CAMAGÜEY. - The scabies is a contagious illness caused by the infestation of the skin, by the mite Sarcoptes scabiei, hominis variety that can appear in any stage of the life, in diverse social layers, although it is more frequent where it predominates over the overcrowding, and when the hygienic practices are scarce.

The above mentioned illness is considered to be an ecto-parasitosis, this means that it is a parasite that infects the human being and, in turn, it needs him to perform its vital cycle, as there are the nutrition, reproduction, or, it does not survive out of the human organism.

These considerations were offered by the Dr. Ailén Delgado Valdés, specialist of the First Grade of Dermatology and in General Integral Medicine (MGI), of the teaching surgical clinical hospital Amalia Simoni, of this city.

- I infer that it does not affect then the animals …

- There is a type of mange that affects the dogs or cats, which possibly can infect the human being who contacts these infected animals, but it lasts in the persons between two or three days and dies. In the individuals only survives the mentioned mite.

- Is the complaint exclusive of any geographical regions?

- Not. It appears on a global scale.

- Is there any statistical report of the suffering?

- It would never be exact. In a few cases they are not brought and in others they do not come to consultation, therefore the real number is always going to be top of affected. Nevertheless, we know that there is an increase of this ailment in the world and also in our country, because in accordance with international statistics a rise happens every eight or 10 years, and here the same thing is happening.

- Does it appear suddenly?

- Not, it has an incubation period of between four and six weeks. Since the person communicates with the patient, this is the time it delays for the symptoms to begin.

- Can this contact that you recount be of a moment?

- It must be direct and supported, for sharing garments, sleeping in the same bed and is considered to be, even, a sexually transmitted disease and there are bibliographies that inform of the mite in inanimate objects, as there can be the personal clothes, bed sheets, because they live approximately three days in these places, and also in these furniture upholstered with damask or velveteen.

- How are they observed in the skin?

- The cutaneous injuries are going to be caused by the female of the parasite. During the night it works a tunnel in the horny layer of the epidermis (the most superficial of the skin); in this tunnel she coitus with the male (which dies later), remains gravid, begins to deposit her eggs, which are about three per day and for the characteristics of the mite of presenting in its surface scales arranged in anterior-posterior sense, which prevents it from stepping back, therefore it advances in the rut without returning, there it deposits the eggs and the fecal dregs, and in the end it dies.

“Like the female mite works at night, the fact is that the affected person suffers more the itching in the night stage, or, the itch is more intense. The eggs emerge between four and six days and give place to other forms of the parasite, as: larvae, nymphs …, and an approximately a month later they will be ready to continue the coitus again, will deposit the eggs and to keep on reproducing in the epidermis. The clinic is revealed about one month after the infestation.

“The only specific injury is the rut or gallery where it penetrates in a linear trajectory of greyish color, for the presence of the eggs and fecal dregs, and in the end there stands out an injury of color darker that sometimes is raised over the level of the skin and can contain liquid and crusts in the surface where the female will be, and it is named as mite eminence and is where the parasite is”.

- What would be the most important symptom?

- The intense itching of night predominance for the heat of the bed and the movement of the mite female on having worked her tunnels, and something to be born in mind is that the intensity of the itch depends on the individual sensibility and not on the number of present mites.

“The affected person scratches like a defense mechanism and sometimes the fingernails take the parasite out, although sometimes this action goes so far as to damage because injuries appear excoriated and provoke dark scabs, the yellow pustules (pimples), and all this masks the rut and hence the difficult of the diagnosis sometimes.

“Another symptom is the high contagion observed in relatives or who live together with the affected one. Some of them depend on the guest because they have to do with the susceptibility of the patient, to a mechanism of reaction tied to a phenomenon of hypersensitivity that comprises the presence of papules, vesicles and lumps”.

- Do the injuries and the symptoms appear in any part of the body?

- Not. The typical distribution of the injuries is in the spaces between the fingers of the hands and the feet, in the internal face of the wrists, in the axillaris anterior creases, in the gluteus, lumbar, of the abdomen, especially in the per-umbilical regions (about the bellybutton) and the thighs.

- Does it stand out equally in men and women, and ages?

- In women we check concerning the areola and the external genitals of the man. In the adults it stands out in the head, the face, the palm of the hands and the plant of the feet.

“The small children, like the persons younger than one year, the whole body can be affected, in the same parts of the adults and we add the head, the face, the palms of the hands and the plant of the feet".

- Is there only a type of scabies?

- We refer to the habitual one; nevertheless, there are 14 clinical ways of presenting the illness.

- Are frequent complications?

- We have the over-added infections to the injuries, eczematization - medical term to define the eczematous transformation that supervenes often during certain dermatosis - and others that would be rarer.

- We never talk about the medicines to be used so that they are faced only by the doctor in situ, more if there was some advice that served in a general way if we mention it, in this case: do you suggest anyone?

- It turns out to be vital to follow the medical orientations, to be disciplined. The first thing is to continue exactly the suitable hygienic habits. Not to suspend the use of the soap, only to evade it if the injuries were indicating another affectation identified by the specialist, and not to use the very warm water at the time of the bath, this sometimes is prevaricated and a major annoyance of the skin takes place, there is that disinfect the clothes of dressing and of bed, which must be boiled and be ironed, and although they dry off to the sun, to stop neither boiling them nor ironing them. The treatment is indicated to all the persons of the house although they should recount not to have any symptom, since there are even bearers of the illness without symptoms.

“When the medicine is oriented for a few days, to rest and to repeat is because we have motives and it is necessary to follow this cycle, and it turns out to be important to know that the itch can disappear up to past one month after being cured. And if the patient does not recover it is because it trumps some of the medical indications”.

- Does the patient always have to come to the dermatologist?

- Not, our doctors are prepared to diagnose the scabies in the Primary Health Care of Health (APS), of course, if they come to us we attend to them.

Translated by Linet Acuña Quilez