like granulomatous
    nodules
  • Sometimes the areas of damage are covered with bloody-purulent
    crusts.
Atypical forms of scabies
Норвежская scabies (корковая). Корковая scabiesVery rare and extremely contagious form.
diseases. On 1 см2 кожи может обнаруживаться до 200
ticks. It develops, as a rule, against the background of reduced immunity. On
the skin forms massive crusts, multiple scabies moves,
polymorphic eruptions (pustules, papules, vesicles) appear.
Joining the infection is accompanied by pyoderma.
Чесотка «чистоплотных» (scabies
�”incognita”). scabies "инкогнитоBlurred form of the disease without
typical lesions of the skin. On коже могут выявляться
small single papules and vesicles. The itch moves are mild,
usually not detected. Itching appears only at night.
Зерновая scabies (соломенная). Соломенная ATызывается пузатым клещом (Pyemotes ventricosus),
parasitic on insects (pests of grain crops).
ATысыпания полиморфные. Papules and vesicles appear on the skin of the neck,
back and arms a few hours after contact with a straw or
зерном, содержащими pathogen. After излечения сыпь сохраняется в
for several weeks.
Постскабиозная лимфоплазия (узелковая
scabies). УзелковаяWith this form of scabies on the skin are detected
красноватые зудящие nodules с гладкой поверхностью, представляющие
is the foci of hyperplasia of lymphoid tissue. They develop in
the result of a delayed type of allergic reaction to the tick itself
и продукты его life activity. Узелковая scabies выявляется у
long ill patients after relapse or recurring
infection.
Scabies without moves. Редкая форма diseases.
ATыявляется у лиц, которые в течение двух последних недель
контактировали с больными scabies. ATызывается личинками клеща. With
examination revealed single papules in the interdigital spaces
(less often on the skin of the body).
Complicated scabies
(eczematous, persistent, etc.).
 Псевдоscabies

Is it possible to get scabies on pets?
Псевдоscabies развивается при заражении чесоточным клещом от
animals (birds, dogs, sheep, horses) as they also
susceptible to ticks and disease manifestations similar to
scabies. Клинически псевдоscabies не сопровождается значительной
symptomatic, manifested by itching, no moves, as these
mites do not penetrate into the stratum corneum. No other person
is transmitted. Через некоторое время псевдоscabies заканчивается
self-healing, because such ticks die independently and not
can reproduce on human skin. Therefore, with such scabies,
symptoms are minor and treatment is not required.

Diagnosis and complications

The diagnosis of scabies can be set by a dermatologist with a physical
examination and confirm with microscopic laboratory
a research (reliability of the analysis only 30%). To take scraping,
glycerin is applied to the affected area, then with a scalpel
scraping material for analysis. Since only in each 3
In case of excreta, eggs or the mites themselves, in the rest
In clinical cases, the diagnosis is determined by the doctor based on
clinics and patient complaints.

Differential diagnosis is carried out with such skin
diseases (with itching), like atopic dermatitis in children,
atopic dermatitis in adults, phleboderma, nodular, pruritus,
microbial eczema, urticaria, syphilitic papules,
pseudosarcoptosis.

Among the complications that can be caused by scabies,
pustular skin lesions (pyoderma) are common,
dermatitis. Sometimes urticaria, eczema, in infants
possible damage to the nail plate.

How quickly can cure scabies?

Today, the pharmaceutical industry offers many
modern scabies drugs that easily destroy
pathogen, literally 24 hours. In some cases
requires additional application of ointments or sprays in 2-3 days
after the primary. Therefore, children and adults a day after the start
treatments can go to work or to kindergarten, school. Only
discomfort characteristic of scabies – itchy skin (allergic
manifestation) will continue for some time. If
symptoms of scabies (new rash, itching) will resume or will
continue for a month, you should again go to the doctor and
it may be necessary to repeat the treatment.

Scabies treatment

The goal of treating any form of scabies is complete destruction.
tick and its larvae. Therefore, drugs should
loosen the stratum corneum of the skin, penetrating deep into itch moves. AT
The following are currently used to treat scabies.
drugs, ointments and aerosols:

  1. Lindane. ATыпускается в виде мази, крема,
    lotion. This preparation is applied to dry skin for 6-24 hours, and then
    wash off. Apply once or twice.
  2. Crotamiton. Used to treat
    pregnant women and newborns. The course of treatment is 5 days.
  3. Эсдепаллетрин (А-Пар аэрозоль 600 руб.,
    Spregal aerosol 800-900 rubles). Synthetic drug available
    in the form of an aerosol, used once and is considered very convenient and
    low toxic. Contraindicated in bronchial asthma, in breast
    feeding.
  4. Перметрин (Медифокс флакон, гель 100-140 руб.,
    Knicks cream 320-400 rub., Pediculosis Hygia 180 rub.)
    rubbed into the skin of the whole body, and washed off after 8-14 hours. Apply
    once.
  5. Ivermectin. It is administered once orally.
    Contraindicated in women during pregnancy and children under 5 years.
  6. Бензилбензоат (мазь 20- 30 руб, эмульсия 100
    rub.) is contraindicated in children under 3 years of age, during pregnancy and lactation.
    Before rubbing the ointment, it is necessary to bath the patient. Ointment applied
    on the whole body except the head and face for the night, rubbed with hands, hands do not
    washed until the morning. Only on day 4, repeat processing and on day 5
    make a change of bed and underwear.

For more on the use of specific ointments, and why
иногда трудно вылечить чесотку читайте в нашей статье ATсе мази от
scabies. For the treatment of scabies in patients over 12 years old
use sulfur ointment (33%). It is used to treat the body.
overnight for 5-7 days. For children 2-7 years old use 10-15%
sulfur ointment twice with an interval of three to four days.

Be sure to use for the treatment of scabies
antistamine preparations (see the list of drugs for allergies), among
them Klaritin, Tsetrin, Zodak, Zirtek, Erius, etc., preparations 2 and 3
generations have a longer duration and have
slight sedation.

AT основе метода Демьяновича также лежит акарицидное действие
sulfur. It consists in the sequential application of a 60% solution.
sodium hyposulfite and 6% hydrochloric acid solution (for children
concentrations are reduced to 40% and 4%, respectively). Between use
the first and second solutions make a break in 10 minutes. After
procedures change all clothes. Shower can only be taken on
the fourth day after treatment (see scabies treatment at home
conditions).

The effect of ongoing therapy during Much not determined by
drug, and the correctness of its use, therefore, in the treatment of
scabies is important to follow a few rules:

  1. Taking a shower, a complete change of bed linen and clothes spend up to
    and after the course of treatment;
  2. Skin treatment should be carried out in the evening before bedtime;
  3. It is necessary to treat not only the affected areas, but also
    the entire surface of the body;
  4. It is necessary to regularly carry out sanitary treatment of personal
    clothes and premises;
  5. Antiparasitic ointment should not be used longer than
    indicated by the doctor (even if itching of the skin continues), because the drugs
    may cause an overdose. With continued itching after treatment
    should continue to receive antihistamine drugs.

Автор: Мельникова Светлана Георгиевна врач-дерматолог

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