Recently, I met several patients who had scabies at work, and I asked them if they knew about scabies. They all ask three questions, but everyone knows this scabies to the 70 or 80 year olds. That is to say, in the past when living conditions were poor this disease was very common, Hangzhou people called mange scabies, Yi Yi Lao Er, scabies. With the improvement of living conditions, health conditions, the incidence of scabies is getting lower and lower, suffering from scabies is also getting less and less, but still not completely disappeared, especially in rural areas still appear. So much so that it is rare for doctors to meet it, so scabies is a skin disease that can be easily misdiagnosed. If you get scabies, your body will be itchy and itchy, and you can’t wait to snap off the skin, and if one of the family gets it, everyone will be infected, and although scabies is not a major problem that kills people, itching is really very torturous.
I. What causes scabies?
Scabies is a skin disease caused by the scabies mite parasitic in the skin that can be transmitted by contact, scabies mite is a permanent parasitic mite, parasitic in the skin of humans and mammals, scabies mite parasitic in the skin of animals can invade humans, but the disease is mild and cannot survive long in humans, scabies mite parasitic in humans can also invade animals, scabies mite digging tunnels in the skin, gnawing on keratinous tissue to stimulate the skin The nerve endings lead to itching and itching increases at night. The course of the disease is long and can last from several weeks to several months.
What is the clinical manifestation of scabies?
The scabies mite is often found on thin and soft skin areas, such as the finger crevices and their sides, the wrist flexure, the elbow fossa, the armpit, the umbilicus, the waist, the lower abdomen, the genitals, the groin, and the inner part 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 immunocompromised, and the rash of this type is extensive and has a special odor. The skin of infants and children has a thin stratum corneum, and the lesions are special, and the lesions are polymorphic and may resemble papular urticaria and eczema, often involving the head, face, and palms and plantars, and these parts are not easily affected by adults, etc.
What are the main groups of people infected with scabies?
Generally, schools, construction sites, prisons, group dormitories and other places where people live are prone to infect each other, and generally spread through direct contact or clothing. Especially, people who often travel and live in hotels are easy to get this disease.
How to determine if you have scabies?
1, see if there is a history of contact, see if someone at home or in the same dormitory also has this disease.
2, look at the site of occurrence and see if the lesions are mostly on thin and tender skin such as the fingers.
3. to see if it is more itchy at night.
4. to see if there are idiosyncratic tunnels and whether there are red nodules on the external genitalia.
5, check for scabies mites, and confirm the diagnosis if laboratory tests confirm the presence of scabies mites or eggs.
IV. What pruritic skin diseases need to be differentiated from?
Scabies needs to be distinguished from common itchy rash, lice, eczema, pruritus, papular urticaria, etc.
Common itchy rash: it occurs on the extremities of the limbs, papules are large, children are prone to this disease, the course of the disease is slow, non-infectious.
Lice disease: mainly skin disease caused by lice, preferably at the trunk, scalp or pubic area, no rash on the fingers, often found insects or eggs. Lice and eggs on pubic hair are visible in the picture.
Eczema: a polymorphic rash that may have papules, papules, blisters, vesicles, oozing, and is prone to recurrence, but is not contagious.
Papular urticaria: A scattered, edematous erythema or papular herpes, pyknotic in shape, often with a history of insect bites. It is mostly seen in children.
V. What are the ways in which scabies can be transmitted?
Scabies can be transmitted through direct contact with the patient, such as shaking hands, sleeping in the same bed, etc. Because the scabies mite can survive for 2-3 days after leaving the body, it can also be transmitted through the use of clothing, quilts, shoes and socks, hats, pillowcases, etc. used by the patient, and it is especially easy to transmit to each other in the family or collective units. It can also be transmitted through sexual contact, especially among young men and women who have sex with each other easily and rapidly.
Six, how to treat scabies?
Scabies treatment principle is to strive for early detection, early diagnosis, early treatment. Although the disease is easily infected, but the treatment is not complicated, need regular, correct, persistent medication. The purpose of treatment is to kill worms, stop itching, and treat complications, and the disease is mainly treated with topical medications, and oral medications can be used when conventional topical medications are not effective.
(1) 10% sulfur ointment, usage is from the neck below, the whole body application, 1-2 times a day, 3-4 days for a course of treatment. Infants and children with 5%, the use of the same.
(2) Lindane emulsion or ointment: usage is applied externally to the skin of the whole body from the neck down, retaining the drug for 8-12 hours and then bathing. If necessary, treat again after a week, but not for those with a large area of broken skin, children and pregnant women are prohibited, and the dosage for adults does not exceed 30g.
(3) Others: 10% clomidone emulsion or application, 10%-25% benzyl benzoate lotion or emulsion, paracetamol cream.
(4) If there are scabies nodules then topical hormone ointment can be used, and if necessary intra-dermal injection of tretinoin etc.
VII. Why is it that some people are still not well after using the medicine?
Many people use the right medicine, but the method of using the medicine is not correct, resulting in incomplete treatment and relapse. Therefore, special attention should be paid to the following when using drugs.
①The medicine should be applied all over the body from the neck down, and do not leave out the skin folds, such as around the anus and nail edges.
(2) The medication can be applied without bathing or changing clothes, so that the medication stuck on the clothes and blankets can also kill the insects, in order to maintain the efficacy of the medication.
③If a treatment is not completely good, the medication should be repeated after an interval of 1-2 weeks until it is completely good.
④ those who live together in the same room should be treated together to prevent repeated cross-infection.
⑤ scabies nodules treatment up to stubborn difficult to cure some, sometimes need 1-2 months. This scabies nodules with insecticide is ineffective, for some scabies nodules that do not disappear for a long time can be locally closed treatment.
Eight, how to prevent scabies?
To pay attention to personal hygiene, bathing, changing clothes, bedding, etc., do not live with the patient, shake hands, and do not put together with the patient’s clothes. If someone at home is suffering from this disease, the patient’s used bedding, bedding, clothes, shoes and hats, pillowcases, socks should be boiled and disinfected, and the clothes that cannot be boiled, pillowcases, cotton tires, etc. can be wrapped in plastic, and then washed after a week when the scabies mite dies. Families with children are best not to keep pets such as cats and dogs, because scabies mites parasitic on animals such as cats, dogs, cattle, horses and pigs can be transmitted to people after contact with people. If you get this disease do not scratch excessively, to trim nails in a timely manner to prevent excessive scratching secondary infection.