WHAT IS SCABIES?
Scabies Treatment. Scabies is a skin disease, with which mankind has been plagued since time immemorial. The term comes from “scratching” and thus already describes the problem: sufferers experience an almost intolerable itching and therefore have to constantly scratch. Scabies is one of the parasitic diseases (parasitoses), which is caused by micro-organisms that need a different organism to feed and reproduce. In the case of scabies, these are certain mites.
Typical scabies occurs only two to five weeks after the first infection. In the case of new infections, signs of illness occur within a few days. Without therapy, scabies cannot be completely healed, although cases of spontaneous cures are described.
Special forms of scabies
Depending on nature and the symptoms, it can be divided into certain special forms:
- Scabies in newborns and infants
- Well-maintained scabies
- Nodular scabies
- Bullous scabies
- Scabies norvegica (crustosa), also known as bork rattles
Causes and risk factors
The triggers of the scabies are special mites called Sarcoptes scabiei variation Hominis. With normal house dust mites, they have nothing to do.
The parasites, which are counted among the spinning animals, have specialized in humans, so they are the only host. There are other species of mites that cause scabies in animals (mange).
Female scabies reaches a size of 0.3 to 0.5 millimetres and can thus be seen just as a point with the naked eye. The males, on the other hand, are smaller and no longer visible. A female is between four and six weeks old and from the second week of the week puts up to four eggs every day. Outside of the host, for example on furniture, the mites can survive a maximum of two days. Under unfavourable conditions (warm temperatures, low humidity), they die after a few hours.
Infectious diseases are contagious; this also applies to scabies. “Contagion” or “infection” are sometimes referred to as “infestation” in connection with it.
The transfer of scabies takes place from person to person, so there is no intermediate host, as is the case with many other parasitoses. Basically, there must be long body contact before the mites can skip from one host to the next. Short touches such as handshaking are usually not sufficient for this. Nevertheless, body contact with infected persons without protective clothing should be avoided as far as possible.
Typical transmission paths are, for example:
- sleeping together in a bed
- Body cleaning of small children by the parents or by the nursing staff
- Caresses and cuddles
- playing together
In very rare cases, it can also be transmitted between animals and humans, although this form of scabies usually does not last long and heals out of itself.
Contrary to widespread opinion, contaminated objects hardly play a role as a path of infection. However, there is always a certain residual risk, which is why, for example, furniture or medical instruments with which the patient came into contact should always be cleaned.
This creates scabies
Scabies still plants themselves on the human skin. After mating, the males die while the females use their powerful mouth tools to drill small tunnels into the outermost skin layer (stratum corneum). In these passages, the mites dwell for a few weeks, lay their eggs, and excrete many cudgels, which are also called scybala. After a few days, larvae hatch from the eggs larvae, which become sexually mature after another two weeks. Thus, the cycle starts from the front.
The mites neither produce poison nor attack the body directly in a different way. Even the digestive ducts in the skin do not cause pain or itching. The symptoms are only because the body’s immune system reacts to the mites and their waste products. This activates certain cells and messengers, which cause swelling, redness and itching. The affected skin areas can ignite and the scratching of the skin irritates the skin.
Because the first contact with the mites takes a few weeks before the body produces the special “anti-mite” immune cells, the symptoms also occur after this period. In the case of new infections, the immune system quickly recalls the parasites and can react in just a few days.
Within some groups, scabies occurs more frequently than in the normal population. These include:
- Children, since they have a lot of physical contact with each other, and the child’s immune system is not as well developed as adults.
- People with reduced itching perception, such as people with Down syndrome (trisomy 21) or sugar sickness.
- Dementia may favour scabies.
In addition, there are a few other diseases, in the context of scabies relatively often. Basically, a weakened immune system is a risk factor. For example:
- Patients under chemotherapy
- Leukaemia sufferers
Even whole-body therapy with cortisol can increase the risk of scabies in unfavourable cases.
Examinations and diagnosis
Theoretically, scabies with typical signs of illness such as severe itching and skin changes. In practice, however, they are not always so easy to recognize. The mite veins, which can be up to one centimetre long and look like small commas, are often scratched or covered by other hay-shadows. With darker skin types they are generally difficult or not visible at all.
Some of its symptoms also occur in other skin diseases ( eczema, contacts, psoriasis, etc.), which often confuse scabies. The doctor should have a practised look.
In the course of the history of the patient anamnesis, it is always important to remember that it can take several weeks before the first symptoms occur. It is therefore essential to identify possible infections in the past.
If the suspicion this suspected, this must be confirmed with the detection of mites or their larvae or mite products. For this purpose, a sharp scoop of skin is scraped off (curettage) in order to examine them microscopically. The doctor usually opens a dairy cycle beforehand: if he does not find one, he will at least choose a skin area that shows many symptoms.
A possible alternative to curettage may be supervisory microscopy.
The typical symptoms of scabies are caused by mites. The most important aim of scabies treatment is therefore to kill these parasites.
- Permethrin: Apply as a cream to the entire body surface and is considered the first choice. Only in exceptional cases does the doctor take alternatives.
- Allethrin: Used in combination with piperonyl butoxide as a spray, but only used if therapy with permethrin is not possible due to possible complications.
- Benzyl benzoate: Although it has a high activity against the mites, it is also used only in exceptional cases because of the relatively complicated application.
- Ivermectin: If applied as anthelmintics and unlike other medications for scabies treatment swallowed
Disease course and prognosis
With the right and consistent therapy, the mites can be killed within a few days. The symptoms of it, especially the itching, may, however, persist for a few weeks. Especially if the skin of the affected person has been damaged by dehydration and intensive scraping, the healing process often goes away. After a certain time, however, all symptoms should have completely disappeared.