Itch – a widespread parasitic disease of skin, is caused by a scabby tick of Sarcoptes scabiei. also is highly contagious. Incidence of itch is rather high, at the same time, in spite of the fact that itch is considered a disease of asocial persons, people of all social groups are surprised. At children and at people of young age itch is registered more often because of their mobility and more active lifestyle. Treatment of itch demands processing by benzylbenzoate not only affected areas, but also all integument. It is followed by regular change of next-to-skin and bed linen.
Itch – a widespread parasitic disease of skin, is caused by a scabby tick of Sarcoptes scabiei. also is highly contagious. Incidence of itch is rather high, at the same time, in spite of the fact that itch is considered a disease of asocial persons, people of all social groups are surprised. At children and at people of young age itch is registered more often because of their mobility and more active lifestyle.
Itch is an antropofilny parasitic disease as the scabby tick parasitizes only on the person. A source of infection is the sick person, itch is transmitted directly at contact or through the infected use objects. The adult scabby tick has the sizes about 100 microns and the powerful maxillary device for making of tunnels in epidermis, tunnels make females, males generally do not move, their main function – fertilization. In population the ratio of females and males makes 2:1. Fertilization of a female happens under skin then the hatching larvae come to a surface for further introduction in epidermis layers. Pairing of pincers of itch happens on a surface too.
Thus, the tick comes to a surface two times for the life cycle. To take root under skin to a scabby tick there is enough 15-20 minutes, and contageousness of itch is explained by it. The first half of day the female lays eggs, and at night gnaws through the courses, life cycle of the causative agent of itch makes from two weeks to two months then the tick perishes and decays in the progryzenny courses. The tick of itch not of racks and at a temperature of +55 degrees perishes in 10 minutes, and at a temperature of +80 perishes instantly. Out of the person the tick also quickly enough perishes.
Mechanism of infection with itch
Infection with itch is possible in public places via door handles, a handrail of ladders, receivers. As a result the epidemic center is created and infects with sick itch the environment of household and professional character. Infection with itch can occur at sexual contacts, there is infection of the man from the infected woman more often. The scabby tick can quickly be on animals therefore infection with itch from animals is not excluded though meets extremely seldom. The causative agent of itch is most active from September to December, at this particular time diagnose the greatest number of outbreaks of itch. Activity causes high risk of infection at night in a family when one bed is used. Initially interdigital folds, zones of wrists are surprised and already at development of itch other parts of the body, except a hairy part of the head and area of armpits are surprised.
Clinical displays of itch
The incubatory period of itch from three days to two weeks, but at attentive survey it is possible to notice places of an entrance of a scabby tick in the first days after infection. After females begin to lay actively eggs, clinical displays of itch accrue. The intolerable itch amplifying in evening and night time is noted. On skin the scabby courses in the form of the line inflamed sections are visible, inflammatory reaction at itch is explained also by presence at saliva of a parasite of chemically active agents therefore in a zone of defeat allergic infiltration can be observed. Because of a severe itch, skin matserirutsya, on a body the raschesa sometimes covered with bloody crusts are observed. Clinical displays of itch depend on activity of activity of a tick, on as far as personal hygiene and from organism allergization degree to the activator is observed.
Typical form of itch
At a typical form of itch of a rash are localized on a stomach in an okolopupochny zone, on the perednevnutrenny surface of hips, on buttocks, mammary glands, the side surfaces of fingers of brushes and feet, on interdigital skin folds, at men itch can be localized on skin of a scrotum and a penis. The scabby courses look as the whitish or grayish straight line or the curved line from 5 to 7 mm which is slightly towering over skin. On a face, on skin of palms and feet only single rashes can develop. The scabby course is well visible under a magnifying glass, the terminations of the course at itch come to an end with a small papule or a vesicle. Papulovezikulyarny elements are partially covered with dot bloody crusts and reach in sizes to 0,5mm.
Besides the scabby courses which have pair papulovezikula on skin of the patient with itch there are dot and linear raschesa because of a severe itch. Depending on severity of itch there can be centers of a piokokkovy infection which are found in razgibatelny zones more often. On elbows there are purulent or bloody and purulent crusts – Ardi's symptom.
Itch of clean
Itch clean is the erased disease form which occurs at the people having a normal immunoreactivity owing to what allergic reaction to presence of pincers is not observed. Special attention to personal hygiene when people several times a day take a shower and change next-to-skin and bed linen also stertost of clinical manifestations at itch promote. It is characterized by single rashes on a breast and around a navel which practically do not matserirutsya and do not cause discomfort, the itch is noted only at night. Emergence of hemorrhagic crusts is possible.
Nodal itch results from giperergichesky reaction of the slowed-down type which develops as the answer to waste products of a tick. The nodal form of itch usually is a consequence of uncured or incorrectly lecheny itch. A long course of disease, reinfestations a scabby tick promote emergence of the itching henna-red small knots. Rash has lentikulyarny character, small knots arise under the scabby courses and are located in places, typical for rashes. This form of itch of a rezistentn to various protivoskabiozny therapy as because of dense crusts medicinal substances practically do not affect a tick.
The cortical (Norwegian) form of itch is diagnosed in rare instances for patients who have sharply weakened immunoreactivity. Cortical itch is the most high-infectious form as in crusts the highest concentration of pincers is noted. Immunodeficiency, the general diseases at which decrease in immunity and exhaustion, long therapy is noted by corticosteroids cytostatics and alcoholism promote development of cortical itch.
Clinically cortical itch is characterized by existence of the grayish and dirty crusts tending to stratification at each other. Crusts of usually different size and thickness, are densely soldered among themselves and the subject fabrics, are very painful during removal. After removal of crusts erosion of yellow color are bared.
Razgibatelny surfaces, back part of brushes, elbows, knees, interdigital intervals, buttocks, stomach, auricles are surprised, the person and a hairy part of the head are more rare. On palms and soles develops thick which limits freedom of movement. If nail plates are surprised, then they are deformed, crumble, become reinforced and change color.
Diagnosis of itch
The diagnosis is made by the dermatologist, the therapist or the infectiologist on the basis of clinical data and complaints of the patient. Having combed existence of an itch which amplifies in evening and night time and existence characteristic linear, small papules and a positive symptom of Ardi allow to suspect existence of itch. At survey of contact persons it becomes clear that the most part has the same clinical manifestations, there are data on stay in an itch epidochaga.
The research on itch confirms existence of this disease, but it must be kept in mind that many patients before a visit to the doctor carefully wash and therefore pincers can not be found. Besides, at formation of crusts or in the period of low activity of pincers, their concentration decreases therefore in the absence of pincers at microscopy, but in the presence of a characteristic clinical picture, begin therapy of itch.
To increase physical activity of pincers, before material capture skin is heated warm glass or a little oils drip. Putting ink and aniline dyes helps to paint the scabby courses. In some cases, when it is not possible to find causative agents of itch, positive dynamics at purpose of protivoskabiozny medicines is the medical and diagnostic procedure. Such diagnostics is called ex juvantibus.
Treatment of itch
At therapy of itch regardless of the scheme, it is necessary to process all leather, and not just affected areas, except for a hairy part of the head (except cases when itch is localized also on head skin). Washing of a body and change of next-to-skin and bed linen to make only before treatment of itch, during therapy washing of a body is forbidden.
Benzylbenzoate produced in the form of emulsions is the most widespread antiskabiozny medicine as it has small toxicity and high efficiency. Before application it is necessary to wash up all body, then to process the top extremities, the lower extremities and a trunk except for a hairy part of the head. Time of rubbing in has to make not less than two minutes on each area. Change of next-to-skin and bed linen with a double proglazhivaniye after washing is made. In two days according to the same scheme a repeated course is conducted. It reaches influence on an individual which were in a phase of larvae. At full knocking over of the epidemic center and lack of a reinfitsirovaniye of a double course by Benzilbenzoat it is enough to cure itch. After the end of treatment furniture, clothes need to be processed solution antiseptics or UF-radiation.
Aerosol medicines for treatment of itch are simpler in application and their volume is enough to process the patient and contact persons, there are aerosol medicines which it is possible to treat also children. They are sprayed on 20-30 cm from skin, without leaving free sites, in 12 hours carry out sanitary cleaning of a body and an epidochag. One application is enough, but at the complicated itch forms it is recommended to repeat the procedure.
Lindane – the medicine in the form of cream which does not have color and a smell at treatment of itch it is rubbed daily or twice a day in skin. Before therapy and before each processing by a lindane it is necessary to take a shower. Such method of treatment suits those who got used to take a shower or a bath daily. Also the lindane is released in the form of powder for rubbing in in skin and in the form of shampoos. However during pregnancy and a lactation it is better for children and women to use special gel.
Treatment of a cortical form of itch has several features. Before antiskabiozny therapy the softening of crusts and their removal is necessary. Usually apply soap and soda bathtubs and keratolitichesky ointments. After full rejection of crusts treatment is carried out according to the usual scheme, courses are repeated before full treatment. Besides carry out correction of the main disease which became the reason of easing of reactivity of an organism.
Prevention of itch consists in timely elimination of epidochag, purpose of preventive therapy. Regular survey of children in preschool and educational institutions and respect for personal hygiene significantly is reduced, but do not exclude infection with itch.