What is Norwegian scabies and how to get rid of ticks under the skin. Norwegian scabies: death leaning Possible complications of the disease

The date: 19.10.2019

Norwegian scabies or acariasis, particularly severe form of ordinary scabies, which is characterized by the appearance of thick dense dark gray scales on the affected skin. According to experts, Norwegian scabies, as well as ordinary scabies, causes usual scabies cluster clocksCoptes Scabiei Var Hominis. Lyme or borreliosis disease is an infectious disease that is transmitted by Ticks of Borrelia (BorreliaBurgDorferi), the Essemission of Spirochetaceae. This is the only form of borrelia that lives in moderate latitudes and is a pathogenic for a person.

Cause and symptoms of Norwegian scacreat

For this reason, this type of scabies occurs in patients with immunodeficiency states (tuberculosis, AIDS, leukes, autoimmune diseases, Bloom syndrome, etc.) for the first time the disease was described by Norwegian researchers, from here and the name of the disease.

Norwegian scabies develop equally both in women and men of all ages and races. The duration of the disease can vary from several months to almost 50 years. The duration of the incubation period ranges from 3 months to 16, when the first cortical layers appear.

Symptoms of Norwegian scaca

A characteristic symptom of Norwegian scabies is the lack of intense itch. There is no itching - not quite favorable symptom, since combing is a kind of protective reaction of the body. Infected foci are localized most often on the skin of the upper and lower extremities, face, buttocks, palms and soles.

The affected areas are covered with massive crusts from 2 mm to 4 mm, gray or yellow-green, emitting an unpleasant specific smell. Sometimes the crusts may have a skin view, can spread to large areas of the skin in the form of a hornbar. The surface of such sites is covered with cracks, of which the blood-over liquid is distinguished, and in the joints of the joints, the skin is littered with deep furrows resembling a plowed land.

These furrows are filled with a huge amount of ticks at different stages of development. In addition to the crust, multiple rashes are noticed in the form of empty, scales, papules and vesicles. Sometimes skin lesions are accompanied by the general malery of the organism: headaches, fever, pains in joints, increasing lymph nodes.

The disease is characterized by high contagiousness up to the occurrence of local epidemics.

Norwegian scabies are transmitted from person to man with the following ways:

Continated consumer. Using common personal care items: towels, bed linen, mattresses, pillows, blankets. Most often, infection occurs with shared housing in hostels, trains, in hotels, in children's preschool institutions.
Contact method of infection. This method of infection is the most common. Most often you can get infected with the institution of hands, with the overall use of household items.
In gender. Sex contact is able to provoke infection by Norwegian scabies.

There are evidence that Norwegian scabies are transmitted from pets. In this case, we are talking about a pseudochief. It is known that the pathogens causing the disease in animals are absolutely safe for humans.

Diagnosis of the disease

When making a diagnosis of Norwegian scabies, it is necessary to carry out differential diagnosis with some dermatoses. For example, congenital keratodermias, in contrast to Norwegian scabies, appear immediately after birth or in the first years of life.

Or, for example, with the differential diagnosis of Norwegian scabies from Deligney's disease, it is necessary to take into account the fact that this disease is often appearing in children or youthful age. Also, its characteristic symptom are rashes in the form of horny cones on the surface leather fingers.

Norwegian scabies can be confused with eczema, piederma, as well as psoriasis. Psoriasis and Norwegian scabies exist similar symptoms that sometimes it makes it difficult to diagnose the disease.

To accurately diagnose the disease, a bioptate histological analysis and a biochemical blood test is carried out. A shift in blood formula is observed in the direction of increasing leukocytes, eosinophils, and an accelerated reaction of sedimentation of erythrocytes (RWE) is observed.

Treatment of the disease

When processed by the affected sections with a convection aerosol, a persistent positive dynamics is observed. There is a total rejection of the crust, the regression of numerous papular elements and the relief of other symptoms. It is worth mentioning that treatment is performed only by a specialist after confirming the diagnosis. In no case should not be engaged in self-medication, as you can aggravate the patient's condition.

Prediction and prevention of the disease

The forecast may be unfavorable. Errors in the diagnosis of disease, late treatment and aggravation of symptoms can lead to terminal state-death. The prevention of the disease is to comply with sanitary and hygienic standards:

careful observance of personal hygiene;
everyday change of underwear;
regular change of bed linen;
early diagnosis of scabies patients;
regular visit to the doctor and identifying contact persons.

Lyme disease: causes, treatment, prevention

You can get infected with this pathology in forests and parks in the spring-autumn time of the year, when the ticks are especially active. The disease was first discovered in the United States in the town called Lime, hence his name - Lyme disease.

In modern medicine, Lyme disease is interpreted as a "famous simulator." The fact is that the disease is characterized by the multi-formability of symptoms and sometimes a person appeals for help to a rheumatologist, a neuropathologist, an allergist, a dermatologist, without reaching the main specialist infectiousness.

As mentioned above, causes the Plischi pathology of Borrelia (Borreliaburgdorferi), the Eassessay of Spirochetaceae. Transferring diseases are ticks. Moreover, the tick is infected at any stage of its development: whether it is a larvae or an adult. The person is infected after the tick bitter when the insect saliva penetrates into its body.

The bite of the tick causes the itching of the skin and through the bumps the person itself rubs the elements of the insect into the skin. Then, for some time, the ticks multiply, spread to other areas of the skin, and even on the internal organs (joints, heart, brain). In addition, pliers can be in the body in an inactive state or to determine the long chronic course of the disease with recurrent periods.

There are cases when the infection was transmitted from mother to a child through a placenta.

Symptoms and stages of the disease

The incubation period of the disease is about two weeks, but can last and up to the year. Pathology has three stages of development, but this does not mean that all patients must pass all three stages. It happens that some disease ends in the first stage, others only begins to manifest themselves in the third stage.

The first stage is a local infection that develops during the first month after insect bite. At this stage, the disease is characterized by general discomplication, weakness, articular and headaches, with a very high body temperature and chills.

The symptoms of Lyme disease in all signs resemble influenza state. The disease occurs in severe form, patients have vomiting and nausea, and the fever sometimes continues up to 12 days or more. The symptoms of general malaise joins the lesion of the skin in the form of red round spots, which are capable of moving from one skin area to another.

In some patients, at the first stage of the disease, symptoms are manifested only in the form of characteristic ring-shaped rashes. At the site of the bite there is a round red spot, with clear edges, which grows in all directions. Over time, the center of the edge is pale, leaving only a bark reddish - a blue shade. Spots can cause unpleasant sensations: itching, burning, soreness.

The second stage is developing in a few weeks and months, most often in the absence of adequate treatment. At this stage, internal organs and systems are already amazed: cardiovascular, nervous and musculoskeletal. Defeats are noted on the skin in the form of urticaria, round red spots, ring-shaped elements. Inflammatory processes of eyes, throat, bronchi, kidneys and liver occur. For this stage, the following syndromes are characteristic:

neurological;
cardiology;
meningleal.

Meningleal syndrome is the most common state, which is a consequence of serous meningitis. The patient's condition is characterized by strong headaches, pain in eyeballs, especially when looking up, strong vomiting, sensitivity to light and sound. There is a rigidity of the occipital muscles and other symptoms of a meningadeal nature. The development of encephalitis or encephalomyelitis is also recorded, neurites of the cranial brain nerves: auditory and eye.

The third stage is a chronic recurrence of the disease. This stage begins after the end of the previous two and is able to develop even several years after infection. Pathology acquires a long flow with periods of exacerbations and remissions.

At this stage, various organs and systems are affected. Patients complain of general weakness, fatigue, head and articular pain. Neurological symptoms are observed: excitability, sleep disruption, depression, as well as chronic neurological lesions in the form of the following pathologies:

encephalitis;
memory disorders;
polyneuropathy;
ataxia;
dementia.

Diagnostics

The above-mentioned stages of the disease are conditional in nature, and the symptoms characteristic of each stage are not mandatory for each patient. And the course of the disease, and the symptoms of the disease in all cases are individual.

The diagnosis at an early stage of the disease is carried out on the basis of clinical and epidemiological symptoms. Unfortunately, most often the disease is recognized at a later stage when the internal organs appear. The diagnosis is confirmed using a specific serological study of blood, which is carried out in the laboratory of an infectious hospital.

Treatment

The first stage of the disease allows the treatment of outpatient. Patients with the second stage are subject to mandatory hospitalization in an infectious hospital. At all stages of the disease are used antibiotic therapy.

The choice of drug, dosage and the duration of use depends on the specific stage of the disease that prevails in it syndrome, its shape and severity. In the absence of adequate treatment, the disease progresses, turning into a chronic form, and in some cases even leads to disabilities.

Prediction and prevention

With timely treatment for medical care, the disease forecast is favorable. In case of late treatment, internal organs are affected, the disease progresses and goes into a chronic form. Therefore, with suspected the slightest bite of the insect, it should be immediately to the infectious doctor.

The prevention of Lyme disease is protective measures against ticks. Going for a walk in the park, the forest must wear high shoes, boots, pants to fill in shoes, shirt in pants, carefully fasten the zipper on the jacket. From the attacks of insects on open areas of the body can protect repellents.

There are special costumes that fully protect against ticks. They impregnated with a special preparation that scares insects.

Cause of the disease

As mentioned above, Norwegian scabies cause a normal scabies tick, but, despite this, immune mechanisms play a leading role in the pathogenesis of the disease. The disease develops against the background of a decrease in the body's protective forces. For this reason, this type of scabies occurs in patients with immunodeficiency states (tuberculosis, AIDS, leukose, autoimmune diseases, Bloom syndrome, etc.)

The disease provokes a conventional gabble tick, which makes patient under the skin, causing scabies. For the first time, the disease was registered at the end of the 19th century in Norway, hence her name.

The disease distributes only the tick female. The male dies immediately after fertilization. The female makes winding moves under the skin of man, in which the eggs are laying. The larvae after ripening is chosen on the same move out. They reach maturity after 4-7 days.

Norwegian scabies is very inference. People, with weakened immunity are in the risk area and have more chances to get infected. For this reason, the disease is more often diagnosed in persons suffering from HIV infection, tuberculosis, lymphoma, leprosy, Down disease.

Clinical picture and pathogenesis

The incubation period lasts about 2 to 6 weeks. Next, the disease can develop for years and even decades. The patient's fever is rarely observed, but the skin becomes very dry and on the touch of hot - this is the first symptoms of scabies in adults.

Due to the formation of strokes, the patient's skin gradually becomes thicker and rougher. It forms the scape of gray, yellow and even greenish color. In the absence of treatment, the upper skin layers acquire the type of shell covered with grooves. When removing the upper crusts, you can see the reddish skin with the foci of erosion.

Norwegian scabies is accompanied by the appearance of stakes throughout the body, including the face. The patient's nails are thicken, become friable and change the color - the process resembles a fungal damage to the nail plate. Man's hair becomes dull, thin and brittle. The patient comes from a characteristic source, which is an important diagnostic criterion.

Varieties of scabies

Scabies - a very infectious disease that requires immediate treatment. It is important to monitor the condition of the skin, to react to changes in time and not engage in self-diagnostics.

Scabies from different persons can flow in different ways.

2. scabies without moves.

Its difference from typical scabies is that there are no breadcrumbs on the skin, but there are bubbles up to 2-3 mm in diameter. Scabies without moves developing in people who have in contact with patients with scabies, but they have no infection with adult individuals, but with larvae, for the development of which time is necessary.

4. Norwegian scabies develop in persons with weakened immunity (for example, with AIDS, tuberculosis), drug addicts, people with Down syndrome. Norwegian scabies take place very hard, striking the whole body, including his head, and is very contagious.

5. Pseudochildren (pseudosarkoptosis) develops in people who have become infected with animals. Animal Chesoccal Tick is not able to cause a typical scabies for man and manifests only a strong itch. Cure takes place independently after the cessation of contact with the sick animal.

Clinical picture: What kind of symptoms is accompanied by the disease?

Clambly moves appear, as a rule, starting with the side surfaces of the fingers of the hands, in the space between them, in the field of the reverse side of the elbows and knees, the mammary glands, the lower part of the abdomen and the extreme flesh of the penis.

The skin thickens and grisges, gradually forming a kind of shell, cooked by furrows. Changes are noticeable on the face, nails and even hair, which is not typical for a typical form of the disease.

A typical feature is the appearance of dirty-yellow crusts (stuffing), which can reach 2-3 cm thick. They cover extensive areas of the skin. When removing the crust, there are quite large wet erosion.

Nail plates are thickened and burst out, which leads to their increased fragility. Externally, this feature resembles a nail fungus.

The patient's hair becomes dull. A characteristic sour smell comes from an infected person.

Signs of Norwegian scabies are pronounced quite brightly, which is uncharacteristic for the usual form of the disease. It is due to the fact that there are about 1 million scaffolding ticks on the contaminated human skin, and with the usual form of illness - no more than 15 individuals.

These furrows are filled with a huge amount of ticks at different stages of development. In addition to the crust, multiple rashes are noticed in the form of empty, scales, papules and vesicles. Sometimes skin lesions are accompanied by the general malery of the organism: headaches, fever, pains in joints, increasing lymph nodes.

The disease is characterized by high contagiousness up to the occurrence of local epidemics.

Norwegian scabies are transmitted from person to man with the following ways:

Continated consumer. Using common personal care items: towels, bed linen, mattresses, pillows, blankets. Most often, infection occurs with shared housing in hostels, trains, in hotels, in children's preschool institutions.
Contact method of infection. This method of infection is the most common. Most often you can get infected with the institution of hands, with the overall use of household items.
In gender. Sex contact is able to provoke infection by Norwegian scabies.

This type of scabies is distinguished by an increased level of contagiousness, but despite this, it is extremely rare. The main carriers of this disease are people having an asocial lifestyle. Next, the risk group includes drug addicts, people with mental retardation, with weakened immunity or with its minimum level (with HIV infection), patients with tuberculosis and rheumatoid illness.

Itching skin, single rash and the likely detection of small insects on it is the most likely primary signs of the disease. Increasing by night, they interfere with a person to sleep, irritate the nervous system, lead to exacerbation of existing chronic diseases.

In addition, numerous combs lead to the attachment of purulent infection. In this case, the symptoms of Norwegian scabies may be complicated by the temperature of the body, inflammatory septic processes, phenomena of general intoxication.

The lack of timely fighter measures leads to a rich population of the skin with ticks, a multi-layer damage to the dermis. At the same time, extensive fusion centers are formed, which are covered by dead cells of the epithelium - crust of gray, yellowish-brown or brown.

Symptoms of the disease appear only after the end of the incubation period, which can last from 2 to 6 weeks. How quickly the first manifestations of scabies will appear depends on the amount of ticks in the skin.

For the disease, the following symptoms are characteristic:

the skin of an infected person becomes very dry and hot. The upper layers cover the layers of green-gray crusts;
some skin sections are covered with dense, globular growths;
when leaving crusts, it can be noted that under them is very thin and bleeding skin;
on the skin is a huge number of scales;
the color of the crust can be different: green gray, yellow-gray, gray brown. The surface may be smooth or loose;
crusts can be located in several layers and have a thickness of 2-3 cm;
chesoccal jute primarily affects the skin in the abdomen, elbows, faces, neck, buttocks. There are cases when the disease affected the whole body;
the hair in the field of lesion becomes dull;
nails thicken and deform;
lymph nodes around the body;
a characteristic symptom for the disease is the specific smell of a sauer test.

The main symptoms of Norwegian scabies are manifested in the form of polymorphic rashes, erythrodermia and massive layers of crusts. The thickness of such a layer can reach 2-3 centimeters, while a kind of shell is formed.

The surface is covered by deep cracks, and in places of large joints you can see deep furrows. The upper layer is characterized by a special density, and the lower has a loose structure.

Sometimes symptoms of the disease can manifest itself differently. For example, the lesion area can be nails.

They acquire a gray-yellow color, crumble and break. The patient has problems with hair, they acquire ash-gray shades, become brittle and dry.

Since this is one of the forms of scabies, it does not work out without a strong itching, unpleasant odor and increasing body temperature.

Pathognomonic sign is the presence of scales.

As soon as the female tick falls on the human skin, it immediately begins to "dig" a stroke in a corporate skin layer at a rate of 0.5-5 mm per day. As a result, on the surface of the skin, with attentive consideration, it is possible to detect a slightly towering over the skin of the skin of a whore-gray-gray line, sizes from 1 mm to 1 cm.

More often scabies can be found in the interfallated intervals, on the inside of the wrists and on the skin of the penis. Sometimes scales to detect failure (scabies without moves).

Primary rash is represented by small erythematous papulas that can be scattered or multiple, drain. Over time, papulas can be transformed into vesicular (bubbles), rarely bullous (pemphigoid) rash.

The rash is most often distributed (in descending order) in interfallated brushes, on the bending side of the wrists, men quickly moves with brushes on penis and scrotum.

Then the elbows, feet, armpits, breasts are affected by women, umbilical area, belt line, buttocks. As a result, the whole body, except the face and the scalp can be used (although these areas are affected by children under 3 years old).

The presence of itching, primary rash and scales is the main clinical symptom complex of a typical shape of scabies.

Papulas and vesicles are often developing into secondary scabies: excorials (mass), eczematous elements, secondary guns and peels. Primary and secondary elements are coexist on one patient.

Ardi's symptom - Pustules and purulent crusts on the elbows and in their circumference; - the symptom of Gorchakov - there is no bloody crusts; - symptom of Michaelis-Corn crusts and impetiginous rashes in an inter-fodder fold with the transition to the crescent; - Sesari symptom - the discovery of scales Elevation with their palpation.

Principles of diagnosis

The diagnosis is based on clinical data (characteristic rash), epidemiological information (inspection of contact persons, information about staying in an epidemic focus), laboratory diagnostics (tick detection and its eggs on the skin). When lesion, there is an increase in leukocytes in the blood, eosinov and ROE.

Differential diagnosis of the Norwegian form of the disease is carried out with eczema, pyoderma and hyperkeratotic psoriasis. With the development of serious complications in the absence of timely treatment, the forecast of this disease is unfavorable. Medicase therapy is effective only at the initial stages of the development of the disease. Often there are fatal outcomes, which is due to the strong intoxication of the organism of the patient or the defeat of cardiac activity.

When making a diagnosis of Norwegian scabies, it is necessary to carry out differential diagnosis with some dermatoses. For example, congenital keratodermias, in contrast to Norwegian scabies, appear immediately after birth or in the first years of life. Or, for example, with the differential diagnosis of Norwegian scabies from Deligney's disease, it is necessary to take into account the fact that this disease is often appearing in children or youthful age. Also, its characteristic symptom are rashes in the form of horny cones on the surface leather fingers.

Norwegian scabies can be confused with eczema, piederma, as well as psoriasis. Psoriasis and Norwegian scabies exist similar symptoms that sometimes it makes it difficult to diagnose the disease.

With Norwegian scabies, leukocytes in the blood and ROe are elevated. To diagnose the disease, several methods are used:

Needle extract method.
Layer slap.
Thin cuts.
Using a solution of lactic acid or alkaline preparation.

It is important to exclude the following diseases:

pyodermia;
eczema;
hyperkeratical psoriasis.

1. Traditional removal of a tick needle from the blind end of a garlic move, with the subsequent pathoger microscopy. This method is inffective in the study of old dilapidated papules.

3. Method of layer-by-layer scraping from the region of the blind end of the scales before the appearance of blood. With the subsequent microscopy of the material.

4. Method of alkaline skin preparation, with an alkaline solution to the skin, followed by aspiration of maceral skin and microscopy.

Diagnostic measures are differential. The absence of itching sensations is often leading to an incorrect diagnosis. At an early stage, it should be differentiated from allergic reactions, dermatitis and infections transmitted by the air-drip path.

The diagnosis of scabies is due to the presence of the following criteria:

Anomalous thickening of the skin, detecting a large number of scales, which are located tiers.
Symptoms of acanthose - severe pigmentation in the area of \u200b\u200bgroin and axillary depression.
Changes in quantitative blood indicators. In particular, the level of leukocytes, eosinophils increases, the rate of sedimentation of red blood cells increases.

After the removal of cortical formations, the patient must wash. During the subsequent treatment, it is prohibited. Each hand washing requires the subsequent application of specialized funds. Nails are cut under the root.

The diagnosis is made after full-time inspection of the patient. An important role is played by collecting clinical data, as well as epidemiological information. Laboratory study is required, which allows you to confirm the diagnosis.

Effective may be the treatment started only at the initial stage of the disease. There are no cases when Norwegian scabies led to a fatal outcome as a result of heart lesions and strong intoxication.

It is very important to correctly diagnose the disease. Medicine is known for the case when the patient put the wrong diagnosis and prescribed treatment from psoriasis. This led to the generalization of the patient's process and death.

Of course, the collection of anamnesis and the inspection of skin fabrics must push a specialist for the thought of scabies. The epithelium is covered with crusts, and the skin on the folds of the neck, groin and the armpits acquires more pronounced pigmentation. Next, the patient rents blood for analysis - in the samples, the specialist can detect an increase in the number of eosinophils and leukocytes.

Ways of infection with tick

Collective infection occurs mainly in contact types of sports, strong handshakes and children. Domestic infection is considered unlikely, which was proven back in 1940 in the UK. 272 attempts to infect volunteers who went to bed immediately after the sick person was raised from her, whose symptoms of Norwegian scabies were expressed quite brightly. Only 4 people were infected.

The disease develops, as a rule, against the background of severe somatic and mental pathologies. Most of the cases of infection fall on patients of psychoneurological boarding schools and guests of disabled houses. Among the special contingent of patients can be distinguished by people with Down disease, infantilism, asthenia, sedening dementia and immunodeficiency state.

The process of transmitting a disease from a person to a person is happening in the following images:

infection during sexual contact when communicating tel. It is also due to the fact that the scaffold tick in the evening becomes most active;
infection through household items. Interaction with patient's personal belongs can provoke the transmission of the disease from a person to a person. You can get infected through towels, bed linen, mattresses, however, only 4 cases of infection in this way are known;
infection through direct contact. The most common way to transfer the disease. There is an infection with handshake, or while sleeping with a sick person.

Despite the high infinity of the disease, Norwegian scabies are quite rare. There are no more than 160 cases of infection in the world from the moment of its discovery.

A healthy person can be infected with a tick in three basic ways:

Aluminum occurs during the direct contact of the skin healthy with the affected skin of a sick person.
The contact-household journey occurs through household items previously used by an infected person.
The sexual transmission is carried out in individuals who lead an indiscriminate intimate lifestyle.

A contact-household mechanism of transmission contributes to the development of the epidemic process.

A household transfer path is possible. For example, in one house with a sick person, an infection can be picked up using the same kitchenware, linen, towels, clothing, toys and other objects.

Medicia treatment

A good therapeutic effect shows the treatment with a convection aerosol. When processed by the affected sections with a convection aerosol, a persistent positive dynamics is observed. There is a total rejection of the crust, the regression of numerous papular elements and the relief of other symptoms. It is worth mentioning that treatment is performed only by a specialist after confirming the diagnosis. In no case should not be engaged in self-medication, as you can aggravate the patient's condition.

When a person is noticed by this ailment, it needs urgent and comprehensive treatment. The best tool for the treatment of the Norwegian form of the disease is the water-soap emulsion of benzylbenzoate.

Processing of affected areas is produced daily within 3-5 days. The patient must be pre-taking a bathroom, which will help soften the crusts and other infectious inflammation. Ointments rubbed with their hands, as it is a kind of prevention.

In order not to break your head over how to treat various skin diseases, I recommend subscribing to updates to our site. If you like this article, tell your friends about it on social networks.

You can also use the online advice service, which is very convenient.

Treatment from Norwegian scabies consists in:

extermination of ticks (by processing special insecticides);
restoration of the integrity of the skin cover (treatment with anti-inflammatory, regenerating and antibacterial compositions);
removal of allergy-symptoms (antinistamine and desensitizing drugs);

Personal prevention

Protect itself from such a disease, you can comply with the necessary preventive measures:

compliance with hygienic standards and rules;
when symptoms appear - appeal to the doctor;
conducting a healthy lifestyle;
strengthening immunity;
avoiding stress and conflict situations.

The course of treatment includes drugs containing:

crotomiton;
benzylbenzoate;
permethrin;
malation.

In some cases, the reception of these drugs is also assigned orally, however, the greatest effect can be achieved by local applications.

The treatment of Norwegian scabies has its own characteristics:

ointment is applied under briefly cropped nails;
local preparations are applied to the whole body;
medicines are used repeatedly;
treatment lasts at least 4 days;
displaced skin elements are recommended to scrape a non-rigid brush;
clothes and bed linen is changing every day.

If the treatment of Norwegian scabies is inevitable, it is important that all members of the family infected are at the same time. In this case, it is necessary to strictly comply with all the recommendations of the doctor.

To date, there are many anticipressive drugs containing melation, permethrin, Crohyton and benzylbenzoate.

Experience shows that there are no relapses in scabies, the reasons for the resumption of the disease are reinvasia from unpriced contact persons in a focus or outside it, the negliction of the patient in connection with non-compliance with the treatment regimens, partial treatment of skin cover, reducing the duration of the course of therapy.

Treatment must be carried out exclusively under the guidance of the doctor;

Treatment of all patients living together must be carried out simultaneously;

It is necessary to clearly adhere to the processing scheme written in the instructions for the drug or as a doctor will appoint;

The drug is applied to the whole body, except for the face and the scalp, and in children under 3 years old, it is necessary to process these sites;

It is important to cut the nails short and thickly apply the drug under them (when combing under the nails, eggs are accumulated);

Rubbing any drug is carried out by hand, which is due to the high number of scales on the brushes. If the crotch and groin are thickly covered with hair, the drug is better to rub the brush;

Treatment must be carried out in the evening, which is associated with the night activity of the pathogen;

Patient washing is recommended before starting and at the end of the course of treatment, if necessary, the patient can wash off the drug every morning, while its exposure on the skin should be at least 12 hours, including the entire night period;

Changing and bed linen is held at the end of the course of therapy;

One teaspoon of the turpidar is thoroughly mixed with two tablespoons of butter and the resulting mixture is treated affected skin;

One tablespoon of the juice was mixed with 4 tablespoons of vaseline and the resulting mixture is treated with the skin;

Birch delet is applied by a uniform layer on the affected skin. After three hours, it was washed away to tar warm water;

When scabies need to be confused with freshly edged yellow "Buttons" of the Pijmas and this grated mass to lubricate the skin, affected by a garlic tick. Sometimes two or three such procedures are enough to get rid of sores;

Pour in the evening in the enameled dishes of 0.5 liters of water 1 tbsp. L.

Wear a clean laundry laundry, flying bed and go to bed. Repeat the procedure blackmaged to recovery;.

Mix 1 tsp. Pharmacy Skipidar with 1-2 T.L. Pork smalts or boiled olifa and regularly lubricate this ointment of the place of rash to its complete disappearance;

Dilute in the dishes with warm water soap so that a large coat of soap foam turns out, to moisten a sponge in this solution and rub the body of the patient so that the layer of soap remains on the surface of the skin.

All components are stirred to obtain a homogeneous mass. If in a few hours the body will begin to hide much, then it is necessary to wash off the ointment from the body of a patient with warm water and put on it clean underwear.

If there is traces of combing on the body, then it is necessary to apply a sulfur ointment made of 1 part of the weight of sulfur in the powder and 4 parts of the smaller. To process this ointment body 2 times a day must after the bath;

Brew (just brew!) In an enameled saucepan 6-8 kg of salt and pour the decoction into the water bath 37-38 ° C. Tell in a solution for at least an hour and, coming out of the bath, do not wipe, but heat. Conduct a procedure daily to cure;

A mixture of chicken litter with tar treats scabies. Composite needs to be well confused and cooked ointment to lubricate the place affected by the sickness. Lingerie is preferably not to wear. In the morning the body thoroughly wash;

When scabies, soda chalk, ask him through a thick sieve and this "flour" well lubricate the races. Scabies will pass;

Under the skin diseases, especially when scabies, it is necessary to wash a strong decoction of the root of nine times until the body is cleaned. Do not wait for instant healing, and patiently treat, and soon the recovery will come;

Sutitate the household soap on the grater and soften, adding water. Stir and put on a slow fire. Constantly stirring. As soon as the mass becomes homogeneous, remove it and add the middle ground on the grater of the bulb and the head of garlic. Cool down, roll in the balls and wash this soap daily;

Often, the treatment of scabies at home is possible, but only after the preliminary consultation of the attending physician.

The drug benzylbenzoate is produced in the form of ointments and emulsion. He is one of the most common drugs from scabies; Treatment in this case takes up to four days.
Permetrin - produced in the form of gels, ointments, sprays and lotions. The cost of the drug is slightly higher than benzylbenzoate, however, in two days of therapy, you can completely get rid of the disease.
Sprugal is one of the most expensive drugs manufactured in France. This aerosol is very simple and easy to use: does not leave traces on clothes and practically no smell. Most often, dermatologists are recommended to carry out twofold treatment with an interval of 3 days.

Basic principles of therapy

The treatment of Norwegian scabies is carried out with the help of special ointments:

Benzylbenzoate - a drug used in lesion of the skin. Available in the form of 20% of the drug or ointment.

A group of pyrethrines is a drug containing insecticides in its chemical composition, they have an active anticipating effect and have a less toxic effect.

Yakutin is applied to damaged areas immediately after the shower, and wash off after 6 hours. The drug is applied extremely rarely as it can affect the human nervous system with the development of its defeat. It is strictly forbidden to use the preparation during pregnancy and in childhood.

The polysulfide liniment is an anticipating drug, which is produced in the form of 10% ointment or solution. 3-4 days after the initial application, it is possible to carry out skin hygiene.

Treatment of scabies requires a huge amount of time and regular application of drugs. In case of non-fulfillment of the necessary rules, treatment will be ineffective.

Preparations from Norwegian scabies: brief description and instructions

IMPORTANT: Preventive treatment is undergoing all persons in contact with the patients.

Medical practices use medicines:

Sulfur ointment: simple instructions for use

The drug is used to treat scabies, acne, psoriasis, demodecosis, pediculter, dandruff. Before applying the skin ointment, you need to take a shower. The residues of the ointment can not be washed off during the day. The procedure is repeated for three days in a row. Sulfur ointment is a cheap and effective treatment. But today the drug is rarely used. The fact is that the tool has a sharp, unpleasant smell, and spots remain on clothes and bedding.

The drug "benzylbenzoate": instructions for use, price

As mentioned, this drug is most often used to treat Norwegian scabies. What is "benzylbenzoate"? Instructions for use, price, properties are those questions that interest every patient.

Ointment (or emulsion) cannot be used if the skin has uluses. The price of the drug is not too high - the jar of cream volume of 50 g will cost about 60 - 100 rubles.

Are there risk factors?

Norwegian cortical scabies develop against the background of weakening the immune system, as it allows the ticks to be actively multiplied. Scientists identify several risk factors:

the presence in the body of HIV infection;
system autoimmune diseases, including red lupus;
oncological diseases;
common Candidiasis;
tuberculosis, lepreras and some other diseases;
exhaustion of the body arising against the background of nervous overvoltage, strong stress, alcoholism;
neurological and mental disorders, including infantilism, dementia, dementia;
long-term therapy with the use of cytostatics and hormonal steroid drugs;
paralysis, impaired sensitivity of peripheral nerves.

Basic prevention measures

careful observance of personal hygiene;
everyday change of underwear;
regular change of bed linen;
early diagnosis of scabies patients;
regular visit to the doctor and identifying contact persons.

After the end of the main course of therapy and elimination of symptoms, preventive measures begin, which allow you to avoid re-infection.

Norwegian scabies are severe and dangerous disease, the treatment of which should not be conducted without the control of the doctor.

Persons from one focus are treated together with the aim of preventing re-infection. All persons in contact with affected conduct a single prophylactic treatment of skin with antiquity drugs.

After the patient is treated, many leaders recommend the treatment of all things and linen with which the patient contacted (special sprays, washing in hot water).

Important! Contrary to common misconception, scabies are not related to low hygiene. Chesoccal tick is not susceptible to water or soap. With daily reception of the shower / bath, the number of ticks and the probability of infection are not reduced.

As a rule, with illness, scabies should be carried out several times a day.

All surfaces should be wiped with a damp cloth, and then process furniture with 1% soda solution.

It costs to remember that frequent medical examination of adults and children, as well as continuous observance of personal hygiene, can significantly reduce the risk of developing such a kind.

Maybe you will be interested

After a person completely got rid of the illness, his things and household items should be carefully processed, in order to avoid recurrence of the disease.

After the end of the main course of therapy and elimination of symptoms, preventive measures begin, which allow you to avoid re-infection.

Norwegian scabies are severe and dangerous disease, the treatment of which should not be conducted without the control of the doctor.

Specific prevention of the infectious disease is carried out with the development of a critical epidemiological situation in a certain region. All in contact with an infected person must undergo mandatory skin treatments against scabies. After a person completely got rid of the illness, his things and household items should be carefully processed, in order to avoid recurrence of the disease.

This is a serious illness - it can not be ignored, nor try to treat himself. Folk methods and home remedies can be used only with the permission of the attending physician and just along with medication therapy.

The causative agent of the disease (scaffolding tick) appears outwardly resembles a small turtle. The dimensions of these ticks do not exceed 0.3 mm, and the danger represents only females. Men's individuals live on the skin surface, they die immediately after the fertilization of "ladies". The females are introduced into the skin, leaving there many moves there. They put eggs in them, leave a lot of excrement of other livelihoods. It is such activity and leads to the development of Norwegian scabies.

Although the main pathogen of the Norwegian scabies relates to ordinary ticks, many infectiousists suggest "intervention" into the development of the Norwegian scabies of some more aggressive species. This is definitely not confirmed, so you will not consider this option seriously. If you get a tick on the skin, the infection occurs almost instantly - the females are fixed on the external covers, after which the "dig" canals begin with suction cups and shallow bristles. The paths of transmission of infection are as follows:

If the conditions for the life of the tick are unfavorable, then he quickly dies, not leaving the offspring. In such a situation, Norwegian scabies are not developing. Thus, for the beginning of the disease, provoking factors are needed:

immunity problems, including HIV;
alcoholism, smoking, addiction;
oncological diseases;
tuberculosis;
pump (lepreing).

The first points of this list are the most popular provoking factors of Norwegian scabies. The case, of course, is not in HIV infection, but in the fact that people do not follow their health, they are depletion of the state of immunity.

It has been established that people suffering from mental inferiority are more often victims of Norwegian scabies. Diseases include age dementia, Down syndrome, various neurological disorders. Probably the reason is that such patients are worse behind them.

Symptoms

The disease almost never costs without bright symptoms. This has its advantages - the diagnosis rarely causes difficulties that, in turn, provides timely and proper treatment. So, the main symptoms of Norwegian scabies:

the skin becomes dry and hot;
in some areas, "scabies" appears - a characteristic chain of rashes arising due to the accumulation of ticks;
erythrodermia;
nails relax, change the color, become loose;
inflammation of lymph nodes;
the growth of the horn layer on the palms and footsteps, which sometimes prevents the normal movement (hyperkeratosis).

But the main sign of Norwegian scabies is multi-layered gray or black peels (sometimes yellowish). They can cover the whole body, the thickness of them reaches 3-4 centimeters.

Pain sensations this symptomatology does not cause itching, too, can sometimes be absent. The reason for this lies in weak immunite - toxins that are isolated by mites are not perceived by the protective forces of the body as something alien, harmful. In addition, the absence of itching in some cases is explained by genetic predisposition. But the most dangerous situation is folded when the patient cannot scratch the affected skin. In this case, atrophy begins, nerve fibers are affected, which is the reason for the absence of itching.

If you "disembark" with a scabies, then you can detect a wet yellowish bottom with bleeding. It is not necessary to do a similar procedure - it is very painful.

Diagnostics

Although the disease has characteristic symptoms, it is often confused with eczema, psoriasis and pyoderma in acute form. The reason is that Norwegian scabies have external manifestations similar to them. In order to eliminate the erroneous diagnosis, you need to pass tests. Blood is used as biomaterial and, most importantly, samples of crusts and leather with affected areas. Put the Norwegian scabies in the event that:

obo acanthosis (increased pigmentation on the neck, under the mouse and in the groin area);
in the bounded corneal layer, many screaming depressions were discovered - characteristic traces from the channels made by ticks;
increased leukocytes;
erected erythrocyte sedimentation rate (ESO).

Treatment

Norwegian science therapy usually takes two stages:

It sounds simple, but in fact, the procedure is quite complex, require a lot of time. Moreover, the interruption of the course of treatment until complete recovery provides all efforts to not. If at least a small population remains from a multi-million dollar colony, then in a short time they will break again, the therapy will need to begin again.

If the doctor did not give separate recommendations, then use drugs should be accurately in accordance with the instructions. In the occurrence of side effects in the form of irritation, a strong itching after applying the means and especially in violations of consciousness, it is urgent to consult with the attending specialist for the selection of an alternative.

An important part of the treatment of Norwegian scabies is to strengthen immunity. Without it, the effectiveness of drugs will be somewhat lower, which means that the course of treatment from Norwegian scabies will become longer, more complicated and more expensive, especially when using ivermectin. For this you need:

take vitamins and immunomodulators;
establish a power mode;
regularly walking outdoors;
treately treat colds.

You can also watch a video where you will be told about various types of scabies: Typical, Norwegian, pseudochildren, etc.

Norwegian scabies is not the only term to designate this dangerous skin disease. You can also hear such names like "Cork", "Keratotic" or "Crubious scabies". In Latin, the disease sounds like Scabies Norvegica. The disease is so called for the reason that it was first described by scientists in Norway.

Features of the development of pathology

Norwegian scabies is a heavy skin disease of an infectious nature. The incidence frequency is extremely low. Since the opening of the disease, no more than 150 cases were officially fixed. It does not affect human infection, neither the age or the floor nor racial affiliation. Called Norwegian scabies in the same itch, as well as ordinary scabies.

There are certain factors that contribute to the spread of scabies.

Failure to follow the rules of personal hygiene.

The process of development of the disease is most actively on the soil of somatic and mental abnormalities, as well as in people with a weakened immune system. Therefore, the following groups of people are most susceptible to infectness:

patients of the psychoneurological clinic;
operations living in disabled homes;
people with Down Syndrome;
infantile Operations;
people with asthenia;
sick AIDS, Leproi;
patients with dementia;
people suffering from leukemia, leukemia;
patients with tuberculosis;
struck by red lupus, bloom syndrome;
people who are forced for a long time to use hormonal preparations.

You can get a garlic tick when contacting the skin of a person for a long time. The most common mechanism for the transfer of Norwegian scabies is sexual. Accordingly, infection can occur as a result of contact with the skin of a sick person in bed.

However, it should be noted that the infection of children in the bed of a sick person is extremely rare. This can be explained by the fact that so that the tick is penetrated into the skin of another person, it takes at least half an hour and close contact. When you find a tick in the external environment, it will die after 36 hours.

There are also outbreaks of collective infection. The most susceptible to the athletes of contact species of competitions. It can also occur in the case of strong handshakes, as well as in the places of great presence of children. The chance to pick up this disease during contacts in everyday life is almost equal to zero.

Manifestations of the disease

While with normal scabies, the number of ticks is usually no more than two dozen. That is why, with Norwegian scabies, the symptoms are very pronounced:

For the formulation of an accurate diagnosis, the following components are necessary:

the presence of clinical data;
epidemiological data;
laboratory research.

The results of blood test may indicate a high level:

Leukocytes.
Eosinov.

Medical tactic

Treatment of the disease is effectively at the initial stage of Norwegian scabies. In the case of an incorrect diagnosis or a launched face, a person may die from intoxication or the occurrence of complications from the cardiovascular system.

Treatment should be fully carried out to the recovery of the patient, which must be confirmed by the results of laboratory studies. Otherwise, there is a high probability of recurrence of the disease.

It is also important that the treatment should pass all family members.

Medical therapy

General principles of treatment

Successful medical tactic provides for compliance with some rules for therapy and prevention:

Norwegian scabies is a very dangerous skin disease that can end with a fatal outcome. Therefore, in case of suspicion of this disease, it is necessary to seek specialized help and not engage in independent therapy.

Etiology and epidemiology

The daily rhythm of the activity of the garlic tick explains the strengthening of itching in the evening, the prevalence of the direct path of infection when contacting the bed in the evening and night, the effectiveness of appropriate drugs for the night.

Infection of scabies occurs mainly with close bodily contact, usually with a joint stay in bed and intimate communication. Invasive stages are females and tick larvae.

The hearth during scabies is defined as a group of people in which there is a patient - a source of infection and the conditions for transmitting the pathogen. In the irradiation of the focus, a crucial role is played with patients with patients at night during the maximum activity of the pathogen (direct path of transmission of infection).

The second place in the epidemic significance is occupied by invasive-contact groups - groups of persons living together having a common bedroom (hostels, children's homes, boardings, nursing homes, barracks, "supervisory" chambers in psychoneurological hospitals, etc.) if there are close household contacts With a friend in the evening and night time.

There is no generally accepted classification.

Symptoms scabies

The incubation period in infecting females of the chicken tick is practically absent. When invasion, larvae can talk about the incubation period, which corresponds to the time of metamorphosis of ticks (about 2 weeks).

The following clinical varieties of science are distinguished:

typical;
scabies without moves;
scabies of "clean" or "incognito";
scABIOS skin lymphoplasia;
scabiose erythrodermia;
norwegian scabies;
complicated scabies (secondary pyodermia, allergic dermatitis, less often - microbial eczema and urticaria);
pseudosarkoptosis.

Typical scabies occur most often, its clinical picture is represented by various variants of scales, follicular papulas on the body and limbs, unreactive vesicles near the moves, mass and bloody crusts disseminated throughout the skin. For typical scabies, there is a lack of rash in the inter-opumen region.

Itching is a characteristic subjective symptom of scabies, due to the sensitization of the body to the causative agent. When primary infection, itch appears after 7-14 days, and during reinvasia - after a day after infection. Strengthening itching in the evening and night is connected with the daily rhythm of the activity of the pathogen.
Punches for scabies are caused by the activity of the tick (scales, follicular papulas, non-agitative vesicles), an allergic reaction of the body on its livelihood products (miliar papules, comb, bloody crusts), pyrogen microflora (pustula).

Chesoccal moves are the main clinical symptom of scabies. There are three groups of moves, including their various clinical options:

The source (intact) type of stroke and variants of moves, the formation of which is associated with the ability of the skin to respond to the occurrence of those or other primary morphological elements to the introduction of female tick.
The moves formed from the clinical options of the first group in the process of natural regression of the moves themselves and / or transform the primary morphological elements dedicated to them into secondary.
The moves due to the addition of secondary infection to the exudate of the strip elements of the first group.

Typical moves have a slightly towering line of whitish or dirty gray, straight or curved, 5-7 mm long. The so-called "paired elements" can not be identified with moves and consider as a diagnostic characteristic of the disease.

Papulas, vesicles, breaks and bloody crusts often prevail in the clinical picture of the disease. The imperfect stages of the development of a garlic tick, young females and males are found in 1/3 papules and vesicul. For papules with ticks, a follicular location and small dimensions (up to 2 mm) are characterized. Vesiculi is usually small (up to 3 mm), without signs of inflammation, are located isolated mainly at the brushes, less often - on the wrists and footsteps.

Diagnostic symptoms for scabies are:

ardi's symptom - Pustules and purulent crusts on the elbows and in their circumference;
gorchakov's symptom - bloody crusts in the elbow area and in their circumference;
symptom of Michaelis - bloody crusts and impetiginous rashes in an inter-fodder fold with the transition to the crushes;
sesari symptom - detection of the scabies of palpatorial in the form of a light bandwidth.

Scabies without moves is registered with less frequently typical scabies, it is detected mainly during examination of persons who were in contact with scabies sick, occurs when infected with larvae, exists in its original form not more than 2 weeks, is clinically characterized by single follicular papulas and non-inflammatory vesicles.

The scabies of "clean" or "incognito" arises from persons often taking water treatments, especially in the evening, corresponds to typical scabies with minimal manifestations in their clinical picture.

The scabiose lemphoplasia of the skin is clinically manifested by strongly denicing lenticular papulas, localized on the body (buttocks, belly, the axillary region), genitics of men, lactic glasses of women, elbows. Scabiose skin lymphoplasia persists after full-fledged therapy of scabies from 2 weeks to 6 months. The epidermis scraping from its surface speeds up the resolution. With reinvasia, it recurs in previous places.

Scabiose erythrodermia occurs in cases of long-term (2-3 months) use of systemic and topical corticosteroids, antihistamine drugs, psychotropic drugs. Itching is weak and diffuse. Patients are usually not combed, but rub the skin with palms. The main symptom of the disease is pronounced erythrodermia. Chesoccal moves arise not only in places of typical localization, but also on the face, neck, the hairpiece of the head, in the inter-pumping area. In this case, they are usually short (2-3 mm). In places subject to pressure (elbows and buttocks), hyperkeratosis is expressed.
Norwegian (Cork, Cruelous) Scabies - a rare and very contagious form of the disease. It occurs in immunosuppressive states, long-term reception of hormonal and cytostatic drugs, impaired peripheral sensitivity, constitutional organization anomalies, in patients with seden dementia, Down disease, in patients with AIDS, etc. The main symptom of the disease is erythrodermia, against the background of which massive grayish-yellow or brown-black peels are formed with a thickness of several millimeters to 2-3 cm, limiting movements and make them painful. Between the layers of the crust and under them is a huge amount of scabies ticks. At the brushes and footsteps there are many scales. Nails are often amazed, lymph nodes increase, hair falls out, the body temperature rises. From patients, an unpleasant smell occurs. Often surrounded by such patients arise microepidemia - family members, medical workers, patients in the same Chamber are infected.

Complicated scabies. Scabies are often complicated by secondary pyoderma and dermatitis, less often - microbial eczema and urticaria. Among the nosological forms of pyodermia, staphylococcal impetigo, ostiopholic acids and deep follicles are dominated, less commonly, furunculae and vulgar ecctims arise. Impochigo prevails in places of frequent localization of moves (brushes, wrists, foot), ostiopholyculite - in places of metamorphosis of ticks (the front-glass surface of the body, hips, buttocks). The microbial eczema is more often observed in the location of the skin of a scabiose lymphoplace of the skin, especially in the field of buttocks.

Scabies in children are characterized by a greater prevalence of the process with the involvement of the skin of the face and the scalp. The reactive variants of scabies near exudative morphological elements prevail, a scabiose skin lymphoplasia is often encountered, the complications of the disease are often encountered. In the process, especially in infants, nail records can be involved.

Scabies in elderly people have certain features: scales - single, their intact options prevail; Vesiculi and papules are small. Among the rashes are often there are bloody crusts and combs. Allergic dermatitis and microbial eczema develops from complications.

Features of the flow of scabies when combined with other dermatoses. For scabies against the background of atopic dermatitis, vulgar ichthyosis (severe skin dry) there are single scales; Against the background of hyperhydrogen, discharge eczema, epidermofitilation (increased skin moisture) - multiple. During scabies against the background of psoriasis and red flat, the isomorphic reaction of Cubner is sharply expressed dramatically.

Pseudosarkoptosis is a disease that occurs in a person with an infestation with chicken animal ticks (dogs, pigs, horses, rabbits, wolves, foxes, etc.). The incubation period of the disease is several hours, there are no scabies, since the ticks do not multiply on the owner unusual for them and only partially introduced into the skin, causing heavy itch. The rashes are localized in open areas of the skin, represented by urticular papulas, blisters, bloody crusts and combs. From person to man, the disease is not transmitted.

Diagnosis of scabies

The diagnosis of scabies is established on the basis of a complex of clinical and epidemiological data, confirmed by instrumental and laboratory studies aimed at detecting the causative agent.
The diagnosis of scabies must be confirmed by the detection of the pathogen.

The proceeding method is used to verify the scales. Suspicious on the scabies element is lubricated with an alcoholic solution of iodine or aniline dyes.

The oil vitropression method allows you to quickly detect a scabies. Due to the calculation of the capillary channel, when pressing the subject glass, visualization of surface skin inclusions is improved. The enlightenment effect is enhanced after the preliminary application of mineral oil on the intended scales.

The method of extracting a needle tick. For this purpose, sterile disposable injection needles use. The needle is revealed to the blind end of the course on the site of the browned point inclusion corresponding to the localization of the female of the scabed tick. The needle's edge is promoted in the direction of the course. The tick, which is fixed with its suction cups to the needle, is removed and placed on a slide glass of water or 40% of lactic acid, cover with coating glass and a microscopic examination is carried out.

The method of scraping allows you to detect the contents of the scabies, papural and vesicle. A drop of 40% of lactic acid is applied to the scales, papula, vesicula or a crust. After 5 minutes, the loose epidermis scraped the scalpel until the blood drop appears. The material is transferred to the slide glass in a drop of the same lactic acid, covered with coating glass and a microscopic examination is carried out. The result of laboratory diagnostics is considered positive if the preparation is detected by female, male, larvae, nymph, eggs, empty egg shells, straight skins. The presence of excrement indicates the need to study scrapets from other sections of the skin.

Dermatoscopy is a mandatory method when examining a patient with scabies. In typical scabies, dermatoscopy makes it possible to obtain a positive result in all cases, with scabies without moves - in 1/3 of cases, while the detectability of scabies rises by one third in comparison with the examination of the patient without optical instruments. In the presence of destroyed moves and the absence of females of the garlic tick in them, an externally unchanged skin is examined near the course of at least 4 cm 2.

Differential diagnosis of scabies

Scabies are differentiated with pseudosarkoptosis, contact allergic dermatitis, urticaria, toxicodermia, rat tickle dermatitis, pediculose, phlebotodermia, discharge eczema, atopic dermatitis, skin itch, in children - with scratch, wind inspi, etc. For differential diagnosis, all the above clinical, epidemiological and laboratory criteria for diagnosing scabies should be taken into account.

Cachet treatment

Treats of treatment

elimination of clinical manifestations of the disease;
prevention of the development of complications;
prevention of infection of other persons.

Non-specific methods of therapy are used to treat complications associated with scabies, and reduce the intensity of the skin.

General comments on therapy

Treatment during scabies is divided depending on the purpose that the doctor pursues. Highlight three types of therapy:

specific;
prophylactic;
trial (ex juvantibus).

Specific treatment is carried out in the presence of scabies in the patient, the diagnosis of which is confirmed by clinically and laboratory by detecting the pathogen.

Preventive treatment is carried out on epidemiological indications in the foci of scabies to persons who have no clinical manifestations of the disease.

Members of family foci (parents, children, grandparents, grandfathers, other relatives), as well as nanny, governess, nurses;

if there are conditions for transmission of the pathogen (close body contact, sexual contact, joint stay in bed in the evening and night time, etc.);
in the presence of patients with scabies of children of the youngest age group, with whom most family members usually contact;
when identifying two or more patients in the hearth (irradiating hearth). Members of invasive contacts:

persons having common bedrooms, if there are close bodily contact with patients with scabies;
all members of groups / classes / divisions where several cases of scabies are registered or new patients are revealed during the observation process behind the hearth.

Trial treatment (EX JUVANTIBUS) is carried out only in cases where a doctor for clinical data suspects the presence of scabies, but the diagnosis is not confirmed by the detection of the causative agent. With a positive effect on the use of scabysides, scabies are recorded.
The principles of therapy should be observed by the doctor regardless of the scabing chosen for the treatment of scabies:

the simultaneous treatment of all patients identified in the focus to prevent reinvasia;
application of anticipating drugs in the evening to increase the effectiveness of therapy, which is associated with the night activity of the pathogen;
application of anticipation of anticipating drugs allowed in children under the age of 3 years to all skin cover, in the remaining patients the exceptions are the face and the moay of the head;
application of scabysides with bare hands, and not a napkin or a swab, especially thoroughly preparations rub into the skin of the palms and soles;
if after applying the drug there was a need to wash his hands, then they must be reused with a scabicide;
washing before the first application of scabing and after the completion of treatment; change of native and bed linen - after the course of therapy;
the exposition of the drug on the skin should be at least 12 hours, including the entire night period, in the morning it can be washed;
conducting complications at the same time with the treatment of scabies;
a persistent scabiose lemphoplasia of the skin is not an indication to continue specific therapy;
in the presence of post-clip itching, the question of repeated processing scabicide is solved individually after a thorough examination of the patient;
after completion of therapy, it is necessary to carry out a disinsection of a native and bed linen, towels, clothes and shoes, carry out wet cleaning in the room where the patient was located.

Indications for hospitalization

patients with mental, neurological or other diseases in which the patient, in the absence of persistent person, cannot fully fully fulfill all the necessary appointments;
patients from organized collectives in the absence of the possibility of insulation from healthy individuals (for example, if there are scabies in people living in boarding schools, orphanages, etc.).

An indication for directions to the hospital can also serve as a scabies complicated by secondary pyoderma with multiple, more often deep pustules (furunculae, carbuncules, ectims), especially in children, as well as scab, accompanied by lymphadenopathy, high temperature, etc.

When revealing scabies in a patient in a somatic separation, the translation into a specialized dermatovenerological hospital is not required. Treatment is carried out in a separation where the patient is due to the main disease. The patient loses contactness after the first processing of a scabicide. With a common process, Norwegian scabies and scabiose erythrodermia requires temporary insulation of the patient in a separate ward for the treatment of scabies (4 days). In these cases, all patients in the same chamber with sick scabies are subject to preventive treatment.

Come on the treatment from the receiving office (or the patient scabies detected in the compartment) is insulated with a separate chamber (insulator). After consulting a dermatovenenerologist and confirmation of the diagnosis of the patient (adults and children over 1 year old), treatment is carried out and objects of individual use (towel, urine, soap in small packing) are issued. Food is organized in the ward. Competitive and bed linen patient is processed.

Manipulation against patients with scabies, as well as room cleaning are carried out using personal protective equipment - rubber gloves, individual bathrobes. Rubber gloves and harvesting inventory after the completion of cleaning are disinfected.

Preparations for the treatment of scabies:

Emulsion and ointment of benzylbenzoate
Permeter 5% - water 0.4% emulsion
Sulfuric ointment
Piperonylbutoxide + esbiol aerosol

Special situations

Treatment of pregnant women with scabies:

For the treatment of scabies in pregnant women, an aerosol is used to external use of pyeronylbutoxide + esbiol and a permeter solution prepared from 5% emulsion concentrate in ethanol.

Treatment of children with scabies:

For the treatment of children under the age of 1 year, an aerosol is used to external use of pyeronylbutoxide + esbiol; For the treatment of children aged 1 to 3 years - aerosol for the external use of pyeronylbutoxide + esbiol and 5% permethrin emulsion concentrate in ethanol; For the treatment of children aged 3 to 7 years - 10% emulsion and ointment of benzylbenzoate, 5% sulfur ointment are added to the specified means; The therapy of children over the age of 7 is carried out according to the treatment of adults.

Treatment of a scabiose lymphoplace of the skin (SC) can be long. After a full-fledged course, any beabycid of ticks die. The UNSC is permitted much faster if before the start of specific therapy of the epidermis from the surface of the papural scrape the sterile scalpel before the appearance of blood droplets. The skin defect is treated with antiseptic preparations (aniline dyes, a 5% potassium permanganate solution, a solution of povedium-iodine, chlorhexidine Bigluconat, etc.). Specific treatment of scabicides (in the evening) combined with rubbing in Papula (morning and day) of topical combined glucocorticosteroid drugs: Diflukortalon + isokonazole, betamethasone + gentamicin + clotrimazole, hydrocortisone + neomycin + natamycin, cliqueinol + flumetazone, etc.
If after the resolution of the basic clinical manifestations of science, the clinic is observed, the treatment is continued by single-component topical corticosteroids under an ancient bandage: methylprednisolone Aceponat, hydrocortisone butirate, mometasone Furoate, etc. You can use phono or photophoresis with these drugs, except in cases where the Sloclone is localized by genitals . Also used surface cryodestruction of the cloaks, followed by applying topical combined glucocorticosteroid drugs.

Treatment of scabies complicated by secondary pyoderma.

Treatment begins with rubbishide rubbing to eliminate itching, contributing to the impaired integrity of the skin. Preference is given to beabycides, the application of which does not require intensive rubbing and does not contribute to the spread of the skin infection (aerosol for the external use of pyeronylbutoxide + esbiol and permeter solution prepared from 5% emulsion concentrate in ethanol).

With surface pyodermia (impetigo, ostiopholic acid, tournament, etc.) use external therapy. Pustules are fascinated by the solutions of aniline dyes, a 5% solution of potassium permanganate, a solution of povedium-iodine and other antiseptic drugs. If there is an impetigo, its tire is pierced with a sterile needle. After dried up, mazi / creams with antibacterial action are prescribed: Bacitracycling + neomycin, Mupirocin, fusidic acid; with antiseptics: povedium-iodine, silver sulfatiazole, chlorhexidine Bigluconat et al.; Combined drugs: dioxomethyltetrahydropymidin + chloramphenicol, etc. The topical combined glucocorticosteroids are shown: hydrocortisone + neomycin + natamicin, hydrocortisone + fusidic acid, betamytomazone + gentamicin + clotrimazole, clockinol + flumetazone, etc.

With deep forms of pyodermia (vulgar ecctim, deep folliculites, furuncular) treatment is supplemented by the appointment of systemic antibacterial preparations of a wide range of action.

Treatment of scabies complicated by allergic dermatitis.

Before starting specific therapy, it is advisable to recommend a patient washing with soap to improve access of an anticipating drug in moves. Treatment starts from rubbing to eliminate the activity of a garlic tick producing allergens. Preference is given to beabycides, the application of which does not require intensive rubbing and does not contribute to the spread of the skin infection (aerosol for the external use of pyeronylbutoxide + esbiol and permeter solution prepared from 5% emulsion concentrate in ethanol).

With a limited process, only local therapy is appropriate. For this purpose, combined topical glucocorticosteroid preparations are used for this purpose, for example, fluortonalon + isokonazole, betamythasone + gentamicin + clotrimazole, hydrocortisone + neomycin + natamycin, cliqueinol + flumetaone, etc.

With a common allergic dermatitis, it is necessary to assign antihistamine drugs inward (levocideminic, chloropiramine hydrochloride, clelestine, cetirizin, dislochildin, etc.). Outdoor therapy in this case is starting with aqueous shabby mixture, zindol and other indifferent means, including products for the care of dry irritated skin. After transformation of the common process in local treatment, one can continue one-component topical glucocorticosteroid drugs: methylprednisolone as acertonate, hydrocortisone butyratom, momethazone fooloat.

Treatment of scabies complicated by microbial eczema.

Considering that the microbial eczema is more often developing in areas of the skin, where SCL is localized, its treatment includes three stages:

treatment of scabies with one of the scabysides;
treatment of microbial eczema according to the generally accepted scheme, after resolving the infiltration and dishelling of the crusts, there are usually lenticular papules (CC), more often than multiple;
treatment of the SCL according to the scheme specified above.

Treatment of Norwegian scabies - has specific features. In the evening of the patient, the patient is treated with a scabicide to destroy the active stages of the pathogen and reduce the patient's contagiosity, in the morning - one of the keratolithic drugs - means of salicylic acid (5% sulfur salicyl ointment, 5-10% salicyl ointment) and urea. Such treatment is carried out until complete disheve of the crust. Next, the patient is treated in the evening only scabicide. After completion of specific therapy, mitigating or moisturizing agents are used to eliminate dryness of the skin. An important condition is the regular study of epidermis scrapings for the identification of a garlic tick. When moving the moving parties, the course of specific therapy is repeated with a change of scabicide.

Treatment of scabiose erythrodermia is also carried out as a Norwegian scabies, but without the use of keratolytic agents.

Postcaboid itching (PZ) - preservation of itching in patients after full-fledged specific therapy with one of the scabs. The main objective clinical symptom of the PZ is the presence of scales, the length of which reaches several centimeters. The absence of holes in the roof of such moves makes it difficult to penetrate the scabicide. The duration of the PZ corresponds to the life expectancy of females and depends on their age at the time of the start of therapy. When preserving the PZ on the background of treatment with antihistamine and topical glucocorticosteroid drugs during the week (the time required to exfoliate the epidermis with the fallen ticks), repeated processing of a scabicide, carried out after a thorough washing of a patient with soap and washcloth is necessary. Another cause of the PZ may be dry skin cover. In this case, emuls are prescribed.

Treatment of scabies in the hot season. Preference is given to drugs in a liquid dosage form (aerosol for external use of pyeronylbutoxide + esbiol and permeter solution, prepared from 5% emulsion concentrate in ethanol) that do not require intensive rubbing. The use of ointments at high air temperature can lead to the overheating of the patient, the occurrence of dermatitis or the appearance of pyodermia.

Requirements for the results of treatment

destruction of the pathogen at all stages of its development;
elimination of itching and disappearance of clinical manifestations of the disease.

Terms of observation of patients are individual and depend on its clinical form. When scabies without moves, typical scabies, scabies "Incognito" after a full-fledged course of therapy and a full range of preventive measures in a focus, the timing of patients is 2 weeks. The duration of the dispensary observation increases with scabies complicated by piedermy, dermatitis, microbial eczema, with a scabiose lymphoplace of skin, scabiose erythrodermia and Norwegian scabes. The patient is removed from accounting after the complete permission of all clinical manifestations. The forecast for scabies is favorable.

The reasons for the ineffectiveness of treatment:

Non-compliance with treatment schemes:

the use of drugs in low concentrations;
non-compliance with the multiplicity and timing of processing;
application of the drug excluding the daily rhythm of the activity of the garlic tick;
partial treatment of skin;
the use of scabysides with overdue shelf life.
Reinvasia in the absence or incomplete amount of anti-epidemic events in the focus.
Resistant ticks to scabysides.

Medicaseous complications from scabysides, manifested by itching and dermatitis, are often mistakenly regarded as a persistence of scabies.

Prevention scabies

The identification of patients with scabies is carried out by medical professionals of all health organizations, regardless of the organizational and legal forms and forms of ownership (including in pre-school and general education institutions, institutions of primary, secondary and higher professional education, during the period of call, etc.), as well as Persons engaged in private medical practice when contacting, preliminary when entering work and periodic, planned, preventive medical examinations and for epidemiological indications.

The prevention of scabies includes several directions.

Registration of all scabies identified by patients.
Implementation of dispensary monitoring of persecuted and contact persons.
Identify the source of infection and contact persons, including sexual partners.
Detection of scabies and work on their liquidation. Members of organized collectives are inspected by medical workers in the field.
Definition of groups of people to be mandatory prophylactic treatment (see above).
The active identification of patients with preventive medical examinations of various groups of the population (decreed contingents, children's teams, faces of the appeal and assembling age, schoolchildren at the beginning of the school year, applicants, military personnel, etc.).
Inspection on the scabies of patients who applied to clinics, ambulance, medical schools hospitalized in medical organizations of any profile, etc.
When screaming from schoolchildren and children visiting children's nursery, gardens and schools, they are not allowed in children's teams at the time of full-fledged treatment. Skin scabiose lymphoplasia is not a contraindication to admit children to organized groups, since the patient after high-quality therapy loses its contagiousness for others.

Medical workers of outpatient polyclinic institutions, hospitals, orphanages, children's homes, children's preschool institutions, institutions of general and vocational education, institutions of social security system, medical enterprises, regardless of the forms of ownership and departmental affiliation, are obliged to actively identify scabies with scabies when providing medical care and carrying out preventive inspections. The inspection on scabies is subject to:

Students of general and vocational education institutions - at least 4 times a year after every holiday, monthly - selectively (at least four-five classes) and 10-15 days before the end of the school year. Inspections conducts medical personnel of institutions with possible attracting teachers.
Students of boarding schools, children living in orphanages, children's homes, etc. - Weekly. Inspection conducts medical personnel with attracting caregivers.
Children traveling to children's health facilities, work camps, prior to departure, are examined by medical personnel by polyclinics at the place of residence. During stays in recreation sites, the examination of children is conducting medical camp staff before every wash (no less often 1 time per week) and before returning to the city (1-3 days).
Children attending pre-school institutions are examined monthly by medical staff of the institution (doctor, nurse).
Employees of enterprises, including in rural areas, are examined by medical employees of the enterprise or polyclinic in medical examinations, clinical examinations.
Persons who are in the institutions of the social security system are inspected by medical staff of the institution 2 times a month.
Patients who entered inpatient treatment are inspected by the medical sister of the receiving department, and with long-term treatment - the medical sister of therapeutic branch is at least 1 time in 7 days.
Persons living in hostels are inspected during settlement, in the future quarterly. Inspection conduct health workers with the involvement of educators, commandant, etc.
Medical workers of therapeutic institutions conduct examination of patients on scabies when applying for medical care. Particular attention is paid to persons sent to inpatient treatment, in organized groups (sanatoriums, holiday homes, children's institutions) living in hostels, single-elderly, chronic patients, disabled people without a certain place of residence, etc.

Anti-epidemic events when identifying scabies

Conducting a full treatment of each identified patient, taking into account indications for hospitalization. Children of preschool and school age at the time of treatment are removed from visiting organized teams. They can be allowed only after the completion of a complex of medical and preventive measures with a confirmation certificate from the doctor.
Determination of the circle of contact persons, including contacts in organized groups (sports sections, institutions of additional education, etc.).
Implementation of medical monitoring of contact persons: in organizations where preventive treatment of contact persons was not conducted, the inspection of the skin is carried out three times with an interval of 10 days.
Organization of disinfection in the foci: when discovered scabies in children attending preschool educational and general education organizations, single, elderly, disabled people, persons. Living in dormitories, members of large families, migrants, individuals without a certain place of residence, concluding disinfection (disinsection) are held by specialized organizations that have a license for disinfectology, on requests from medical workers of the LPU, organizations and individuals, including with chamber processing of a native and bed linen, Bedding.
The survey of a family focus and an organized invasion-contact collective is carried out when the first patient is detected and two weeks after the completion of the therapy of the last scabies detected by the patient, provided that all members of the hearth were inspected in a timely manner, and in accordance with the testimony, prophylactic treatment was carried out by contact persons. In organized groups, where prophylactic treatment of contact persons was not carried out, the inspection is carried out three times with an interval of 10 days.

Conducting the current disinsection in the foci. Current disinsection is aimed at destroying ticks on bedding, clothing and objects of patient's personal hygiene. The methodology for conducting the current disinfection explains the attending physician, and he holds it a patient himself or a member of the family. Each patient must have a separate bed, bedding and individual use objects (towel, washcloth, slippers, bathrobe).
Disinfection of bedding, underwear, towels is carried out by washing at a temperature of 70-90 o, or soaking for an hour in chlorine-containing solutions. Upper clothes are disinfected, stroking things on both sides by a hot iron, paying special attention to your pockets. For disinsection of textile products, shoes, children's toys are used by permethrin and malathion based drugs. A part of things not subject to heat treatment can be posted on open air for 3 days. For disinfection of a number of things (children's toys, shoes, clothing), you can apply a temporary exclusion method from use, for which they are placed for 3 days into hermetically tied polyethylene packages.
With mass flashes of scabies in organized groups, if there are several patients in family foci, when patients with scabies in a hospital enters the receiving department, the room disinsection is carried out.
In hospitals and scabozers, mattresses, pillows, bedding and underwear, clothing of incoming patients are subjected to processing in the disinfection chamber. In the same way, it is treated after discharge from the hospital bedding, which used sick scabies.
Special importance disinsection measures have in identifying patients with scabiose erythrodermia and Norwegian scabies. Around such patients often arise microepidemi. In this regard, preventive treatment should be conducted by medical personnel, caregoing persons, neighbors on the Chamber. Such patients are isolated in a separate ward, where they spend the current daily, and when the chamber disinsection is discharged.
In the "supervisory chambers" of psychiatric hospitals, in the identification of patient with scabies, prophylactic treatment is carried out by all patients in the same Chamber. In the presence of itching dermatosis in a patient entering the hospital of a psychiatric hospital, a consultation of a dermatologist and prophylactic treatment of a scabicide in the receiving department is necessary. With an unfavorable epidemic situation in order to prevent the drift and spread of scabies in large organized groups (army, fleet, prisons), all newcomers in the quarantine zone are subject to prophylactic treatment of scabysides. For this purpose, drugs are suitable in liquid form (permethrin).

If you have any questions about this disease, contact your doctor dermatovenerologist Adaev HM:

WhatsApp 8 989 933 87 34

Email: [Email Protected]

Instagram @ Dermatolog_95