Chigger Bites vs. Scabies: How to Tell the Difference

Was it a chigger or scabies bite? These mite bites both result in itching, but that’s where the similarities end. Here’s what you need to know—and how to protect yourself.

Courtesy Adam Friedman, MDChigger bites vs. scabies

Chiggers and scabies are the mites that bite. Yep, both of these little biters are actually mites, which makes them arachnids, not insects. That means they are more closely related to ticks than other biting insects like mosquitoes.

But they each have their own style of biting, you get exposed to them in different ways, and only one of these mites is highly contagious and requires medical attention.

Here’s how to tell if your bites are due to chiggers or scabies—and how to protect yourself.

Where you’ll find chiggers

Chiggers are an outdoor biting pest. “They feed once, and will not reproduce indoors and have continuous generations,” says entomologist Jody Green, PhD, at the University of Nebraska, Lincoln.

They are typically found in wild plantings, gardens, pollinator habitat, woods and brush, long grass fields, trail edges, dense shrubbery, or even on short, manicured lawns. They like hot and humid conditions, and are most common in the South and Midwest in the United States. However, they can be found nearly anywhere in the world.

Chiggers are tiny, only about 1/100 of a millimeter in size and only bite people when they’re in the larva stage. (Here’s how you can tell the difference between a chigger bite and a mosquito bite.) While chiggers do stay attached to the body while they are feeding, they can be brushed (or scratched) off.

Where you’ll find scabies

An interesting (and possibly terrifying) fact about scabies mite is that they live inside the skin—on humans (and other mammals).

“Unlike chiggers, scabies is an infestation, meaning the scabies mite actually burrows under the top layer of one’s skin,” says dermatologist Adam Friedman, MD, professor and interim chair of dermatology at The George Washington University School of Medicine & Health Sciences.

Unfortunately, you can’t just flick them off your skin. They’re colorless and so tiny, a microscope is the only way to see them. (Here are the 12 gross things living on your body right now.)

Chigger and scabies bite symptoms

Undisturbed, chiggers might stay on the skin for three or four days before dropping off. Scabies, on the other hand, aren’t going anywhere. They can cause a persistent, maddening itch for months or even years until you get a treatment that kills them. (There’s a reason they sometimes call scabies the seven-year itch.)

“Chiggers are ectoparasites, so they bite and feed on the outside of the body. Scabies mites burrow under the surface of the skin,” says Green.

Both bites result in intense itching, but that’s where the similarities end.

Chigger bites

Chiggers will typically deliver a higher number of smaller sized bites, and they tend to target the lower legs, explains Dr. Friedman. Bites often appear as small, reddish, bumps that look like pimples, with severe itching that is often worse at night.

Green was bitten by chiggers, and she describes it as “the most annoying and most intensely insane itching I’ve experienced.” (Bed bugs also like a good blood meal: Here’s are the key differences of a chigger bite vs. a bed bug bite.)

Chigger bites turn up near the ankles and behind the knees, along with any spot where your clothing fits tighter (a waistband, bra line, or the top of socks). “They will migrate to areas of “protection,” and in this case, you can see multiple little “bites” in a line along the waist, for example,” says Dr. Friedman.

And they’ve been known to bite in moist places like the groin and armpit area too. (Stock up on these chemical-free insect repellents to keep bugs at bay.)

Scabies bites

“Scabies are rarely localized to a single area of the body,” Green says. They tend to gravitate to folded areas of the skin to burrow, including between the fingers, the elbow and wrist area, the waist, around genitals, and the buttocks, etc.

Yet, they can affect the entire body from head to toe, Dr. Friedman says. It’s not just exposed skin either. “Skin covered by clothing, jewelry, watchband or ring are other common places to find scabies on the body,” says Dr. Friedman.

As they burrow, they ingest tissue and feed on lymph fluids secreted by the skin, and that results in a itchy rash that looks like red bumps, pimples, or hives. Intense itching can leave sores and bruises. Like chiggers, the itching can be worse at night.

“In adults, the mites rarely burrow into the skin above the neck,” Dr. Friedman says.

Children often have scabies worse than adults. “Scabies can affect the entire body, including the palms, soles, and scalp. Infants and children who have scabies may be tired and irritable from lack of sleep, since scratching at night can keep them awake, and unlike adults, children often get blisters or large nodules from scabies infection,” adds Dr. Friedman. (Keep these tips in mind when you’re looking for a good pediatrician.)

In relatively rare cases, scabies infestations can be so severe that thick crusts of skin develop that have a “super infestation” of scabies and their eggs. This is known as crusted scabies or Norwegian scabies and can occur in people who are elderly, disabled, or those who have weakened immune systems.

In those cases, the itching and rash normally associated with scabies may be absent. A person with ordinary scabies might have 10 to 15 mites on their body, while someone with crusted scabies will have thousands of them.

Getty Images (2), thehealthy.comHow long does it take to see a reaction?

Chigger bite reaction

Chigger bites can occur at any time, whether you’re outside during the day or at night. You may react to getting bit, and ask yourself, “What just bit me?” But you may not see the reddish bite marks that look like pimples or feel the miserable itching right away, says Dr. Friedman: Reactions tend to occur in about six to 12 hours but can take longer. (Keep an eye out for these dangerous bugs this summer.)

Scabies bite reaction

Like with all insect and mite bites, the reaction time will vary depending on the person’s immune response. It’s not the burrowing itself that causes a reaction, but the mite, it’s eggs and fecal matter. Still, Dr. Friedman says, “It may take two to six weeks for the signs and symptoms of scabies to appear in people who have never had the condition.

The itching can start much sooner if you’ve had scabies before. “If a person has had scabies in the past, they usually start itching within one to four days of contact,” Dr. Friedman says. (Here’s how to tame itchy skin with these home remedies.)

Treatment for mite bites

Chigger bites

You might not want to know the mechanics behind a chigger bite, but it helps to understand why you’re itching so bad and why it lasts so long. “Chiggers pierce the skin with a small mouthpart and secrete enzymes into your skin, breaking it down. At the same time, they create a channel or tube (called a stylostome) to suck up the liquified skin cells,” says Green.

The damage from the skin breaking and the duration of how long they ate, equates to how long you will itch. You’re basically going to feel itchy until new skin starts to grows over the little sucking tubes the chigger made. For Green, it took about one week of “uncontrollable itching.”

For others, it can take two weeks to a month. Unlike the itching from scabies, a chigger bite itch will eventually go away. (Unless you get bit by more chiggers.)  The scabies itch continues until you see a doctor for a treatment that will kill them.

To get relief from chiggers-related itching, Dr. Friedman has a few suggestions. “Oral antihistamines or topical corticosteroid creams/ointment. Cold compresses (ice, frozen peas) may also help to obscure the sensation and limit swelling.” (Here’s how to make your own DIY doctor-approved ice packs with things you already have in your house.)

Chigger bites are annoyingly itchy. If you can’t stop itching, call your doctor or dermatologist to get a prescription for a higher potency topical steroid. It’s essential to keep the scratching at a minimum. Otherwise, it can lead to a secondary skin infection.

Dr. Friedman says to call your doctor if you have pain, swelling, pus (white or greenish discharge), fever, weakness, or joint pain. You might not even have to go to the doctor’s office for a diagnosis. (Find out how to make a telehealth appointment work for you.)

Scabies bites

You won’t get by with anti-itch cream to treat scabies because scabies is very contagious. “Most scabies treatments are topical medications, which are applied to the skin. Permethrin five percent cream is the most common medicine used to treat scabies. It’s applied head to toe the first dose and then again in seven days.

Oral ivermectin (while not FDA approved specifically for scabies treatment) deserves consideration as it has shown to be a more practical and effective treatment.

Dosage is based on body weight and repeated a week after the first dose. Other topicals include crotamiton and sulfur ointment for treating scabies in young children and pregnant women. Prescription medicine can kill scabies but the itch may persist for weeks after that.

“The itchy rash can persist for two to three weeks as the dead mites and eggs can continue to annoy the immune system, as the top layer of the skin turns over every 14 days,” adds Dr. Friedman. Topical steroids should help the itch and inflammation. (Here are the 13 OTC skin care products dermatologists love.)

Tharakorn Arunothai / EyeEm/Getty ImagesHow to prevent mite bites

Chiggers

Even with the known habitat we mentioned earlier, chiggers can basically be anywhere when you are outside, Green says. That’s why you shouldn’t walk barefoot or sit directly on the grass.

The best way to prevent chigger bites is covering up. That might not be too appealing in hot summer temperatures, but it’s essential, especially if you know you’ll be in known chigger territory.

“Wear long pants, long sleeves, shoes, boots to cover up and keep chiggers on the outside. Tuck your pants into your shoes or boots and tuck your shirt into your pants,” advises Green. She also recommends wearing permethrin-treated clothing and also DEET (25-30 percent) on the skin.

Because chiggers can hitchhike on clothing, prevent more bites by immediately taking a shower and scrubbing the skin once you get inside. Be sure to wash and dry soiled clothes on high heat to kill chiggers. Wipe down shoes and boots.

You can also cut mitigate the chances of getting chigger bites by keeping turf short and vegetation trimmed. Green says residual insecticides (synthetic pyrethroids) with the active ingredient, bifenthrin, can help suppress chiggers, but spraying large areas can kill beneficial insects and pollinators. (Don’t overlook these surprising hazard zones in your backyard.)

Scabies

Scabies are contagious. They are primarily transmitted by direct human to human contact. But they can be transmitted without touching another human if scabies are on blankets, towels, sheets, and other personal items.

“Scabies mites can survive off the host for up 36 hours and longer in some environmental conditions, so if we’ve been exposed, they will get on our skin and burrow into the epidermis, the upper layer of skin,” says Green. Avoid prolonged close contact with people who have scabies, and if you live someone who has a confirmed case of scabies, Dr. Friedman recommends being treated for scabies. Scabies can also be spread to sexual partners due to skin-to-skin contact.

In addition to the medicinal treatment, some housecleaning is highly recommended to ensure eradication. “Wash all bedding, clothes, and towels that have touched your skin during the past six weeks. Use the hottest water possible for washing and drying,” advises Dr. Friedman.

Anything that can’t be washed in a washing machine should be dry cleaned or sealed in a plastic bag for at least a week. Finally, vacuum your entire home. After vacuuming, throw away the vacuum bag. Vacuum cleaner’s with canisters should be washed with hot, soapy water or cleaned with a cleaning wipe. (Here’s how a messy house could be making you sick.)

Popular Videos

Scabies bites: Pictures, treatments, and causes

Scabies occurs when human itch mites bite and burrow into the skin, laying eggs. The symptoms include intense, uncomfortable itching and a rash.

A person cannot treat scabies with over-the-counter products. They will need prescription medication to treat the infection and prevent it from spreading to others.

This article will help a person identify whether their skin lesions could be due to scabies and how they can treat it.

For more examples of what scabies looks like, click here.

A scabies rash is extremely itchy. Typically, the itching will be worse at night. People who are unsure whether scabies is the cause of their symptoms can consider the following factors:

• Appearance: Scabies bites cause a rash that often presents as small blisters, which doctors call vesicles. Some people may think that it resembles pimples. Itching the vesicles can cause them to turn into open skin sores, making a person more vulnerable to infection.
• Pattern: Scabies mites tend to burrow or tunnel under the skin, which can create a distinct pattern. The pattern consists of lines that are flesh-toned or, sometimes, gray and white. In some cases, the tunnels may be very hard to see.
• Location in adults: The most common scabies sites in adults include the buttocks, elbows, waist, wrists, and skin between the fingers. Sometimes, a person may find mite burrows under a ring, watchband, or fingernail.
• Location in children: The most common scabies bite locations in infants and children are the face, neck, palms of the hands, and soles of the feet.
• Timing: According to the American Academy of Dermatology, if a person has not had a scabies infection before, their symptoms may not appear until about 2–6 weeks after the initial infestation. However, if a person has had scabies before, they will usually develop symptoms within 1–4 days.

In some instances, scabies bites may crust over. Once crusted, scabies may not itch. However, crusting could indicate a significant and highly contagious infection.

Several rashes and bites may closely resemble scabies. These include the following:

• Atopic dermatitis: Also known as eczema, this condition causes dry, itchy patches.
• Contact dermatitis: This allergic reaction to a chemical or another irritant can cause an itchy rash.
• Folliculitis: This condition occurs when hair follicles become inflamed, often due to a bacterial infection. It typically presents as papules or pustules.
• Insect bites: Bites from other insects, such as bed bugs, chiggers, fleas, mites, and mosquitoes, can cause itching.
• Papular urticaria: This condition is an allergic reaction to insect bites. It causes bumps that may appear similar to scabies.

A doctor will consider all of a person’s symptoms when making a diagnosis.

A doctor will typically prescribe a topical treatment called permethrin (Elimite) cream to treat scabies. A person must apply this cream to all skin surfaces, not just where the rash appears. Usually, they will apply the cream at night before bed.

Key areas to which people should apply the cream include:

• between the fingers and toes
• in the bellybutton
• on the buttocks
• on the waistline

The immediate side effects of the cream include a mild burning, itching, or stinging sensation. When a person wakes up, they can shower to remove the permethrin cream, if they wish.

A person should also keep their nails short and trimmed, as this keeps the mites from hiding under the fingernails.

One application of permethrin cream will cure an estimated 95% of scabies infestations. A person may continue to itch or see a rash after the application, but this does not necessarily mean that the scabies is not cured.

Doctors will usually advise a person to apply permethrin cream every week until they are sure that the scabies has gone.

In rare instances, a doctor may prescribe an oral medication called ivermectin (Stromectol) to treat scabies. This treatment is newer than permethrin cream, which is a more traditional and often less expensive treatment option.

At-home relief

In addition to killing scabies with permethrin cream, people can take steps to reduce the itching at home. Examples include:

• taking medications, such as antihistamines or oral steroids, to reduce itching
• applying topical corticosteroid or antihistamine creams to reduce itching
• soaking in a tub of warm (not hot) water and using a soft washcloth to scrub the itchy areas, which can help remove dead mite material

While scabies usually spreads via skin-to-skin contact, its transmission is possible through contact with clothing or linens.

In addition to applying topical treatments to the skin, it is important that people take steps to clean their home and soft materials to prevent reinfestation or the transmission of the condition to another person.

Ways to accomplish this include washing any clothing, linens, and towels that people with scabies have worn or used within the past 3 days. The mites cannot survive washing at any temperature.

Most mites cannot live beyond 3–4 days without being on a human host.

A scabies infection is the result of a bite from Sarcoptes scabiei var. hominis. These mites are microscopic, so a person cannot see them.

Scabies spreads through close and sometimes intimate contact. Examples include:

• in facilities where people are often in close contact, such as child care centers, nursing homes, and prisons
• sexual contact
• sharing bedding, clothing, or towels with someone who has the infection
• sleeping on sheets that have mites on them

Any time a person has direct, close, and sometimes prolonged contact with a person who has scabies, they are at risk of getting it.

However, a person does not usually get scabies from short interpersonal interactions, such as a brief handshake or hug.

A person should see their doctor if they experience the following symptoms:

• itchy areas of skin
• vesicles that appear on the skin
• discolored areas of irritated skin that do not go away

A doctor can often diagnose scabies by visually inspecting the rash and noting any accompanying symptoms. If a doctor still needs to confirm that the rash is scabies, they can perform skin scraping to get a sample for analysis under a microscope.

Scabies infections can be bothersome and contagious. Treating them as soon as symptoms appear can relieve itching and discomfort.

If a person suspects that they have scabies, they should see a doctor or dermatologist as soon as possible.

Scabies

Scabies occupies a significant place among contagious parasitic diseases. It was known 4000 years ago in China, as well as in ancient Babylon, Egypt and a number of other states. Over the past decades, due to the large migration of the population, there has been an increase in the incidence of scabies in many countries. For Belarus, this problem also remains relevant. In 2014, 84 cases of scabies were registered in the Moskovsky district of Minsk.

What is scabies?

Scabies – a contagious skin disease caused by the scabies mite that parasitizes the human skin. A characteristic vesicular rash and itching appear at the sites of tick penetration into the skin (most often the interdigital spaces, as well as the genital area and buttocks).

Ways of infection

There are direct and indirect ways of infection with scabies.

With the direct route of infection , the pathogen passes directly from a sick person to a healthy person at the time of bodily contact.

Indirect route – is the transmission of the pathogen through household items, primarily for personal use.

The most common way of infection is staying in bed together, including sexual contact, cases of infection are much less common when caring for a sick person, a child, during massage, etc.

Of household items with an indirect route of infection the first place is occupied by bed linen, sleeping bags, towels, washcloths, gloves, etc. are of less importance. With an indirect route of infection, the life span of the pathogen outside the person becomes important.

The life cycle of a tick is directly related to the human body. Getting on the skin, the mite is introduced into the epidermis, making scabies there, in which it lays eggs. The larvae emerge from the eggs and leave the passage that the female has gnawed through. Forming their own passages, the larvae molt and mature. The reproductive period of a female’s life is 1-1.5 months. Outside the human body, the scabies mite can live for a short time and is very dependent on hygrometric conditions. At a temperature of 12-14°C and a relative humidity of 90% mites survive up to 14 days. When the temperature rises to 21-24°C, they die on the third day. Decreasing humidity to 35% is detrimental to them, while ticks die within a day.

The course of the disease

Penetrating into the skin , scabies mite causes itching, and rashes, nodules, vesicles appear on the skin, scabies are visible 900 04 moves. Rashes appear, as a rule, on the skin of the hands, lower abdomen, lateral surfaces of the trunk, buttocks, inner thighs, penis in men, around the nipples of the mammary glands in women.

In young children palms, soles, face, neck, back, scalp may be affected.

In debilitated patients scabies can be complicated by purulent diseases. Complications such as dermatitis or eczema may also develop. When combing, secondary morphological elements appear: erosion, blood crusts, linear scratches.

If a sick person has reduced immunity, This disease is complicated by a concomitant infection, up to the formation of thick crusts that cover the body like a shell. This scabies is called Norwegian scabies because it was first described in Norway in patients with leprosy (an infectious disease caused by acid-fast bacteria).

Treatment of scabies

Treatment of scabies, is usually outpatient.

It is aimed at the destruction of the pathogen with the help of special drugs that are used after consulting a doctor and under his supervision.

It should be borne in mind that a person who has been ill with scabies does not develop stable immunity, therefore, in case of subsequent contact with the pathogen, he may get sick again.

Prevention and protection measures

To prevent scabies, certain protective measures should be taken.

First of all:

Personal and public hygiene.

Personal care implies a sanitary and household culture, an attentive attitude to one’s own health. Public hygiene includes, in addition to keeping the public places clean and tidy, the timely implementation of the ongoing final disinfection aimed at destroying the scabies pathogen in the environment.

Identification of the disease at its earliest stages, especially in preschool and school institutions, isolation of patients until a complete cure.

After treatment (even prophylactic) clothing and bedding must be disinfected.

It includes: disinfection of bedding, underwear, towels is carried out in 1-2% soda solution or any washing powder for 5-10 minutes. from the moment of boiling.

Outerwear is ironed on both sides with a hot iron, paying attention to pockets or dry-cleaned.

In the patient’s room daily wet cleaning of the room with a 1-2% soap and soda solution is carried out, including washing the floor, wiping furniture, carpets, etc.

Final disinfection is carried out by employees of the City Disinfection and Sterilization Center.

Remember! Scabies can be prevented. Be attentive to your health!

Scabies. What is Scabies?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Scabies is a common parasitic skin disease caused by the scabies mite Sarcoptes scabiei. and is highly contagious. It is manifested by skin rashes on the abdomen and thighs, between which scabies are visible, severe itching and scratching of the skin. To confirm the clinical diagnosis, vitropressure, dermatoscopy, and scraping examination are performed. Treatment of scabies requires treatment with benzyl benzoate not only of the affected areas, but of the entire skin. It is accompanied by a regular change of underwear and bed linen.

ICD-10

B86 Scabies

• Causes of scabies
  • Exciter characteristic
  • Mechanism of infection
• Symptoms of scabies
  • Typical shape
  • Clean scabies
  • Nodular scabies
  • Crust scabies
• Complications
• Diagnostics
• Treatment of scabies
• Prophylaxis
• Prices for treatment

General

Scabies (scabies) is a contagious parasitic disease caused by the scabies mite. The incidence is quite high. Despite the fact that scabies is considered a disease of antisocial personalities, people of all social strata are affected. In the last decade in Russia, the officially registered incidence rate ranges from 18 to 45 cases per 100,000 population, but in fact it can be much higher. In children and young people, scabies is recorded more often because of their mobility and more active lifestyle.

Causes of scabies

Characteristics of the pathogen

Scabies is an anthropophilic parasitic disease, since the scabies mite parasitizes only on humans. The source of infection is a sick person, scabies is transmitted directly by contact or through infected household items. An adult scabies mite has a size of about 100 microns and a powerful jaw apparatus for making tunnels in the epidermis, females make tunnels, males basically do not move, their main function is fertilization. In the population, the ratio of females to males is 2:1. Fertilization of the female occurs under the skin, after which the hatching larvae come to the surface for further penetration into the layers of the epidermis. Mating of scabies mites also occurs on the surface.

Thus, the tick comes to the surface twice during its life cycle. It takes 15-20 minutes for a scabies mite to penetrate under the skin, which explains the contagiousness of scabies. In the first half of the day, the female lays eggs, and gnaws through passages at night, the life cycle of the scabies pathogen ranges from two weeks to two months, after which the tick dies and decomposes in the gnawed passages. The scabies mite is not resistant and at a temperature of +55 degrees it dies after 10 minutes, and at a temperature of +80 it dies instantly. Outside of a person, the tick also dies quite quickly.

Mechanism of infection

Infection with scabies is possible in public places through doorknobs, stair railings, handsets. As a result, an epidemic focus is created and a person with scabies infects his environment of a domestic and professional nature. Infection with scabies can occur through sexual contact, more often a man is infected from an infected woman. The scabies mite can be on animals for a short time, so infection with scabies from animals is not excluded, although it is extremely rare.

The causative agent of scabies is most active from September to December, it is at this time that the greatest number of outbreaks of scabies is diagnosed. Nighttime activity poses a high risk of infection within the family when sharing a bed. The interdigital folds, wrist zones are primarily affected, and already with the development of scabies, other parts of the body are affected, except for the scalp and armpits.

Symptoms of scabies

The incubation period of scabies is from three days to two weeks, but upon closer examination, you can notice the entry points of the scabies mite already in the first days after infection. After the females begin to actively lay eggs, the clinical manifestations of scabies increase. Unbearable itching is noted, aggravated in the evening and at night. Scabies are visible on the skin in the form of linear inflamed areas, the inflammatory reaction in scabies is also explained by the presence of chemically active substances in the parasite’s saliva, therefore, allergic infiltration can be observed in the affected area. Due to severe itching, the skin becomes macerated, scratches are observed on the body, sometimes covered with bloody crusts. The clinical manifestations of scabies depend on the activity of the mite, on how personal hygiene is observed and on the degree of allergization of the body to the pathogen.

Typical shape

In a typical form of scabies, rashes are localized on the abdomen in the umbilical zone, on the anterointernal surface of the thighs, on the buttocks, mammary glands, lateral surfaces of the fingers and toes, on interdigital skin folds; in men, scabies can be localized on the skin of the scrotum and penis. Scabies looks like a whitish or grayish straight or curved line from 5 to 7 mm, slightly rising above the skin. On the face, on the skin of the palms and feet, only single rashes may appear. Scabies course is clearly visible under a magnifying glass, the end of the course with scabies ends with a small papule or vesicle. Papulovesicular elements are partially covered with dotted bloody crusts and reach sizes up to 0.5 mm.

In addition to scabies that have paired papulovesicles, there are dotted and linear scratches on the skin of a patient with scabies due to severe itching. Depending on the severity of scabies, there may be foci of pyococcal infection, which are more often found in the extensor zones. There are purulent or bloody-purulent crusts on the elbows – a symptom of Ardi.

Clean scabies

Cleanliness scabies is an erased form of the disease that occurs in people who have normal immunoreactivity, as a result of which there is no allergic reaction to the presence of mites. Increased attention to personal hygiene, when people take a shower several times a day and change underwear and bed linen, also contribute to the erasure of clinical manifestations in scabies. It is characterized by single rashes on the chest and around the navel, which practically do not macerate and do not cause discomfort, itching is noted only at night. Perhaps the appearance of hemorrhagic crusts.

Nodular scabies

Nodular scabies occurs as a result of a delayed-type hyperergic reaction, which develops as a response to the mite’s waste products. The nodular form of scabies is usually the result of untreated or improperly treated scabies. The long course of the disease, reinfestation with scabies mite contribute to the appearance of itchy reddish-brown nodules. The rash is lenticular in nature, the nodules occur under the scabies and are located in places typical for rashes. This form of scabies is resistant to various anti-scabious therapies, since due to dense crusts, medicinal substances have practically no effect on the tick.

Crust scabies

Cortical (Norwegian) form of scabies is diagnosed in rare cases in patients who have a sharply weakened immunoreactivity. Crusted scabies is the most highly contagious form, as the crusts contain the highest concentration of mites. Immunodeficiency states, general diseases in which there is a decrease in immunity and exhaustion, long-term therapy with corticosteroids, cytostatics and alcoholism contribute to the development of crusted scabies.

Clinically, crusting scabies is characterized by the presence of greyish-dirty crusts that tend to layer on top of each other. The crusts are usually of different sizes and thicknesses, tightly soldered to each other and to the underlying tissues, and are very painful when removed. After removing the crusts, yellow erosions are exposed.

The extensor surfaces, the back of the hands, elbows, knees, interdigital spaces, buttocks, abdomen, auricles, less often the face and scalp are affected. Thick hyperkeratosis develops on the palms and soles, which limits freedom of movement. If the nail plates are affected, they deform, crumble, become thickened and change color.

Complications

With inadequate treatment or its absence, scabies is complicated by pyoderma, microbial eczema and dermatitis of various nature.

Diagnosis

The diagnosis is made by a dermatologist, therapist or infectious disease specialist based on clinical data and patient complaints. The presence of itching, which increases in the evening and at night, and the presence of characteristic linear scratches, small papules, and a positive symptom of Ardi, suggest the presence of scabies. When examining contact persons, it turns out that most of them have the same clinical manifestations, there is information about being in the epidemiological site of scabies.

Examination of scrapings for scabies confirms the presence of this disease, but it should be borne in mind that many patients wash thoroughly before visiting the doctor, and therefore mites may not be detected. In addition, during the formation of crusts or during a period of low activity of mites, their concentration decreases, therefore, in the absence of mites under microscopy, but in the presence of a characteristic clinical picture, scabies therapy is started.

In order to increase the motor activity of ticks, before taking the material, the skin is heated with warm glass or a little oil is dripped. The application of mascara and aniline dyes helps to color the scabies. In some cases, when it is not possible to detect the causative agents of scabies, a positive trend in the appointment of anti-scabious drugs is a diagnostic and treatment procedure. This diagnosis is called ex juvantibus.

Treatment of scabies

When treating scabies, regardless of the scheme, it is necessary to treat the entire skin, and not just the affected areas, with the exception of the scalp (except when scabies is localized on the scalp). Washing the body and changing underwear and bed linen should be done only before and after the treatment of scabies; during therapy, washing the body is prohibited.

Benzyl benzoate, produced in the form of emulsions, is the most common antiscabiosis drug, since it has low toxicity and high efficiency. Before use, wash the entire body, then treat the upper limbs, lower limbs and torso with the exception of the scalp. The rubbing time should be at least two minutes per area. Change of underwear and bed linen with double ironing after washing. Two days later, a second course is carried out according to the same scheme. This achieves an effect on individuals that were in the larval phase. With complete relief of the epidemic focus and the absence of reinfection, a double course of benzyl benzoate is enough to cure scabies. After the end of treatment, furniture, clothing must be treated with an antiseptic solution or UV irradiation.

Aerosol preparations for the treatment of scabies are easier to use and their volume is sufficient to treat the patient and contact persons. There are aerosol preparations that can also be used to treat children. They are sprayed 20-30 cm from the skin, leaving no free areas, after 12 hours, the body and the epidemiological site are sanitized. One application is enough, but with complicated forms of scabies, the procedure is recommended to be repeated.

Lindane is a colorless, odorless cream preparation that is rubbed into the skin daily or twice a day in the treatment of scabies. Before therapy and before each treatment with lindane, it is necessary to take a shower. This method of treatment is suitable for those who are used to taking a shower or bath every day. Lindane is also available as a powder for rubbing into the skin and in the form of shampoos. However, it is better for children and women during pregnancy and lactation to use a special gel.

Treatment of the cortical form of scabies has several features. Before antiscabiosis therapy, it is necessary to soften the crusts and remove them. Soap-soda baths and keratolytic ointments are usually used.