Saturday, February 19, 2011
Scabies (The Itch)
8:44 AM | 
Posted by
Arif Siregar
Etiology
Scabies is a contagious skin disease characterized by the main complaints itchy especially at night caused by the infestation and sensitization to the secretary and excreta small eight-legged mites (Sarcoptes scabiei), and obtained through close physical contact with others who suffer from this disease. All age groups can be affected. After copulation (mating), which occurs in the skin, adult male mites will die, but that has been fertilized female mites create new tunnels in the stratum corneum with a speed of 2-3 mm / day, lay eggs and die after 2-3 weeks. Female scabies mite burrows in the epidermis made, and laid its eggs in the abandoned burrows. Female mites lay eggs 3-5 eggs / day. After 3-4 days the eggs hatch into larvae, within 3-5 days into nymphs, then become adult mites. At first host (the host) is not aware of a tunnel excavation activity in the epidermis, but after 4-6 weeks of hypersensitivity reaction against mites or materials that release, and start the itching arises.
Clinical Overview
Skin disorders may be caused not only by the scabies mites, but also by patients themselves due to scratching. Patients complain of itching, which is typically felt at all at night. The lesions are typical and patognomonic form tunnels (canalicular) small, slightly elevated, winding canescent (if there is no secondary infection), length about 10 mm. The tunnel is mainly found on the sidelines of the fingers and feet, back legs, thighs, soles of the feet, palms, inner wrists, elbows, armpits, mammary region, the external genital area, the navel and lower abdomen, buttocks, neck and also the face (cheek). The rash is an allergic reaction to the mite body. Abnormalities may include papules, vesicles, urtika, excoriation (scratch marks), crusting and secondary infection arises when there are pustules lentikular which can obscure the primary lesion.
Diagnosis
Definitive diagnosis can only be determined by the discovery of mites or their eggs on microscopic examination. To do this, the tunnel must be found, and these usually need a little expertise. Look carefully, with good lighting, in the hands and feet. Magnifying glass may be a little help. If a tunnel or tunnels suspected to be identified, do it carefully scrapings of the skin by using the blunt edge of a scalpel. Results scrapings are placed on a glass microscope, given a few drops of potassium hydroxide 10%, cover with glass cover, then look under a microscope. The discovery of mites, eggs, or even just the shell of an egg, was able to confirm the diagnosis. Other techniques that can be used is with what is known as a technique 'winkle-picker'. When the vesicles at the end of the tunnel was opened with a needle, needle tip is moved carefully spun in these vesicles, so the mites can often be lifted at the end of the needle with a theatrical movement.
Differential Diagnosis
Pyoderma, Pediculosis corporis, Dermatitis, Prurigo, Folliculitis.
Clinical Overview
Skin disorders may be caused not only by the scabies mites, but also by patients themselves due to scratching. Patients complain of itching, which is typically felt at all at night. The lesions are typical and patognomonic form tunnels (canalicular) small, slightly elevated, winding canescent (if there is no secondary infection), length about 10 mm. The tunnel is mainly found on the sidelines of the fingers and feet, back legs, thighs, soles of the feet, palms, inner wrists, elbows, armpits, mammary region, the external genital area, the navel and lower abdomen, buttocks, neck and also the face (cheek). The rash is an allergic reaction to the mite body. Abnormalities may include papules, vesicles, urtika, excoriation (scratch marks), crusting and secondary infection arises when there are pustules lentikular which can obscure the primary lesion.
Diagnosis
Definitive diagnosis can only be determined by the discovery of mites or their eggs on microscopic examination. To do this, the tunnel must be found, and these usually need a little expertise. Look carefully, with good lighting, in the hands and feet. Magnifying glass may be a little help. If a tunnel or tunnels suspected to be identified, do it carefully scrapings of the skin by using the blunt edge of a scalpel. Results scrapings are placed on a glass microscope, given a few drops of potassium hydroxide 10%, cover with glass cover, then look under a microscope. The discovery of mites, eggs, or even just the shell of an egg, was able to confirm the diagnosis. Other techniques that can be used is with what is known as a technique 'winkle-picker'. When the vesicles at the end of the tunnel was opened with a needle, needle tip is moved carefully spun in these vesicles, so the mites can often be lifted at the end of the needle with a theatrical movement.
Differential Diagnosis
Pyoderma, Pediculosis corporis, Dermatitis, Prurigo, Folliculitis.
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