Itching is one of the common symptoms, with which patients turn to a dermatovenerologist. Often the cause of this is allergies. But do not forget about such a disease as scabies. It is important to immediately determine the cause of the itching. How to find out on primary stage? What questions should you ask the patient?

What is scabies?

There are direct and indirect routes of tick transmission. Direct is carried out at night in bed, when the tick is most active. Indirect path - through common objects and bedding. There is also a transient invasion, which can occur in saunas, trains, bathhouses, where streams of people use objects that were used by a patient with scabies.

The pathogenesis of the disease fully reflects life cycle mite, which is divided into 2 periods - short-term cutaneous and long-term intradermal phases.

The location of the passages in scabies depends on the density of the sweat glands, the type of hair growth, the temperature of the outer skin, the rate of regeneration of the stratum corneum and the structure of the skin. Thus, the passages are often localized on the hands, elbows, wrists and feet, where the thickness of the stratum corneum is greatest. There are also many passages in those areas of the skin where the density of sweat glands is increased (male genitals, wrists, hands, feet). That is why, when a patient has scabies combined with atopic dermatitis or vulgar ichthyosis, there are very few scabies. Also, due to dry skin, there are few of them in older people. But there will be many moves for hyperhidrosis, athlete's foot and dyshidrotic eczema.

But given the fact that modern people wash your hands several times a day with soap and water chemicals, a patient with scabies may not have these passages at all. Then diagnosis becomes difficult, because there is no main symptom, but the disease is there. The only symptom, which can help make a preliminary diagnosis - the time of onset of itching. This is the question that should be asked to the patient in order to carry out differential diagnosis with allergies. This is due to the daily activity of ticks.

Daily activity of scabies mites.

The female is in the daytime calm state. In the evening and at night, she gnaws through the egg knees, laying an egg in each. At the same time, the female deepens the very bottom of this passage, making possible the subsequent emergence of the larvae. This is done by every female and every night. One female leaves up to 2 eggs per night. As a result of this process, the scabies tract on the skin of a person with scabies has a convoluted shape and consists of parts of tracts, which are called the daily element of the tract.

Thus, the night activity of ticks explains the predominance straight path infection through the bed at night and in the evening, as well as the effectiveness of anti-scabies at night.

Clinical picture of scabies

If the infection occurs with larvae, the incubation period lasts 2 weeks. And if the infection occurred from a female, then the clinic is immediately visible. Itching is the main characteristic symptom of scabies. It occurs as a result of sensitization of the body to the end products of mite activity (excrement, secretions of the oviduct glands, oral secretions). Itching appears within 1-2 weeks during primary infection, and up to 3 weeks during re-infection.

Second characteristic feature scabies - the presence of scabies. The skin reacts to the appearance of these same moves. Non-inflammatory vesicles and follicular pustules also appear. An allergic reaction to the end products of mite metabolism also occurs, which manifests itself on the skin as bloody crusts, scratching and miliary papules. But we have found that each person’s skin reacts differently to tick activity. Some have no tracts at all (intact tracts), others have vesicles, blisters, pustules and lenticular papules, which are caused by reactive tracts. Now the similarity between allergies and scabies becomes clear.

Diagnostic symptoms for scabies:

1. Ardi's symptom is pustular crusts and pustules on and near the elbows.
2. Gorchakov's symptom - bloody crusts there.
3. Michaelis symptom - impetigious rashes and bloody crusts in the intergluteal fold with transition to the sacrum.
4. Sezari's symptom - upon palpation, an elevation is determined, which indicates the presence of scabies.

Scabies can be complicated by dermatitis and pyoderma. Sometimes - urticaria and microbial eczema.

When a person is infected with ticks from animals (dogs, pigs, horses, wolves, foxes, rabbits), pseudosarcoptosis develops. With this disease, the incubation period lasts several hours, and typical scabies burrows are absent, because mites do not reproduce in conditions unusual for it. They only penetrate the skin, causing severe itching. Pseudosarcoptosis is not transmitted from person to person.

Scabies in children occurs with possible defeat facial skin and scalp. In infants, even the nail plates can be affected.

Methods for detecting scabies

In our country, the diagnosis of scabies must be confirmed by laboratory tests. For this use:

• Oil vitropression method - the skin is lubricated with mineral oil, after which granulomas are visualized by pressing on the eruptive element.
• Method of painting a suspicious element 5% alcohol solution iodine, ink, ink or aniline dyes.
• Scraping method - detection of contents in the scabies tract, vesicles and papules;
• The method of removing a tick with a needle is after opening the blind end of the stroke. In this case, the sharp needles move in the direction of the stroke and the female is attached with suction cups to the manipulation needle.
• Dermoscopy must be performed on a patient with scabies.

Treatment and prevention of scabies

Scabies treatment is carried out in outpatient setting. The most effective and frequently used ointments for scabies are benzyl benzoate, medifox, spregal and sulfur ointment. But, regardless of the treatment chosen, there are general principles Treatment of patients with scabies:

Treatment of all patients in one focus is carried out simultaneously;

Rubbing in ointments should be done exclusively in the evening;

For children under 3 years of age, all areas of the skin should be rubbed, for others - with the exception of the scalp.

Scarbicides are rubbed in only with your hands, after which you need to wash your hands thoroughly;

The drug should be on the skin for at least 12 hours;

Treatment of complications should be carried out in parallel with the treatment of scabies;

Change of underwear and bed linen is carried out after completion of the treatment process.

Treatment of scabies in children

Children under 1 year old can only use Spregal ointment; from 1 to 3 years old - Spregal and Medifox. From 3 years - no restrictions.

The doctor must remember that when treating scabies, relapses cannot occur, since the mite does not have long, latent periods. And such “relapses” are the result of non-compliance with treatment regimens, an independent decrease in the concentration of the drug, failure to comply with the period and frequency of ointment application, as well as the use of the drug in the inactive phases of the tick cycle (during the day) and the use of stitched drugs. Possible reinfestation reinfection from the primary source of scabies if the latter has not received adequate treatment.

Prevention of scabies involves actively identifying patients during medical examinations and whenever seeking medical help.

Important to know preventive measures that will reduce the chances of getting scabies:

Use of personal hygiene products and bed linen;

Adhere to hygiene standards in saunas, swimming pools, baths;

Observe basic hygiene procedures.

It is not always possible to prevent a disease such as scabies, but by remembering the basic rules, you can significantly reduce the risk of infection. And most importantly, after reading this article, you will have no doubt at the initial stage of diagnosis whether it is an allergy or scabies.

Health to you and your patients!

Since in lately The number of allergies among the entire population of the planet is growing every day, many people are interested in: how to distinguish scabies from allergies? This is important because each of these pathologies has various reasons and as a result different consequences, which to one degree or another can have a detrimental effect on the human body. In order to understand these issues, you need to know the symptoms of each pathological process, as well as methods for their accurate diagnosis.

Outside their normal habitat, these insect representatives live no more than three days. Temperatures exceeding 65 degrees Celsius are fatal for them.

Scabies is transmitted by contact, as a result of close touching the skin of a sick person or his hygiene and household items.

It is worth remembering that if such symptoms are detected, you should consult a doctor as soon as possible, because the disease can gain epidemiological proportions.

Allergy is pathological process, which is formed as a result of repeated entry into the human body of a factor that is commonly called an allergen. It is a certain allergen that provokes the activation of the human protective immune system.

Most people who are susceptible to allergic attacks clearly know what object or substance can cause them. But it often happens that a person develops an allergy for the first time. In this case, consultation with various types of specialists is urgently needed.

Allergic reactions have certain symptoms and signs.

• the appearance of continuous sneezing in the patient;
• formation of itching in the mucous membranes of the mouth and nose;
• the appearance of a characteristic rash throughout the body;
• hyperemia skin;
• prolonged dry cough;
• the appearance of swelling of the mucous membranes of the patient’s body;
• education large quantities blisters;
• swelling and hyperemia of the eyelids.

If you detect any symptoms of an allergy, you must immediately contact a specialist, because allergic reactions can cause complications in the form of anaphylactic shock, which can lead to fatal outcome.

Scabies or allergies – how to tell the difference? It is worth noting that some of the symptoms of these pathologies actually have common features, so an inexperienced person can easily confuse them or not even know how one differs from the other. Few people know exactly how to distinguish allergies from scabies. But we must not forget that this is absolutely various diseases, which have their own specific characteristics and nuances, due to which they differ greatly.

It is very important to know these differences, because the choice of treatment tactics and human health depend on them!

The causative agent of the disease is the scabies mite. This is a small arachnid insect.

The size of female insects ranges from 0.2 to 0.4 mm, males are even smaller. They are not visible to the naked eye.

With scabies, the so-called “scabies tracts” can be seen on the patient’s body - a winding line from 1 mm to 2-3 cm long, but the most typical external manifestation disease - a rash in the form of tiny blisters.

When any of close circle or family members become infected with scabies mites, after a while the entire household will be affected. Allergies are considered non-communicable disease, which is not transmitted through bedding, general subjects, therefore, allergies should be treated individually, while for scabies, all family members must undergo a preventive course of treatment.

Presence of external signs

The scabies mite is capable of making paired passages in the skin, which can be easily noticed when you carefully examine the affected skin. If you have allergies similar signs are missing, paired passages cannot be detected.

The skin is covered with red rashes almost evenly, they focus on the buttocks, stomach, and cheeks.

The female of this mite has the peculiarity of laying its larvae under the skin of the patient. Over the course of two weeks, the young individuals will go through their immediate maturation cycle.

Males of this species die within a few minutes after mating with a female scabies mite.

Outside their normal habitat, these insect representatives live no more than three days. Temperatures exceeding 65 degrees Celsius are fatal for them.

Scabies is transmitted by contact, as a result of close touching the skin of a sick person or his hygiene and household items.

The main symptoms of this disease are:

It is worth remembering that if such symptoms are detected, you should consult a doctor as soon as possible, because the disease can gain epidemiological proportions.

Allergy is a pathological process that is formed as a result of repeated entry into the human body of a factor that is commonly called an allergen. It is a certain allergen that provokes the activation of the human protective immune system.

Associated symptoms

For both diseases outside the skin appears red, which causes itching and scabies

With both diseases, a red rash appears on the surface of the skin, which begins to itch and itch. The symptoms that appear have a number of distinctive qualities: itching with allergic reaction bothers regardless of the time of day, and with scabies it intensifies with the onset of night.

At this time of day, the female tick experiences a period of increased activity.

There you can see barely noticeable paired passages that the tick makes. In the case of itching caused by an allergic reaction, such passages are not visible.

The scabies rash is localized on the hands, elbows, under kneecap, on the thighs and buttocks, as well as in the nipple areas.

In children - on the surfaces of the feet, face, in some cases on the head, in the scalp. In newborn babies, scabies can look like an allergic reaction, urticaria - a huge number of blisters, itching, covered with a bloody crust.

With scabies mites there is no runny nose or watery eyes. This is a sign of an allergic reaction. Allergies involve a painful condition and general weakness, signs that do not occur when infected with scabies mites.

In some cases, a person who notices red spots on himself immediately begins to take antiallergic medications. In the case of allergies, these medications can help.

If the symptoms are associated with infection from a tick, the situation may worsen if treatment is not provided in a timely manner. Characteristic symptoms for an allergic reaction are:.

• swelling;
• continuous sneezing;
• cough;
• itching in the sinuses.

Allergy is a contagious disease. Its presence or absence is determined only by the specifics of the body and immune system, unlike scabies, which is contagious.

Ways of transmission of scabies:

• sexually;
• during handshakes;
• contact sports.

In a family where there is one sick person, infection spreads quickly. Soon, absolutely all family members will be amazed. In case of an allergic reaction, one sick person is treated, but in case of scabies mites, the whole family receives treatment.

Signs of scabies infection common to adults and children:

• Itching, which is especially disturbing in the evening and at night, mites are very active during these periods;
• The appearance of tick burrows, which appear as whitish lines raised above the skin. At the end of these lines you can see black dots, these are ticks.
• The appearance of a small rash in the form of small bubbles.
• Localization of tick burrows in armpits, between the fingers, on the elbows, buttocks.

The external manifestation of scabies in children has its own characteristics. This is due to the specific structure of the skin in babies. Unfortunately, infants can also suffer from this disease.

The trial itself is determined not so much by the actions of the tick, but by the products of its vital activity. A person does not feel how the tick makes passages in the skin, but at the same time severe allergies caused by waste products.

Here it is necessary to clarify that during the initial infection with a mite, itching appears only after a week, but with subsequent infection, allergies lead to severe itching almost within 24 hours. This suggests that the body does not have the opportunity to develop immunity to the scabies mite.

Diagnosis and treatment

Permethrin spray is one of the existing funds for treatment of scabies

It is not difficult to identify the cause of the symptoms; you need to contact a specialist. It's a good idea to do full diagnostics body.

A dermatologist examines the skin, scrapes the top layer of the epithelium and uses a microscope to identify the pathogen.

First of all, it is necessary to destroy the causative agents of the disease - scabies mites and their larvae. There are quite a lot of drugs that can neutralize their effects and destroy mites; they are mainly used in the form of ointments.

The most popular of them are permethrin, benzobelene zoate, sulfur ointment, spregal; crotamiton and lindane are used somewhat less frequently. Ointments need to be rubbed not only into the area of ​​the affected skin, but also into other areas of the skin.

Rubbing ointments into the skin of children under 3 years of age must be done both in the area of ​​the scalp and over the entire surface of the body. Older children do not need to disinfect the hair and face areas. In them, unlike infants, the face and hair area on the head are not affected by mites.

First of all, to get rid of scabies, sulfur ointment is used, which is rubbed all over the body. The course of treatment lasts 5 days, and the ointment is rubbed in once a day.

At the same time, while the course is ongoing, bedding and underwear may not be changed in order to prevent the mites from spreading. A sulfur-based ointment has a minus, this bad smell And possible allergy, especially when reapplying it.

Spregal is also used, which is presented in the form of an aerosol. It is sprayed over the entire surface of the body, with the exception of the head. 12 hours after applying the aerosol, you must take a shower and thoroughly wash the drug with soap from the surface of the skin. Bed and underwear can be changed.

Scabies mite

Reasons for the appearance of mites: unsanitary conditions, violation of hygiene standards, contact with an infected person (vigilance must be maintained even when there is only a suspicion of scabies).

Diabetes mellitus may be a predisposing factor.

Photos of symptoms

They appear 10–12 days after tick infection. This is a painful itching, especially at night in the areas of the extensor surface of the forearms, on the skin of the wrist and elbow joints, interdigital spaces and lateral surfaces of the body.

In children, the affected areas are located on the face, scalp, internal surfaces palms and feet. On the skin, scabies are visible to the naked eye in the form of thin winding strips up to 15 mm long with a vesicle at the end.

A rash forms on the skin in the area of ​​scabies in the form of red spots, crusts, papules, plaques and peeling. Intense itching causes scratching and excoriation, which contributes to the spread of infection, and also often leads to the attachment bacterial infection and in connection with this, the difficulty of diagnosing scabies.

Essential drugs

There are contraindications. Specialist consultation is required.

There are typical clinical symptoms scabies, which are characteristic of the main forms of manifestation of this disease, but there are also deviations from the standards that can be misleading and lead to infection of others, this especially often happens during self-diagnosis and self-medication.

Therefore, at the first symptoms described below, you need to contact a dermatologist to prevent infection of your immediate environment and beyond.

All clinical picture will depend on the degree of response of the immune system and on the degree of maturity of the infecting individual. If the infection is an adult female, then symptoms will appear within 24 hours; if it is a larva, then until its maturation is completed, and symptoms will appear by the end of 4 days on average.

1 — itchy skin, especially intensifying at night (this is due to the daily rhythm of the tick - it is active at night). 2 - whitish-grayish straight or curved lines 5-7 mm on the skin with papules or vesicles at the end of the course (like a polymorphic rash).

3 - point or linear excoriation (combing). 4 - purulent-bloody crusts.

5 - Typical places of rash: interdigital areas of the hands, abdomen (especially around the navel), on the buttocks, mammary glands - where the skin is thinner.

Skin lesions are a classic symptom of many diseases, including scabies and allergic dermatitis. When faced with it, patients do not always understand what kind of pathology they are talking about. we're talking about, due to which infection of surrounding people is likely and lack of effectiveness drug therapy antihistamines. How can you tell if a patient is worried about scabies or an allergy? Read more about the main signs in the article.

Causes of disease development

For differential diagnosis to be effective and correct, you must first familiarize yourself with basic concepts– definition of pathology and causal factors, causing its development. Let's start with allergies - that is hypersensitivity to foreign substances, usually coming from environment. These could be:

• medicines;
• food products;
• cosmetics;
• household dust;
• animal hair and excretions;
• chemicals;
• latex.

Allergies develop due to dysfunction of the immune system. Various factors act as provocateurs:

• genetic (complicated heredity);
• infectious (infection with viruses, bacteria, fungi, helminths);
• inflammatory ( chronic diseases digestive, respiratory system).

Dermatitis is called inflammatory lesion skin. It can be caused by triggers such as:

1. Solar radiation.
2. High or low temperature.
3. Plant juice.
4. Mechanical impact (pressure, friction).
5. Electric current.
6. Contact with chemicals.

There is a division of dermatitis into simple (from exposure to irritating substances) and allergic (occurs upon contact with compounds that cause the formation of individual immune sensitivity - sensitization). They are often characterized by an acute course - the onset of symptoms after contact with the provoking component. The difference is not always clearly visible or exists at all - it all depends on what underlies the pathogenesis (mechanism of development) of the disease - irritation or sensitization, that is, the involvement of the immune system.

Thus, skin damage in allergies is of immunopathological origin, and in scabies it is of infectious origin.

Characteristic symptoms

Tactics differential diagnosis based on comparison of objective clinical signs identified in the patient and expected in one form or another of pathology. To distinguish one disease from another, it is important to know what symptoms are characteristic of them.

Simple contact dermatitis

Develops after contact with aggressive environments: chemicals, plant sap, metals. In this case, a single episode of contact is sufficient for the appearance of symptoms. The following signs are observed:

• redness;
• swelling, itching;
• cracks;
• rash in the form of blisters or large cavitary elements;
• burning, soreness.

At chronic form disease changes are not as pronounced as with acute course, however they are joined additional signs. These are thickening and hyperpigmentation of the skin, numerous traces of scratching. The patient is bothered by constant itching.

Allergic contact dermatitis

Occurs if the human body is already sensitized to the irritant.

The first contact does not lead to the development of symptoms, but after 7–14 days, when the process is actively involved immune system, repeated contact causes a series pathological changes– such as:

• pronounced redness;
• swelling accompanied by itching;
• tingling, burning sensation;
• the appearance of bubbles and spots.

For any form contact dermatitis, whether allergic or simple type, symptoms appear within clearly defined boundaries of the area of ​​​​contact with the provoking substance. In case chronic course characterized by dry skin (up to the formation of cracks), areas of hyperpigmentation.

Atopic dermatitis

Disease caused by hereditary factors, the activation of which occurred under the influence of provocateurs from the environment (for example, infections). Often combined with allergic rhinitis And bronchial asthma. The following symptoms are characteristic:

1. Itchy skin.
2. Redness (erythema), swelling.
3. Bubbles, nodules, cracks.
4. Areas of weeping, crusting.
5. Dryness, peeling.
6. Compaction areas.

Atopic dermatitis is a form of allergy that most often begins in childhood. The skin of the scalp, face, lower limbs. In the future - the torso, the back of the neck, arms. Traces of scratching are clearly visible, patients are worried obsessive itching, painful dryness. The process is characterized by a chronic, recurrent (with episodes of exacerbation) course, possibly involving a secondary infection.

Scabies

The classic symptom of scabies is itchy skin, which sharply intensifies at night.

• rash in the form of nodules and vesicles, or vesicles (occurring in pairs);
• dirty gray lines in the shape of zigzags (from 0.3 to 1 cm long) – scabies tracts;
• scratching, bloody crusts.

A long-term process is characterized by the formation of pustular elements associated with the addition of an infection. Tick ​​burrows have several favorite locations:

• between the fingers;
• between the thighs;
• on the chest, buttocks, lower back, abdomen.

Women may notice passages on the nipples, men - on the external genitalia. In children, the tick also affects the soles, palms, and face.

Differential diagnosis

It is important to remember that a patient may have several forms of pathology at the same time; In addition, the addition of a secondary infection (bacterial, fungal nature) cannot be ruled out.

Additional diagnostic methods

A targeted search begins with interviewing the patient. This is how anamnesis data (information about the development of the disease) is obtained, which is important for further research into the nature of the disorders:

1. For scabies - the fact of contact with the patient.
2. Allergies are the presence of sensitivity to any foreign substances.
3. At simple dermatitis – sudden appearance symptoms upon first contact with the irritant.

Laboratory methods are also used:

If individual sensitivity is suspected, skin tests may be performed.

A prepared provocateur substance is applied to the forearm or back, and the reaction is monitored. The occurrence of itching, blistering, redness, swelling are positive criteria for diagnosing allergies. The method is not intended for use in acute period manifestations, is not informative when taking antihistamines and glucocorticosteroids. It is not used if there is a risk of anaphylactic shock.