The scabies known colloquially as scabies is an ectoparasitosis, that is, an infection by parasites that only affect the superficial layers of the skin, it is of worldwide distribution and in all races, for which it is considered a great health problem and one of the main causes of the appearance of parasitic dermatosis, especially in developing countries, due to the fact that low-income people are often more affected by living conditions and lack of personal hygiene.
The causative agent of this pathology is the female of the Sarcoptes scabiei species, a mite that is in charge of plowing the skin of the individual that suffers from it, the small animal, it enters the outermost layer of the skin and develops tunnels. At the same time it leaves the eggs and secretes toxins that cause allergic reactions.
Symptoms of scabies
Usually, the signs and symptoms are presented by more than one person in the family nucleus, because it is a highly contagious parasitosis, which can be transmitted from one person to another by simple physical contact.
These might be:
· Itching or stinging that usually occurs at night that usually affects several members of a family or closed community.
· Acarinum groove, elevation of the skin, of short length that represents tunnels created by the female mite in the patient's skin, this small animal is capable of moving up to 5 mm per day.
· Acarin papules are small grayish elevations where the parasite is found.
· In some cases, especially in children, pustules or lesions with pus and even blisters are usually observed, due to superinfection due to contamination of the lesions during scratching.
The places most affected by injuries in adults are usually the interdigital spaces of the hands, folds of the arm, armpits, groin region, buttocks and genitals since the mite looks for places where the body temperature is higher. Unlike infants and young children, where the most common sites of infection are the scalp, face, neck, palms of the hands, and soles of the feet.
Some patients may develop fever as a sign of superinfection by bacteria that colonize the skin, such as Staphylococcus and Streptococcus.
Causes of scabies (sarcoptic mange)
· Poor personal hygiene
· Physical contact with infected people
· Use of contaminated clothing and underwear
· Use of contaminated bedding and mattresses
It is important to note that humans and animals are infected by different types of mites, which is why the mites that cause mange in dogs, cats, etc. they do not cause injury or infection in humans.
In general, the diagnosis is purely clinical due to the evidence of the symptoms and signs previously exposed, but there are tests that can confirm it.
Müller's test: consists of applying oil to the lesions caused by the scabies mite, rubbing them, then scraping with a scalpel blade and making a smear which will be studied under a microscope. If the test is positive, the mites and their eggs will have been observed during the examination.
The treatment must be applied or carried out by the child or infected person, the people who live in the same house and their intimate contact, that is, with those who have had skin-to-skin contact despite the fact that they do not present symptoms.
The main options for the treatment of scabies are permethrin a, which is a chemical substance that kills mites, this can be applied alone or in combination with other elements such as sulfur and crotamiton, which also have scabicidal factors. These drugs cause paralysis of the parasite and later its death. Anti-allergy drugs are also usually indicated to improve itching.
These substances are for topical administration and should be applied uniformly throughout the body (from neck to feet) including the scalp in children under two years of age and in immunosuppressed patients.
Administration should be done during the night after showering and the drug should be removed very well the next day before exposure to the sun, as it can cause stains on the skin and clothing. This should be done for three consecutive nights and usually after the first application the mites have already died.
It is also essential to wash sheets and all the clothing that the infected person has used or that has been in contact with the patient with hot water, in some cases it is recommended to pass a hot iron on the mattress to kill the mites that may be present in the cloth.
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