Mange

Description:

Mange is a parasitic infectious disease which etiological agent is the intradermal parasite -  scabby зудень Sarcoptes scabiei de Geer. Despite the undertaken preventive measures concerning itch, growth of incidence of a mange in various regions in this connection studying of an etiology, epidemiology, clinic of a disease, improvement of diagnostic methods, and also treatment and prevention remains an urgent problem is observed. A mange is a special parasitic disease. Scabby зудень which implementation in skin causes a mange is a highly specialized parasite with the difficult life cycle considerably defining a clinical picture of a disease and epidemiological features.
Mange is known for a long time. 4000 more years it were mentioned in China, also ancient Babylon and Egypt. The ancient scientist Aristotle described "the smallest animals" whom found  in vesicles with transparent liquid on integuments of patients with a mange.

Itch reasons:

On domestic animals with whom the person has direct contact, about 10 forms of an itch mite parasitize. On the person the nominal type of Sarcoptes scabiei parasitizes. The morphological structure scabby зудня has peculiar features that is caused by various devices to intradermal parasitism. Ticks carry out the most part of life in the thickness of skin. The female gnaws through the courses in epidermis, eats it and in process of advance lays eggs. The cycle of changes from a larva to an adult individual also passes vnutrikozhno. Mites can come to a surface and move on skin in search of new places of implementation.
The morphology scabby зудня, as well as the majority of mites, is characterized by strict constancy of microstructures of an outside skeleton. What is connected with their microscopic and the sizes.
Structure of a body of a female and male of a tick various. Females have a conjoint body, it wide oval, convex from above and flattened from below, length to 0,4 mm. The oral device  two front pairs of legs act forward. Bristles are differentiated in a form and size. The oral device at a female of gnawing type. In difference from a female, the male tiny, differs in sclerotization of covers and existence of the difficult pregenitalny device and suckers on hind legs.

Development of an itch mite proceeds through several stages, or the phases accompanied with food, growth and molts. Parasitic elements are located in the course as follows. In the front blind end of the course there is a female laying it. Behind it eggs with embryos at consecutive stages of development – from svezheotlozhenny to late embryos are rowed. The ratio of parasitic elements the vrazvity courses is quite stable. 3,7 eggs, from them with the larvae ready to hatching, 1,0 once are the share of one female on average.

The contingent of patients with a mange is defined not so much by biological indicators (a sex, age, etc.), so much specific living conditions and a way of life of people causing a possibility of infection at contact with the sick person. The contingent of patients to a certain extent depends also on an orientation and activity of activity of health workers in relation to various groups of the population. Among patients with a mange persons of young age prevail. People of various professional groups have itch: workers, employees, school and university students.
It is possible to catch a mange in the direct or indirect way. At infection at corporal contact the direct way of infection is diagnosed. The indirect way is a transfer of the activator through use objects, first of all private use. Most often catch a mange at joint stay in a bed, especially at sexual contact. Less significant fact in epidemiology of itch is the nosotrophy the person. The use objects infected scabby zudny are a factor of transfer of a disease. Among them the greatest danger is constituted bed and underwear, sleeping bags, smaller value have a towel, basts, gloves. Infection with a mange with a direct way is noted at 69% of patients, from them 59% - during sexual contact, indirect – at 25%, at 6% the way of infection is not established. Population shift in all its types increases incidence of a mange in population.

Itch symptoms:

Incubation interval at a mange – a concept not quite certain as in several hours after hit on skin and implementations of invasive stages of the activator the itch and the first elements of rashes can develop. According to most of authors, the incubation interval at a mange lasts on average 8-12 hours. The first and main subjective symptom of a disease is an itch. Practically all patients point to strengthening of an itch in evening and night time. The itch reason still is definitely not established. Some authors point to an organism sensitization to a scabby zudnyu and its waste products. Other scientists prove the point of view which explains an itch as result of irritation of nerve terminations at the movement of a tick.

The scabby course is also a disease symptom. The most typical the odes having an appearance of the line of white or dirty-gray color which is slightly towering over skin, direct and curved, from 1 mm to several centimeters long. Morphological classification of the courses allows to allocate their options defined visually and revealed, as a rule, only at a laboratory research. The true type or its part with a vesicle, a dry erosion or a crack, to the second – the course in the lentikulyarny daddy, a chain of vesicles, the course on a bubble or a pustule belong to the first category. The majority of observations indicate localization of the scabby courses on brushes, wrists, elbows, feet, generative organs of men and mammary glands of women.

Outside the scabby courses elements of rash of polymorphic structure are found. Primary elements represent follicular papules on a trunk and extremities, and vesicles on brushes. Also secondary elements – erosion and crusts can be defined. In the beginning there are small knots and bubbles, and in a half-month – and other elements. Most often papules meet on a stomach and the side surfaces of a stomach. Goncharov's symptom described in 1940 – existence of dot bloody crusts on elbows and in their circle is typical for itch. Clinical features of this symptom are considerable dominance of single crusts over multiple and their more frequent localization in a circle only of one elbow.

Diagnosis:

In dermatological practice several methods of laboratory diagnosis of itch are known: long since the applied extraction of a tick a needle, a method of thin cuts of epidermis the acute razor or eye scissors, a method of scraping of pathological elements without blood and before emergence of blood, scraping in mineral oil, alkaline preparation of skin. However the listed methods has essential shortcomings that caused need of development of more modern and effective techniques, for example, laboratory express diagnosis of itch with use of lactic acid. This method has a number of advantages. Lactic acid does not render irritant action on skin and even on the exposure exceeding several times necessary for diagnosis of itch does not cause any subjective feelings. At the same time lactic acid well loosens epidermis that allows to receive full contents of a scabby element at scraping.

Treatment of Itch:

Treatment of itch is directed to destruction of the activator by means of acaricidal drugs. For treatment of itch use many drugs: Unguentum sulfuratum, Vilkinson's ointment, sodium hyposulphate with hydrochloric acid, Flemings, Moore, Elers, Milian, Flitsin's liquids, sulfuric soap of Dyakov, sulfur-soap balls of Yablenik, soap "K", ointments with pyrethrum, drugs DDT, solutions of kreoline, lysol, pure tar, стирекс, the benzoic ether, ethylene glycol, benzyl benzoate. Long since used also not medicines, for example. Kerosene, gasoline, fuel oil, автол, cindery leach.
In connection with a number of requirements imposed to antiscabetic drugs now from their arsenal only some widely put into practice. Such requirements are: speed and an effektvnost of antiparasitic action, lack of irritant action on skin and contraindications to appointment, usability, stability in the course of long storage, availability to wide use, a gigiyenichnost, available cost.
Efficiency of antiscabetic drugs practically is always estimated on dynamics of a clinical picture and only in isolated cases – on  influence on the activator, and only on females. Death of 98% of mites in skin in 24 hours after processing of 25% by benzyl benzoate suspension, and on a slide plate – in 5 minutes is noted.
Sulfur is an effective agent of many antiscabetic drugs long since used in dermatology. In the concentration applied to treatment of itch (10-33%) it gives also expressed keratolytic effect that provides the best access of drug to the activator.
Benzyl benzoate – one of the most effective antiscabetic drugs. It is successfully applied to the accelerated treatment that is especially important at epidemic trouble at a mange. Benzyl benzoate has no toxic effect even at intake. In medical practice benzyl benzoate is applied in the form of various dosage forms prepared for ex tempore silt in the industrial way.
Modern drug for treatment of itch is спрегаль. Poison, neurotoxic for parasites, эсдепалетрин is its part. Considerable plus is the possibility of full treatment after single treatment.