Scabies pubic pediculosis. Symptoms of pubic lice and methods of treating them. What is lice pubis called?

The causative agents of these diseases are scabies mites and pubic lice.

Scabies

Scabies is a skin disease caused by the scabies mite. The length of the female scabies mite is 0.3-0.4 mm. She lives for about 1 month. Females make passages under the stratum corneum of the epidermis, laying 2-3 eggs there daily. The eggs hatch into larvae. Within 2 weeks. The larvae, after passing through several stages, turn into adults. The latter rise to the surface of the skin and mate. The males, having fertilized the female, soon die. The fertilized female implants itself into the skin of the previous or new host. Thus, the clinical picture of the disease is caused exclusively by females.

Outside the human body at room temperature, the scabies mite can live for 2-3 days. At a temperature of 60 C°, ticks die within 1 hour; when boiled or at negative temperatures, they die almost immediately.

How does scabies become infected?

Characteristic is a contact transmission mechanism. Infection occurs through sexual contact, as well as through household contact - through clothing and bedding.

How does scabies manifest itself? (symptoms of scabies)

Scabies manifests itself mainly as itching and scratch marks. The itching intensifies in the evening and at night.

Itching is not caused by the direct action of mites, but by an allergic reaction to mites and their excrement. Therefore, when you are first infected with scabies, itching appears after a few weeks; in case of re-infection - on the first day.

What areas of the skin are most often affected by scabies?

Favorite localization of rashes (in descending order of frequency): interdigital spaces, wrists, shaft of the penis, elbow fossa, feet, external genitalia, buttocks, armpits. The head and neck are not affected by scabies (with the exception of infants).

Despite the characteristic localization of the rash, itching with this disease can occur on any part of the body.

How is scabies diagnosed?

Diagnosis is based on the clinical picture (itching, worsening in the evening and at night; the nature of the localization of the rash). If possible, the diagnosis should be confirmed by identifying scabies tracts and the mites themselves.

What treatment is indicated for scabies?

The main drugs for the treatment of this disease are:

• Sulfuric ointment. The drug is rubbed into the entire skin (except for the head) once a day for 5 days in a row. During the treatment, underwear and bed linen do not need to be changed. 1 day after the last rubbing, wash with soap and change underwear and bed linen. The disadvantage of sulfur ointment is the unpleasant odor and the fact that it often causes skin irritation (especially with repeated treatment).
• Benzyl benzoate. For instructions on how to use, see the instructions included in the package.
• Spregal (aerosol). Spray once over the entire body (except for the head). After 12 hours, wash with soap and change underwear and bed linen. The drug contains very detailed instructions that should be read before use.

When treating with any of the listed methods, underwear and bed linen must be boiled and ironed on both sides. For treating laundry without boiling, as well as for treating outerwear, there is the drug A-PAR (aerosol).

Itching may persist for several weeks after complete treatment of scabies, which confirms the allergic nature of the itching.

Your sexual partners.

Risk of other sexually transmitted diseases

It should be noted that sexually transmitted skin diseases (scabies, lice pubis) are markers of other sexually transmitted diseases. Therefore, if a person who is sexually active is diagnosed with scabies or lice pubis, it is necessary to be examined for other sexually transmitted diseases.

Pediculosis pubis

Pediculosis pubis (phthiriasis) is caused by pubic lice (pubic lice). The pubic louse attaches to the pubic hair. In order to survive, she needs to suck fresh blood twice a day. The female attaches the laid eggs (nits) firmly to the pubic hair and cannot be washed off with water.

How can you get lice pubis?

In most cases, infection occurs through sexual contact. However, it is possible to become infected through bedding, towels and clothing.

What areas of the skin are affected by pubic lice?

Pubic lice live mainly on hair located on the pubis, genitals, and around the anus. Sometimes they spread to other areas of the skin covered with hair - chest, abdomen, armpits.

How does pubic lice manifest? (symptoms of pubic lice)

Itching is characteristic and usually worsens at night. Sometimes the patient is not bothered by anything. In some cases, pubic lice bites cause an allergic rash in the affected area. Often, patients with lice pubis independently identify nodules on their pubic hair (nits).

How is lice pubis diagnosed?

Diagnosis is based on the clinical picture and identification of lice or nits.

What treatment is indicated for pediculosis pubis?

A good product is SPRAY-PAX (aerosol for external use). It is sprayed in the pubic area, genitals, around the anus and left for 30 minutes. Then the treated areas are washed with soap and rinsed thoroughly with water.

The drug is used 1 time. One bottle is enough to treat 2 people.

After using the drug, it is necessary to change underwear and bed linen. Old linen should be boiled and ironed on both sides.

Your sexual partners

Risk of other sexually transmitted diseases.

It should be noted that sexually transmitted skin diseases (scabies, lice pubis) are markers of other sexually transmitted diseases.

Therefore, if a person who is sexually active is diagnosed with scabies or lice pubis, it is necessary to be examined for other sexually transmitted diseases.

Defense reactions of the host body:

1. Cellular:

Pediculosis

There are several types of pathogens that cause pediculosis in humans:

The embryonic period lasts from 4 days to 6 weeks, the larvae go through three stages lasting from 3 to 5 weeks each, the mature individual lives from 27 to 46 days. The oval-shaped eggs are yellowish-whitish in color and are attached to the hair or tissue villi with the secretion of adhesive glands produced by the female. The larva differs significantly from the adult in size, body structure, and the absence of a reproductive apparatus. 30 minutes after hatching, the larva begins to suck blood, and after the third molt it turns into an adult. The complete life cycle from the egg to the laying of eggs by the female lasts 15 days.

Head lice

Lice are found on the scalp, most often affecting the occipital and temporal areas; eyebrows and eyelashes can also be affected. In the presence of long hair, the process is most pronounced; this applies to a greater extent to women and children. Head lice are grayish-white individuals, the size of males reaches 2-3 mm, females 2.4-4 mm.

Insects pass from an infected person to a healthy person only through close contact.

Clinical picture when infested with lice represented by papules, vesicles, erythematous spots, which occur at the sites of bites due to irritation of the skin by the products of the salivary glands. Dermatitis, eczematization, and excoriation develop. In this case, inflammation, secondary pustulization, and exudation occur. Crusts of a purulent-hemorrhagic nature, peeling, followed by lichenification and pigmentation of the affected areas of the skin appear. The disease is accompanied by severe itching.

Pustules, exudative changes, crusts formed on the scalp shrink, promote hair sticking and the formation of tangles (trichomes). Infection may occur through inhalation of dust. since rickettsia are well preserved in a dry place.

Relapsing fever caused by a spirochete (Spirochaeta reccurens), which enters the stomach of the insect with the blood and is quickly evacuated from it. However, on the 6th–7th day, spirochetes develop in large quantities and accumulate in the cavity fluid, and therefore infection can occur already on the 6th day after the insect hits the patient, when crushing him and rubbing spirochetes into damaged skin, wounds, scratches, etc.

Treatment

The most effective therapy requires shortening or shaving hair. When treating affected areas of the skin, it is necessary to get rid of i nids by combing or mechanical removal from the hair. Sanitation of lower and outer clothing and bed linen is also necessary. Anti-pediculosis drugs are represented by various drugs that have a detrimental effect on both adults and nits. Methods of treatment with kerosene, 50% soap-solvent paste, hellebore water, and karbofos solution are currently used extremely rarely due to the available more effective and convenient drugs. Highly effective means are nittifor, para-plus, itax, nix, 20% benzyl benzoate solution, antiscab and etc.

Couple-plus — a drug V aerosol package containing permethrin, malathion, piperonyl butoxide. The product is left on the treated surfaces for 10 minutes, followed by rinsing and removing nits. The drug is easy to use and effective with a single use. Para-plus is also used to treat things that the patient has come into contact with.

Knicks — a cream containing permethrin is applied to the affected areas for 10 minutes and washed off in the usual way, making sure to remove nits.

Antiscab a complex hydrophilic gel-like preparation containing benzyl benzoate, active substances of plant origin. This remedy is rubbed into the affected and adjacent areas on the 1st, 3rd and 7th day in the evening. Wash off on the 8th day.

Nittifor contains 0.0005% permethrin in an aqueous-alcoholic solution. The drug is used to destroy head and pubic lice and their nits. Nittifor is applied to the affected areas and after the hair has dried, 40 minutes after treatment, it is washed off with shampoo; if necessary, the treatment is repeated. Therapy pediculosis complicated by pyoderma, includes antibacterial therapy, both local and oral. It is advisable to use broad-spectrum antibiotics (amoxicillin, lomefloxacin, roxithromycin, doxycycline, etc.). External means must be used aniline antiseptics, ointments and pastes with antibiotics (gentamycin, heliomycin, lincomycin, hyoxysone, triderm, diprogent, belogent, celestoderm with garamycin, etc.).

With developed dermatitis necessary use antihistamines (loratadine, ebastine, terfenadine, ketotifen, etc.). External therapy should include steroid ointments.

Anti-inflammatory drugs that can be used are argosulfan, desitin, drapolene, etc.

Preventive actions

The most important are sanitary and hygienic measures, personal hygiene, frequent washing of the head and body, regular change of linen and clothing. As a public prevention, regular examination of people in places of forced congestion or long-term residence (hospitals, child care institutions, schools, kindergartens, dispensaries, etc.) is necessary.

If lice are detected, a thorough sanitary treatment of infected people and those in contact with them, treatment of premises, clothing, and washing of household items is carried out. Medical personnel carrying out sanitary treatment must have special clothing made of rubberized material or thick canvas. Sanitary educational work among the population and timely implementation of sanitary and anti-epidemic measures are of great importance.

Demodicosis

Demodicosis is a common pathology in humans and animals caused by mites of the genus Demodex. Currently, out of 65 species and several subspecies of Demodex, only two are found in humans: Demodex follikulorum and Demodex breis. Each species and subspecies of demodex is strictly specific to its owner.

Demodectic mange, which affects animals, forces appropriate measures to be taken in agriculture, since it is associated with damage not only to the skin and skin, but also to the internal organs of animals.

Iron mite (Demodex follikulorum) occurs most often, found only in humans in

hair follicles, sebaceous glands, and outside the host, its reproduction stops. The tick is viable outside the host at constant humidity and room temperature in the dark for up to 9 days. The optimal temperature for tick development is 3040 °C; at a temperature of 14 °C the ticks are in a state of torpor, and at 52 °C they quickly die. Insects survive in water for up to 25 days; in dry air they die after 1.5 days. The most favorable nutrient medium for demodex is vegetable oil, fat, petroleum jelly.

The pliers have dimensions of 0.3 x 0.4 mm. In the cavity of the hair follicle, females lay eggs, from which after 60 hours a larva hatches, which is motionless and constantly feeds. After 40 hours, the larva turns into nymph 1, which is also inactive and remains in the follicle. After 72 hours, transformation into nymph 2 occurs, mobile, moving along the skin, and after 60 hours, transformation into an adult. The adult re-enters the follicle and dies after laying eggs. The life cycle of a tick is about 15 days.

Clinical manifestations of demodicosis are varied. There are skin and ocular manifestations of the disease. It is necessary to distinguish between demodicosis itself and diseases the course of which is aggravated by the presence of mites. The most common diseases are presented in the table:

Treatment

External therapy includes vasoconstrictors (aqueous adrenaline-resorcinol solution, etc.), ointments containing antibiotics, mupirocin (Bactroban), erythromycin, fusidine, tetracycline ointment, antihistamines, steroids, non-steroidal anti-inflammatory drugs (indomethacin, butadione, orthophenic ointments, etc. ), preparations containing sulfur, naphthalan, metronidazole, 20% benzyl benzoate solution, vitamin A derivatives (retinoic ointment, retin A, airol, benzoyl peroxide (oxy-5, oxy-10), etc. For the treatment of the periorbital region, alcohol-ether mixtures are used, 3 5% trichopolum cream, sodium sulfapyridazine, etc.

The drug is effective Spregal, containing a solution of esdepaletrin and piperonyl butoxide. For demodicosis and rosacea, Spregal is rubbed into the affected areas of the skin using a tampon 1-3 times a day. Clinical improvement and recovery can be achieved in 7087% of cases. Spregal is well tolerated and does not cause serious side effects.

Prevention of the disease consists of observing general hygiene rules at home and in public places. Proper and adequate skin care, proper nutrition, and adherence to a rest regime are necessary. In case of minor changes in the skin of the face and periorbital area, timely contact with a dermatologist is necessary.

Scabies

The source of infection with this disease is a sick person, and there is a direct and indirect route of transmission of the pathogen. Direct infection is the transmission of a pathogen from person to person at the time of contact. With indirect transmission of ticks, infection occurs through objects of common and personal use.

The life cycle of a tick is represented by two periods: reproductive and metamorphic.

The reproductive cycle of the mite is as follows: an oval-shaped egg is laid by the female in the scabies duct, in which the larvae then hatch. Scabies can persist for up to 1.5 months and serve as a source of infection. The metamorphic period is determined by the appearance of a larva, which penetrates the skin through a passage and, after molting, turns into a protonymph, then into a teleonymph, which in turn turns into an adult in papules, vesicles, and on the skin.

The scabies mite has a tortoiseshell shape, dimensions 0.35 x 0.25 mm. The male is significantly smaller in size than the female.

The female moves on the skin using two front pairs of legs, which have suckers. The tick penetrates the stratum corneum of the skin using its jaws and the terminal spines of the front pairs of legs. The female feeds on the granular layer of the epidermis and makes passages in the stratum corneum of the epidermis. Eggs are laid in the passages sequentially in a row.

The incubation period of the disease ranges from 8 to 12 days. The beginning of the process is characterized by itching, which sharply intensifies in the evening.

Itching is caused by the movement of the mite, which is most active in the evening. In this case, the skin and nerve endings are irritated not only by the tick itself, but by its metabolic products, excrement, saliva, etc.

The diagnostic criterion for making a diagnosis is the presence of scabies, papules, and vesicles. The most typical lesions in the form of tracts, serous crusts, papules, vesicles appear in the area of ​​the hands, elbow joints, abdomen, buttocks, mammary glands, and thighs. There are also erased forms of scabies, which lead to erroneous diagnosis and are often regarded as allergic dermatosis.

The clinical picture of scabies is not only the rashes described above, but also the appearance of erosions, hemorrhagic crusts, excoriations, and erythematous-infiltrative spots. When skin changes are complicated by a secondary infection, impetiginous elements, pustules, and purulent crusts appear. A complication of the disease is the formation of post-scabiosis lymphoplasia, as reactive hyperplasia of lymphoid tissue.

There are separate forms of scabies: nodular scabies, scabies in children, Norwegian scabies, pseudoscabies)