Scabies - the structure of the parasite, routes of infection, symptoms, diagnosis and how to treat in children or adults

Description of the parasite

The mite is yellowish or creamy white in color. It is difficult to notice with the naked eye, since the male is about 0.20 mm in size, and the female is 1.5 times larger.

Only female parasites spread the infection. The role of the male is to fertilize the female once, and after that he dies. The tick's body is oval, similar to a turtle shell or a bean. Adult ticks have four pairs of paws, females have peculiar suction cups on the front two, and males have 1, 2 and 4 pairs of paws. The eggs are small, oval, approximately 0.2 mm in size. The larvae are white, round, with 3 pairs of legs; the body size is also 0.2 mm. The next stage of scabies development is the nymph. This is a white round individual with 4 pairs of legs, it is slightly smaller than an adult tick.

Symptoms and first signs in children

The same signs of itching are also characteristic of children, including newborns. Scabies, papules and vesicles can be found on the skin. In children in the first months of life, the clinical picture may resemble urticaria, which complicates the diagnosis of the pathology. Some babies experience weeping, onychia and paronychia. Localization of rashes: on the feet, scalp.

The blisters then spread to the back, buttocks and face. Due to discomfort, the child does not sleep well. Against the background of itching, children may experience:

• lymphangitis;
• deterioration of general condition;
• temperature;
• decreased appetite;
• tearfulness;
• lymphadenitis;
• albuminuria;
• leukocytosis;
• acceleration of ESR;
• sepsis (in infants).

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Where do they live?

Scabies are found wherever their possible hosts live. Infection usually occurs in spring or autumn. Each type of scabies itch chooses its owner. It can settle on horses, cattle, pigs, dogs, rabbits, sheep and humans. Ticks that live on animals cannot live long on humans and soon die on their own, although they cause some inconvenience.

Scabies mites usually live their entire lives in one place, but in warm and humid places they can survive without a host for 2-4 weeks. In this case, it is the ambient temperature. close to human body temperature is the main factor for the survival of the parasite.

Diagnostics

Already on the basis of clinical signs, the doctor may suspect that the patient has scabies, but additional research is necessary to confirm the pathology. Their list includes:

• initial examination of the patient for the presence of scabies;
• express diagnostics using lactic acid;
• coloring the skin with iodine tincture - tick burrows turn brown;
• detection using a videodermatoscope.

Scabies test

General laboratory tests will not be informative. Increased levels of eosinophils may be detected in the blood, which are a sign of sensitization. In addition, its analysis can show that there is an inflammatory process in the body. The disease can only be confirmed by scraping for scabies. The procedure involves cutting and collecting a small area of ​​the upper layer of the epidermis near the scabies. The mites themselves or their larvae are found in the material taken.

How does a tick reproduce?

Unfertilized females make long passages in the skin, after which they return to its surface and mate with males. Then, after a few hours, they return to the previously made passages and lay eggs in them. The laying process lasts about 1 month with breaks of 2-3 days. Each female lays up to 25 eggs every 14 days, but only 10% of these develop into adults.

After 3-5 days, the eggs hatch into larvae that live in scabies ducts or hair follicles. After 2-3 days, the larvae turn into nymphs, and after 4-6 days the nymphs grow to the size of adult ticks, and the whole cycle repeats again. So a new generation of parasites reproduces every 14 days.

Scabies

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Scabies is a contagious parasitic skin disease caused by the scabies itch Sarcoptes scabiei. Scabies was known 4 thousand years ago in the countries of the East, China, and the term “scabies” came from ancient Rome.

Scabies itch spends most of its life in the thickness of the skin, and its morphological appearance is determined by its adaptation to intradermal parasitism. Female scabies, which determine the clinical picture of the disease, gnaw passages in the epidermis, feed on it, lay eggs, and the males, having fertilized the females on the host’s skin, die.

Scabies mite.

The female mite Sarcoptes scabiei has an oval tortoiseshell shape, dimensions 0.3–0.4 mm in length and 0.25–0.38 mm in width, the male is 1.5 times smaller than the female. The tick's mouthparts protrude somewhat anteriorly; on the sides there are 2 pairs of legs with suckers and 2 pairs of hind legs with bristles. The eggs of the mite are oval, the eggs hatch into larvae 0.15–0.1 mm in size, having not 4, as in an adult, but 3 pairs of legs, the nymphs are morphologically similar to the adult tick, but differ in smaller sizes. The shells of the eggs from which the larvae hatched are transparent, collapsed, with a longitudinal crack along the edge. This characteristic of the stages of transformation of a scabies mite from a larva to an adult is important for the laboratory diagnosis of scabies.

The life cycle of the scabies mite is divided into two periods: reproductive and metamorphic. The reproductive period takes place in the maternal passage, where the female lays eggs, and the metamorphic, i.e. development from larvae to adult mite - in vesicles, papules, even in externally unchanged skin. The itch serves as a constant source of larvae that infest the patient. Females make passages at the border of the stratum corneum and granular layer of the epidermis. So, the parasitic elements are located in the scabies duct as follows: at the front blind end of the burrow there is a female, then eggs are laid one after another in succession. The productivity of scabies is on average 1 larva/day.

The survival rate of a mite removed from a scabies burrow ranges from 3 to 14 days; the detrimental effect for them is a decrease in humidity to 35%, while the mites die within 24 hours; at a temperature of 60°C, the mites die within an hour; when boiled, they die immediately.

Epidemiology

The incidence of scabies has increased over the past two decades. There are several reasons for this: population migration has increased, susceptibility to scabies mites has increased, possibly due to an increase in the number of patients with immunodeficiencies. The 15–30 year rhythms of solar activity play an important role. The maximum incidence occurs in the autumn–winter period.

The source of infection is a person with scabies and his things. More often, infection occurs directly from the patient through close contact (staying in bed together) or during care. This is a direct route of infection from person to person. You can also become infected through things (indirect route): bed linen, sleeping bags, towels, washcloths. In a humid environment, scabies mites can survive up to 5 days.

Clinic

The incubation period averages 8–12 days, but can range from several hours to 6 weeks, it all depends on the number of embedded mites and the reactivity of the body. The first symptom of the disease is itching, which appears when parasites invade and worries mainly in the evening and night hours, since this is the time when the female scabies mite is most active.

When the clinical picture of scabies develops, the main symptom of the disease is the scabies tract, which the female lays at the border of the stratum corneum and granular layer of the epidermis. A typical scabies burrow looks like a whitish or dirty gray line, 0.5 to 1 cm long, slightly rising above the skin level. At the anterior end of the burrow, you can see a female mite visible through the stratum corneum in the form of a black dot. Sometimes scabies can be represented by a chain of small bubbles arranged linearly. Such scabies are most often located on the lateral surfaces of the hands, fingers, palms, wrist joints, elbows, ankles, dorsum of the feet and soles. With a long-term process, old dry scabies are revealed in the form of dry surface cracks. In adults, on the skin of the armpits, inner thighs, abdomen, lower back, inguinal and intergluteal folds, scabies may appear as linear peeling on the surface of dense bluish-purple nodules. If the disease is less than two weeks old, then scabies may not be found. With great difficulty, they are also detected in clean people - low-symptomatic scabies.

In addition to scabies, the clinical picture of scabies is characterized by the appearance of small blisters and pink nodules, bloody crusts and scratches in typical locations (hands, wrist and elbow joints, the front and inner thighs, buttocks, lower back, lower abdomen, mammary glands in women , genitals in men).

Scabies in children

Scabies in children has its own characteristics. Usually all areas of the skin are affected, including the scalp and facial skin, which is never observed in adults. The clinical picture shows a polymorphism of rashes with a predominance of the exudative component with a tendency to eczematization and the addition of a secondary infection. In general, the clinical picture resembles weeping eczema, which is refractory to conventional therapy. It is characteristic that in children of the first three years of life, the interdigital spaces and lateral surfaces of the fingers, as well as the skin along the anterior edge of the axillary fold are rarely affected. In some cases, in infants and young children, the process may involve nail plates affected by scabies, which thicken, loosen, and cracks appear on their surface.

The diagnosis of scabies in young children is based on a thorough history taking, examination of persons in contact with a sick child, and identification of scabies mites during laboratory testing.

Norwegian scabies

Norwegian scabies is a rare type of scabies. This form of scabies was first described by Boeck and Danielsaen in 1848 in Norway in patients with leprosy. Norwegian scabies is caused by the common scabies mite and occurs, as a rule, in weakened and emaciated individuals, in patients with Down syndrome, patients with tuberculosis and HIV-infected people, cancer patients and patients receiving hormonal and cytostatic drugs for a long time. Norwegian scabies is characterized by polymorphism of rashes (papules, vesicles, pustules, cracks), rough dirty yellow crusts up to 2–3 cm thick appear, which in the form of a shell can cover large areas of the skin. In the lower layers of the crusts you can see winding depressions corresponding to scabies. When the crusts are removed, extensive weeping erosions are exposed. Between the layers of crusts a huge number of mites are found at all stages of development (up to 200 per 1 cm2). The process involves the nail plates, which thicken, loosen, and break easily, rough hyperkeratosis develops on the palms and soles, the hair loses its shine, becomes dull, the patient emits an unpleasant sour odor, and the body temperature often rises. Patients with Norwegian scabies are extremely contagious.

Nodular scabies (post-scabiosis skin lymphoplasia)

In some patients who have received full treatment, dense, itchy lenticular papules of a bluish-purple color appear more often on the inner thighs, buttocks, lower abdomen and genitals in men, and on the mammary glands in women. T.V. Sokolova (1987) proved the presence of scabies in the stratum corneum of lenticular papules by scrapings followed by microscopy of the contents in lactic acid. In all cases, females, eggs, larvae, empty egg shells and excrement were found. Moreover, the number of parasitic elements was twice as high as in scabies tracts of typical localization (on the wrists, hands and feet). It is assumed that long-term persistence of tick antigen in the reproductive tracts leads to the appearance of itchy papules in areas of accumulation of lymphoid tissue. The pathogenesis of the development of scabious lymphoplasia lies in the peculiarity of the skin to respond to mite penetration with reactive hyperplasia of lymphoid tissue. 2–6 weeks after specific treatment of scabies mites, no such papules were found in scrapings of the stratum corneum from the surface.

Pseudoscabies

Pseudoscabies or tick-borne dermatitis occurs when ticks from animals (dogs, pigs, horses, sheep, goats, rabbits) get on human skin. The incubation period ranges from several hours to 2 days. Female mites, when they penetrate the epidermis, do not form burrows or lay eggs; papular and urticarial elements appear at the site of penetration. The disease is not transmitted from person to person; the rashes regress on their own when the source of infection is eliminated.

Differential diagnosis

When elements of scabious lymphoplasia appear, it is necessary to differentiate them from lenticular papules in secondary syphilis. Anamnesis data and the presence of the stratum corneum of scabies mites in scrapings allow a diagnosis of scabies to be made. In doubtful cases, serological diagnosis is carried out to exclude syphilis. Scabies in children should be distinguished from childhood pruritus and urticaria.

Complications

A long-term process and irrational treatment can lead to complications of scabies with dermatitis, microbial eczema, and pyoderma. As a rule, as the duration of the disease increases, the likelihood of complications increases, which often leads to diagnostic errors.

Laboratory diagnostics

The diagnosis of scabies is based on clinical manifestations, epidemiological data and laboratory tests (detection of scabies mites):

• method of removing ticks with a needle

• thin section method

• layer-by-layer scraping method

• alkaline skin preparation method

• express diagnosis of scabies using a 40% aqueous solution of lactic acid.

Treatment

The following requirements are currently imposed on antiscabiotic drugs: speed and reliability of acaricidal action, lack of irritation to the skin, ease of use and availability for mass use. The aerosol scabicide Spregal meets all these requirements .

The drug is simple and easy to use, economical (one package is enough to treat 2-4 people). Treatment begins in the evening hours so that the drug acts at night, during the maximum activity of the female scabies mite. The patient takes a shower and applies the aerosol once to the entire surface of the skin from top to bottom at a distance of 20–30 cm. The drug is especially carefully applied to the skin of the fingers, interdigital spaces, feet, armpits, and perineum. After treatment, clean underwear is put on, and bed linen is also changed. All family members are treated in the same way at the same time. After 12 hours, the patient takes a shower again and again changes his underwear and bed linen. Usually, a single use of Spregal is sufficient, however, based on the duration of embryogenesis, it is advisable to repeat these procedures after 2 days, i.e. on the 4th day of the course with calculation of the effect on hatched larvae. In infants and early childhood, if the face is affected, Spregal is applied to a napkin, then the skin is carefully treated, avoiding the drug getting into the eyes and mouth.

Benzyl benzoate

– one of the effective and most famous antiscabiotic agents. Treatment with benzyl benzoate, used as a 20% suspension in adults and 10% suspension in children, is recommended for 6 days according to the following method. A 20% water-soap suspension of the drug in an amount of 100 g is rubbed once only on the first and fourth days of the course. Be sure to bathe the patient before each rub. On the second and third days, benzyl benzoate is not rubbed in. These days can be used to treat associated complications. Underwear and bed linen are changed twice: after the first treatment (on the first day) and two days after the second rubbing, i.e. on the sixth day of treatment, when the patient must wash again.

It is worth mentioning the treatment according to the Demyanovich method, which consists of sequentially rubbing in a 60% solution of sodium hyposulfite (solution No. 1) and 6% concentrated hydrochloric acid (solution No. 2). Also used to treat scabies are the following ointments: Wilkinson's, 33% sulfur and benzyl benzoate ointment. However, they are less convenient to use and are significantly inferior in effectiveness to Spregal and a 20% benzyl benzoate suspension.

When dermatitis or microbial eczema occurs, anti-inflammatory and desensitizing therapy is carried out. Antihistamines are prescribed (suprastin, fenkarol, loratadine, etc.), calcium gluconate in the form of injections of a 10% solution, 10.0 IM for 10 days. Corticosteroid ointments are used externally: elocom, advantan, diprogent, etc. For resorption of infiltration foci - pastes containing 2-10% tar, naphthalan, ichthyol, ASD-3.

For pyoderma, which complicates the course of scabies, it is advisable to prescribe antibiotics internally if the process is widespread, as well as active external therapy (baneocin, lincomycin, erythromycin ointments). If pustular rashes are limited, then simultaneous treatment of scabies and its complications is carried out. If there is an abundance of pustules, crusts, and erosions, intensive antiscabiosis measures cannot be carried out due to the possible dissemination of pyogenic infection. First, the manifestations of pyoderma are stopped, and then antiscabiosis therapy is carried out.

Scabies rash on the wrists.

Postscabiosis lymphoplasia.

Rash due to scabies in the area of ​​the hands.

For long-term scabious lymphoplasia, cryotherapy is effective in some cases, as well as the injection of depot forms of corticosteroids under the lesion.

In case of tick-borne dermatitis (pseudoscabies), first of all, it is necessary to isolate the infected animal and thereby interrupt the contact of ticks on human skin, after which therapy is carried out with the above-mentioned anti-scabious drugs.

Prevention

Treatment of a patient with scabies should be complete, followed by monitoring every 10 days for 1.5 months. It is equally important to treat all persons who have sexual and close household contact with the sick person. To prevent re-infection and the spread of infection, proper disinfection of linen and household items is necessary. Disinfection of bed linen, underwear, and towels is carried out by boiling in a 1–2% soda solution or with any washing powder for 10 minutes from the moment of boiling. To treat outer clothing, hats, gloves, furniture, carpets, mattresses, pillows, shoes, toys and other items that the patient has come into contact with and that cannot be boiled, A-par, a preparation specially developed for this purpose, is used

in aerosol packaging.
One cylinder is enough to treat the belongings of 2-3 patients or 9 square meters. m of surface in the room. The product does not leave stains and does not require subsequent washing or cleaning of treated items and surfaces. Outerwear that is not subject to boiling is ironed with an iron with a steamer on both sides. Raincoats, coats, fur coats, leather and suede products are hung out in the open air for 5 days. Children's toys and shoes are placed in a plastic bag and excluded from use for a while (at least 7 days). The patient's room is wet cleaned daily with a 1–2% soda solution, paying special attention to door handles, chair armrests, etc. In the prevention of scabies and reduction of morbidity, sanitary education plays an important role. Literature:
1. T.V. Sokolova, R.F. Fedorovskaya, A.B. Lange. Scabies. – M., Medicine, 1989, 175 p.

2. Scabies. Methodological recommendations for doctors. – .M., 1992, 20 p.

3. T.V. Sokolova. Benign lymphoplasia of the skin due to scabies. Modern aspects of diagnosis, treatment and prevention of skin and sexually transmitted diseases. – Vladivostok, 1992, p.17.

4. Skin and venereal diseases: A guide for doctors, edited by Yu.K. Skripkin, V.N. Mordovtsev. – M., Medicine, 1999, pp. 426–436.

5. Kubanova A.A., Fedorov S.M., Timoshin G.G., Levin M.M. Spregal in the treatment of patients with scabies. – Magazine “In the World of Medicines”, 1999, 1, p.59.

Esdepaletrin + piperonyl butoxide –

Spregal (trade name)

(Laboratoires Pharmagiene–Scat)

Danger from scabies mite

The movement of the parasite under the skin, its excrement, saliva and eggs cause inflammation in the form of allergic rashes. Allergic reactions in those who are initially infected develop within 1.5 months, and in those who are re-infected - after a few days.

The main symptom of scabies is unbearable itching. It first appears in one place where the skin is tender and thin, and then affects the entire body. Small children are bothered by ticks on the scalp, face, feet, and palms. Another sign of the disease is a papulovesicular rash, pimples with red spots with clear liquid inside.

The disease spreads through contact - through contact with the skin (handshakes, games, sexual intercourse, use of other people's utensils, personal hygiene, etc.). Scabies can be contracted on trains and hotels. The disease does not go away on its own, it lives constantly, often subsiding, and then returning with renewed vigor.

Infection

The scabies mite lives outside the human body from 3 to 14 days. Life expectancy depends on climatic conditions. The higher the humidity, the more comfortable the parasite feels. Dies at a temperature of +21 degrees Celsius, with humidity from 40 to 80% after 36 hours. The itch lives on the human body for about a month.

Tick ​​infestation occurs in several ways - through contact with a sick person, his things, or an infected environment. The parasite is also active in the aquatic environment, so you can catch scabies by swimming in a pond with stagnant water.

Larvae of different ages and adults can be infectious. But more often the disease is transmitted through a fertilized female. During the day, parasites are inactive, so the likelihood of infection is reduced. At night, sexually mature individuals crawl out to mate, after which they crawl to different parts of the body. During the day, the female digs out a 3 mm long passage under the skin. In the process of life activity, a person’s itching intensifies.

On a note!

The incubation period for scabies is 14 days. During this time, first instar larvae appear, the parasitism of which becomes noticeable. However, due to the individual characteristics of the body, the disease proceeds unnoticed for a month. The question often arises, where does scabies come from, already at the time of the active development of the disease. Determining the location of infection is problematic.

The transmission features of itches are explained by their life cycle:

• itching is inactive during the day;
• in the evening and at night, adults mate, larvae of different ages intensify their activity in digging passages;
• It takes half an hour for the tick to penetrate the skin.

The parasite focuses on a person’s skin, personal belongings, clothing, bedding, and towels. Infection also occurs through them.

Symptoms of scabies

Prevention

To protect yourself from scabies infection, follow these simple rules:

• do not use other people’s underwear, clothes, towels, combs, toothbrushes, razors, washcloths;
• shower daily;
• change your underwear every day;
• change bed linen once a week;
• do not let dirty laundry sit, wash it in hot water above 60 degrees;
• iron all laundry after washing;
• cut your nails regularly;
• wash your hands before eating and after returning from the street;
• carry out wet cleaning once a week;
• be careful in baths, swimming pools, saunas, wear a hair cap there, use only your slippers.

If you touch something suspicious, quickly wash your hands with soap or use a disinfectant.

Precautionary measures

If you live with someone who has scabies, do the following:

• immediately send the patient to a dermatologist to prescribe treatment;
• treat your body for preventive purposes once;
• never use the patient’s personal belongings and clothing;
• treat all objects touched by the patient - telephone, pencils and pens, door handles, toilet flush float, faucet valves, furniture, mattresses, pets;
• wash all clothes and bedding in the house, iron things on both sides;
• Rinse and vacuum all surfaces and immediately discard the dust bag.

The sooner you start treating a patient, the more effective it will be. If you “start” scabies, then it will linger for a long time, reliably “eating” into all things, household items and household items.

Treatment

Currently, scabies is not a very serious disease. It only becomes like this when it is very neglected. Nevertheless, let's look at methods and treatment options.

Basic principles of treatment

The main goal of treatment is to destroy all ticks.

Therefore, it is very important to follow the following rules:

Treatment must be carried out in the evening or at night. Before treatment, you must take a shower and thoroughly wash your entire body with soap and a washcloth. Immediately after the shower, apply the medicine to the entire body (except the head). After drying, you can get dressed and go to bed.

It is important that clothes are clean and disinfected. To do this, you need to wash it at high temperature with powder or boil it in water and soda.

Do the same with bedding. After 12 hours, you can wash off the medicine, but it is better not to wash for 15-20 hours. After 4 days, repeat the procedure in order to get rid of new parasites emerging from the eggs.

Anti-scabies drugs

Anti-scabbing preparations can be of three types:

1. Ointments (the most common and effective).
2. Preparations in the form of an emulsion.
3. Spray.

The actions of all drugs have strong insecticidal activity. Simply put, they are aimed at destroying arthropod parasites. Also, all drugs have a strong antiseptic and anti-inflammatory effect.

It is also worth saying that many manufacturers claim that drugs can destroy not only young and adult individuals, but also their eggs. However, doctors strongly recommend repeating the treatment procedure after 4 days.

Ointments

Let's look at a few of the most popular ointments that are great for helping with scabies:

• Sulfuric ointment. The drug is made on an emulsion basis and is used exclusively for the treatment of scabies. It is one of the most popular and accessible. Its action is aimed directly at the causative agents of the disease - scabies mites.
• Medifox. It is also a popular remedy that contains the main active ingredient - permethrin: it has a strong ability to combat arthropod parasites in the human body;
• affects the nervous system of parasites, as well as the permeability of sodium channels in the body of parasites;
• leads to paralysis and death of ticks.

Traditional medicine methods

Traditional recipes against ticks:

• Lard and laundry soap. You need to take a tablespoon of melted lard, a quarter of melted laundry soap, a teaspoon of birch tar and two tablespoons of sulfur. Heat all this and mix. When you get a homogeneous mass, you need to spread it all over your body.
• Laundry soap. Another recipe with laundry soap. You need to grate it on a fine grater, add water and heat until it becomes a viscous mass (like glue), add finely chopped onion and a couple of cloves of garlic. Mix the resulting substance well and make a bar of soap from it. Wash with the resulting soap several times a day.
• Lavender oil. Probably the simplest and most accessible remedy. You need to apply lavender oil to your body and wait 15 minutes, then rinse it off. Repeat the procedure several times a day until complete recovery.

"Lindane"

Another fast-acting remedy is lindane one percent lotion. This substance can also be in the form of a powder, cream, shampoo or ointment. The uniqueness of the drug is that keeping it on the skin for six to twelve hours is enough to completely cure scabies. In addition, it has a fairly low cost. But its widespread use is impossible due to the identified negative properties.

Lindane is toxic, accumulates in fatty tissues and persists for two weeks, penetrates the white matter of the brain and can irreversibly damage a person’s mental activity, cause epilepsy and schizophrenia. In addition, some ticks are resistant to Lindane.

Complications

Everyone needs to know what scabies burrows look like in the photo, especially parents of small children. A child under 3 years of age with scabies can suffer severe complications in the form of purulent skin lesions (pyoderma) and an inflammatory syndrome that develops in response to the infection (sepsis). In advanced cases, these pathologies are fatal. By looking at photos of scabies mite passages and knowing what they look like, you can seek medical help in time.

For adults with normal immunity, scabies does not pose a threat to life or ability to work. The exception is advanced forms of the disease, when there is no treatment for a long time and complications arise in the heart and kidneys. This occurs due to bacterial infection of the scratched scabies, which causes the purulent disease pyoderma to develop. Inflammation can affect internal organs.

In half of the cases, this manifests itself externally in the form of boils and tissue suppuration. Because of this, the lymph nodes become enlarged and the blood vessels become inflamed. More rare are complications such as inflammation of the lungs and finger tissues.

More dangerous is Norwegian scabies, which is practically untreatable, leading to severe intoxication and affecting the patient’s cardiac activity.

Unfortunately, it is impossible to 100% insure yourself against scabies. Contrary to popular belief, its occurrence has nothing to do with human cleanliness, since mites are not susceptible to water and detergents. Therefore, at the first signs of scabies, you should consult a doctor and, if necessary, undergo treatment.

Historical data

Almost everyone has now seen photos of scabies, but this problem was first described in the 4th century BC. Mention of illness can be found in the Bible. Scabies was also described in the works of Aristotle. The ancient Greek philosopher identified it as a skin disease belonging to the “psora” group. In Rome, from ancient times to the present day, the disease is called “scabies”.

Already in the Middle Ages, it was hypothesized that scabies on the skin were caused by parasites. But evidence of this could only appear after the creation of an optical microscope. It was with his help that at the end of the 17th century, the Italian doctor Bonomo and the pharmacist Cestoni established the nature of the infection, and in the middle of the 20th century, a detailed description of scabies appeared in the manual of the Austrian doctor Hebra.

Epidemiology

Many people have worked to identify patterns in the occurrence and development of the disease. It was possible to establish with relative certainty only that 5% of cases of skin diseases are scabies. However, these data are valid for peacetime; during periods of war, scabies appeared in 30% of the population. This was due to a sharp deterioration in living conditions, food, hygiene, and the need for large numbers of people to live together. Such social phenomena are also typical for natural disasters or famines, which is why surges in morbidity rates are also observed during such periods.

Studying photographs of scabies mite passages taken at different periods of time, some researchers drew attention to the cyclical occurrence of the disease. So the theory was put forward that scabies appears in autumn and winter (during cold or dry seasons) every 7-30 years. Regarding periodicity, the theory does not stand up to criticism, and seasonality is explained by the biological activity of ticks, their increased fertility and better survival in the external environment in the cold. In addition, in the summer, sweat, which contains antimicrobial peptides, prevents ticks from infiltrating.