how do.you get scabies

                                                 How to do. you get scabies

 Scabies

Scabies is caused by a mite Sarcoptes scabiei hominis, the word scabies is derived from the Latins word, which means scratching. Scabies is a contagious skin disease.

Most people get scabies in a place where there are a lot of people and can spread quickly through close physical contact in a family, school class, nursing home and public transport. 

Mites reproduce on the surface of the skin and burrow into it and the females lay eggs under the skin. Especially at night and on warmer days Sarcoptes scabiei lay eggs, therefore, itching at night more severe than a day. 

After 21 days hatch the larvae once hatched, the larvae move to the skin surface and spread across the body. Between 15 -20 mites are involved in an infection. Some people will say that they are itching because of their bites, that is not true.

The itching is an autoimmune response to the mites living underneath patient skin. Because of itching, red rash to form on the skin. Scabies affects people of all ages, race, and gender.

There are two types of scabies 1. Classic scabies  2.Crusted  scabies 

1. Classic scabies is a common type of contagious disease. Usually severe and worse at night. Axillae, areola, webs of fingers and genitalia are the affected areas of the body .

2. Crusted scabies, is a less common type but more severe form of scabies, also known as Norwegian scabies. Usually occurs in a poor immune system older people, HIV patients or cancer patients .we can see higher mites burden in these kinds of patients. Crusted scabies targets scalp, hand and feet.

Symptoms 

Severe itching is almost always present worse at night and can be quite severe. A rash of tiny red bumps that sometimes form in a straight line. 

The lesions consist of more or less generalized excoriations with small pruritic vesicles, pustules, and "burrows" in the web Spaces and on the heels of the palms, around fingernails, buttocks, wrists, elbows, around the axillae, knees and on the breasts of women. In infants, the site of infestation may include other parts of the body e.g scalp, palms, neck and face.

The feet are a good place to identify burrows, since they may have been scratched off in other locations. The burrow appears as a short irregular mark, 2-3 mm long and the width of a hair. 

Causes

Scabies commonly occurs in people in crowded living conditions, it is most often spread during a long period of direct skin contact with an infected person, such as during shake hands, hugging, during sex or living together.

Scabies can also be spread by sharing bed, cloth or furniture infested with mites. When these patients are hospitalized, hospital-based epidemics can occur. These epidemics are difficult to eradicate since many health care workers become infected and spread the infestation to other patients.

Diagnosis 

The scabies mites are very small and usually not directly seen. A dermatologist can usually diagnose based on patient symptoms and by looking at rashes Sometimes the doctor will scrape one or two bumps open. In the situation where the diagnoses are difficult polymerases, chain reaction testing is possible.

The diagnosis should be confirmed by microscopic demonstration of the organism, ova, or faeces in a mounted Specimen, examined with tap water. Best results are obtained when multiple lesions are scraped, choosing the best un excoriated lesions from interdigital webs, wrists, elbows, or feet.

 Patients with crusted/hyperkeratotic scabies must be evaluated for immunosuppression (especially HIV and HTLV-1 infections) if no iatrogenic cause of immunosuppression is present.

Treatment 

Treatment is aimed at killing scabies mites and controlling dermatitis, which can stay for months after effective eradication of the mites.  

 Permethrin 5% cream is highly effective and safe in the management of scabies. Permethrin 5% cream once for 12 hours-or 5% or 6% sulfur in petrolatum applied thinly thoroughly behind the ears and neck down over the entire body after showered with neem soap at nightly for 3 nights, permethrin cream is to be removed with warm water and soap after 10 hours. Each of the family members should apply it.

Patients will continue to itch for several weeks after treatment. Antihistamines such as diphenhydramine hydrochloride (Benadryl ) or hydroxyzine hydrochloride (Atarax) and calamine lotion may be used to relieve itching. Calamine lotion must be applied head to toe and scalp, especially before bed and after you have showered.

A single oral dose of Ivermectin is also very effective .Ivermectin is not recommended for pregnant women and children. Pregnant patients should be treated only if they have documented scabies themselves.

 Use of triamcinolone 0.1% cream will help resolve dermatitis. If secondary pyoderma is present, it is treated with systemic antibiotics.

 In areas where nephritogenic streptococcal strains are prevalent, infestation with scabies or exposure to scabies-infested dogs may be followed by acute post-streptococcal glomerulonephritis.

Persistent pruritic postscabietic papules may be treated with mid- to high-potency corticosteroids or with intralesional triamcinolone acetonide (2.5-5 mg/mL). )Because of the contagious nature of scabies, a dermatologist often recommends treatment for all family members at once.

Neem has antibacterial and antifungal properties, neem oil, soap can be a useful alternative treatment for scabies.

Prevention 

Maintain hygiene. Naver touch rashes without medical gloves, avoid scratching itchy skin. Daily Vacuum carpet and your furniture, then empty outside. Mop with soap and hot water.

To prevent reinfestation, Wash all clothes, bath towel carpets, bedsheets, sofa covers should be laundered or cleaned or set aside for 14 days in plastic bags.

These mites usually only can survive for three days without a host. Don't share clothes & towel. Preventative care after the treatment is the best.