How to be on the alert for intractable pruritus

  Recently, outpatient clinics often see some persistent itching that does not heal, especially some adolescents, young children patients in the local hospital according to dermatitis, eczema, pruritus, insect bite dermatitis, etc. treatment, the condition is sometimes good and bad, careful examination of these patients, some of them are infected with “scabies”.  Scabies is transmitted by the human scabies mite through direct contact (including sexual contact), and can also be indirectly transmitted through the clothing used by the patient. The adult scabies mite is parasitic in the human epidermal stratum corneum, and a tunnel is cut under the skin parallel to the body surface in a tortuous manner. The scabies mite is often parasitic on thin and soft skin areas, such as the finger crevices and their sides, the wrist flexure, the elbow fossa, the axilla, the umbilicus, the waist, the lower abdomen, the genitals, the groin, and the inner side of the upper part of the femur. The head and face are not involved, with the exception of children. The lesions are pinhead-sized papules and herpes. Tunnels dug by scabies are often found at the fingertips, and female worms can be picked out at the mouth of the tunnels with the tip of a needle. This is a characteristic symptom of scabies. It is often accompanied by severe itching at night. If the lesions do not heal over time, secondary changes often occur, such as scratch marks, blood scabs, punctate pigmentation, eczema-like changes, and pustules. Some patients may have pale or reddish-brown, mung bean to soybean-sized hemispheric inflammatory hard nodules with severe itching in the scrotum and penis, called scabies nodules. Another rare type is Norwegian scabies, a severe form of scabies that occurs mostly in patients who are weak or have low immune function, and the rash of this type is extensive and has a special odor.  To prevent scabies, you must first pay attention to personal hygiene, “three diligence”: diligent bathing, diligent changing of clothes, diligent drying of clothes and quilts. Do not live with the patient, shake hands, not put together with the patient’s clothes. Found the patient timely treatment, change down the clothes to boil to exterminate the insects, can not boil the scabies mites starved to death after 1 week with plastic bag wrapping, to be cleaned.  The last thing to remind everyone is that scabies is usually spread through frequent close personal contact or common items in the family or neighborhood, and even shaking hands has the possibility of being infected.