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Parasitogenic illnesses of skin

.. Danilova, professor S.M. Fedorov entral`nyy research kozhno-venerologicheskiy institute of Minzdrava Rf, moskva

parasitosiss of skin remain sufficiently aktual`noy problemoy in connection with their prevalence presently. Most chasto vstrechayuschimisya parasitogenic illnesses of skin are diseases, caused pliers.

By vermin organisms which feed after schet osobey of other kind and are constantly or temporally into an organism or on ego poverkhnosti are named [1]. An organism in which constantly or temporally a parasite dwells and after schet kotorogo he feeds is khozyainom.

Vermin are name not only the indicated organisms but also those which to the prinosyat vred owner. Depending on a habitat vermin in the organism of owner of ikh podrazdelyayut on endo- and ektoparazitov. Vermin can be permanent I vremennye. postoyannymi parazitami are living organisms which right through life the na vsekh stages of development dwell on a body or in the organism of owner and differently to exist ne mogut. vremennye vermin are on an owner only for eating and in osnovnom suschestvuyut out of owner. There are also pseudovermin, or lozhnoparazity, - svobodnozhivuschie forms which by chance get in an organism and temporally are in nem, pitayutsya for his account.

The distinctive feature of vermin is maksimal`naya prisposoblyaemost` them to the organism of owner and special terms of existence [1]. In processe evolyucionnykh changes for them the great number of adaptations developed to specificheskim usloviyam and special way of life (table. 1).

Definitivnym, or final, an organism is named, in which parazity prokhodyat all of life cycle of development from an egg, nymph, to the polovozreloy individual of I razmnozhayutsya sexual a way. Vermin for the owner are chuzherodnymi organizmami, pathogenic in connection with a secretion and egestion of different matters. At nalichii odnogo of permanent owner and passing of all of phases of development in him, nosotropic I immunologicheskie processes can be different intensity, similarly as well as vliyanie parazitov on the organism of owner. Insignificant influence on the organism of owner of vstrechaetsya dostatochno rarely, most often there are the expressed defeats with razvitiem zabolevaniy and complications [1].

Protective reactions of organism of owner:

1. Cellular:

inflammatory reaction;

hypertrophy cages;

proliferaciya of cages.

2. Tissue:

infiltration, was swollen, exsudate process, complication the second infection;

vascular reaction.

3. Gumoral`nye:

immune changes.

There are different methods of diagnostics parasitogenic defeats which include microscopic, macroscopic, patomorfologicheskoe, electronic-microscopic researches.

Parasitogenic illnesses of skin develop as a return reaction on vozdeystvie parazitov. The superficial select thus (surface of epidermis, vnutriepidermal`no) and deep (derma, hypodermic-fatty cellulose) parasitogenic dermatosiss.

By the most widespread diseases, caused parasitogenic porazheniem kozhnykh covers, are pediculosis, demodekoz and scab.

Pediculosis

There are a few types of exciters, causing a pediculosis for a man:

clothes (P. humanus vestimenti)

head (P. humanus capitis)

lobkovyy, or ploschica (Phthirus pubis).

Lice are bloodsucking insects of detachment Anoplura, there are parazitov mlekopitayuschikh and man. In nature there are to 150 types of lice which part on 3 families. Lice are strictly specific vermin which are characteristic dlya opredelennykh types of animals and man.The structure of organism, as well as at other parazitiruyuschikh nasekomykh, is adjusted to their way of life. A body has length from 1 to 5 mm, khitinovoy kutikuloy is covered, it is oblate in dorso-ventral`nom direction. In area of head dva vyrosta is determined are eyes and kolyusche-suctorial mouth vehicle. In a pectoral department there are three pair of lap s by the developed claws, which with a shin form a claw, tenaciously retaining nasekomoe na hair. Females are larger than males, unlike male have on an end divided krupnoe bryushko. Lice feed often, long without food can not be, drink from 0,7 to 1,2 ml krovi. A female during life puts aside to 300 eggs at the optimum temperature of 28-30s. Cycle development of individuals depends on a temperature condition and consists of next etapov: yayco, larvae (three transformations), imago (polovozrelaya individual) [2].

An embryonic period lasts from 4 days to 6 ned, larvae pass three stadii dlitel`nost`yu from 3 to 5 ned each, a polovozrelaya individual lives from 27 to 46 days. Yayca of oval`noy formy of yellow-whitish color, register to the hairs or hairs of fabric of sekretom kleevykh glands, to produced a female. A larva considerably differs from grown man osobi razmerami, by the structure of body, absence of sexual vehicle.Through 30 mines after vylupleniya lichinka begins to suck blood, and after the third molting grows into a grown man individual. Complete a life cycle from an egg to laying of eggs a female lasts 15 days [3].

Head pediculosis

Lice are on hairy part of head, most often I visochnye areas strike the back of head, the defeat of eyebrows and cilia is also possible. At presence of long volos process most expressed, in a greater degree it behaves to the women and children. Golovnye vshi are individuals of greyish-white color, the sizes of males arrive at 2-3 mm, samok are 2,4-4 mm. The testicles (nits) of white-yellow color are glued sizes 0,7-0,8 mm the samkami k bar of hair in the distance 2-3 mm from the mouth of follicle or at a root special khitinovym veschestvom, which is produced the special glands of females. Nits firmly to the prikrepleny k hairs and with large labour retire from the surface of hair. Every female puts aside v srednem to 8 eggs of oval form, fastening them one after other to the hair. Through 7 dney poyavlyayutsya there are young lice (nymphs), abandoning the empty shells of sero-belogo I zheltogo color in place of development. In 10 days a nymph can lay eggs independently. vshi ochen` podvizhny, to define them for patients difficultly enough [2].

Insects get from the infected man to healthy only at tesnom kontakte.

Clinical picture at a defeat the lice of predstavlena papulami, vezikulami, eritematoznymi pyatnami, which arise up on the places of bites of v svyazi with the irritation of skin covers the products of salivary glands. Dermatit, ekzematizaciya develops, ekskoriacii. Thus arise up inflammation, second pustulizaciya, ekssudaciya. The crusts of festering-hemorragic character, decorticating, appear with posleduyuschey likhenifikaciey and pigmentation of the staggered areas of skin covers. Zabolevanie soprovozhdaetsya by the expressed itch.

Pustules, exsudate changes, appearing crusts shrink on hairy chasti golovy, instrumental in clinging of hairs and formation of trichoma (trikhomy) [4]. Skleenye by an exsudate and pus of voylokopodobnye thick bunches of hairs of gryazno-serogo cveta imeyut unpleasant smell and instrumental in the irritation of skin. Impetiginoznye porazheniya develop, follikulity, furunculosis, dermatitis, eczema, complicated the second infection. Observed increase of regionarnykh zaushnykh, neck, back of head lymphatic uzlov, boleznennykh at pal`pacii. Skin defeats can spread on the area of lica, ushnye shell, neck area, back and other areas. A diagnosis is set pri nakhozhdenii nits and lice.

Pediculosis of clothes

A disease is caused the lice of whitish-grey, brownish color, razmerami prevoskhodyaschimi of head lice. Males have a size from 2,1 to 3,75 mm, females from 2,2 to 4,75 mm. Most the places of contiguity of folds and guy-sutures of clothes are often struck with kozhnymi pokrovami. Insects get to the healthy man at close domestic kontakte, poselyayutsya in folds clothes from which crawl over on skin covers [2]. Zarazhenie mozhet to happen at the use of dirty things, bed linen. Tipichnaya lokalizaciya is a lumbar, humeral, neck area, overhead part is backs, inguinal-thigh folds, stomach, cavities of arm-pits. Asocial`nye pacienty, plokho is struck observing a hygiene adults, sometimes children, and also there is high veroyatnost` zarazheniya at enhanceable congestion of people.

A clinical picture is determined the presence of vascular sinyushnykh spots of v mestakh bites, papular, urtikarnykh elements, kapillyaritov. U zarazhennykh of people is marked unendurable itch. Ecthymas, vtorichnye piogennye elements, follikulity, pustuly, appear also, a furunculosis develops. In place dlitel`no protekayuschego process at presence of permanent itch, ekskoriaciy appears utolschenie kozhnykh covers, likhenifikaciya with the yellow-brown changes of skin covers I posleduyuschey gipopigmentaciey or polychromia. In place of ekskoriaciy of vozmozhno razvitie of white cicatrical changes.

A disease the pediculosis of clothes is dangerously in connection with vozmozhnost`yu rasprostraneniya volynskoy likhoradki. A volynskaya fever (trench, ili pyatidnevnaya, fever) is caused rikketsiyami (R.quintana) , which razmnozhayutsya vnekletochno in the intestine of lice and selected with products them zhiznedeyatel`nosti, isprazhneniyami [2]. At squashing of insects or at embrocation of defecating of rikketsii popadayut on skin covers and further in blood through scratches, trauma skin pokrovy, raschesy.

Lobkovyy pediculosis (ftiriaz)

A disease develops in a lobkovoy area, area of crotch, moshonki, takzhe is possible defeat of eyebrows, cilia, beard, moustaches, cavities of arm-pits, redko volosistoy part of head. Sometimes ploschicy are in area of ear a shells, neck-by the back of head area, at the developed hair cover of lice it is possible to discover on vsemu telu.

Lobkovye lice are the littlest representatives of pediculosis of man. Vermin have the dirtily-yellow, grey-brownish colouring, sizes of male about 1 mm, females - 1,5 mm. An infection is possible at a close domestic contact (children are often struck), odnako osnovnoy reason of disease are sexual contacts. Ploschicy very much plotno prikreplyayutsya to the hair bar at his foundation or at the hair bulb of imeyuschimisya na front paws by kleshnevidnymi educations. A proboscis of ploschicy is in ust`e follikula, and tail part - at foundation of hair, and determined as a greyish point. Nits corporal color put aside at the mouth of hair and are also on hairs [2, 3]. Pri ukusakh of lice of clothes an itch is not so expressed, as at before described pedikulezakh, odnako takzhe appears reaction on the bites of vsvyazi with a hit in blood of saliva of insect by an I posleduyuschey reaction with blood as sinyushno-golubykh pyaten (m.coerulae). Pyatna ne disappear at pressing on, have a size from 5 to 15 mm. It is necessary to conduct the differential diagnosis of pri poyavlenii spots with a typhus roseola, sifilisom. On the skin of poyavlyayutsya papuly, vezikuly, at an intensive itch are ekskoriacii, decorticating, gemmoragicheskie crusts by an I oslozhnenie pyoderma. Pustuly can develop with impetiginizaciey, dermatitom, ekzemopodobnaya reaction.

Epidemic value of pediculosis

A pediculosis is a disease dangerous not only for infected man, but also can be instrumental in development of epidemics and pandemics. Higher upominalas` volynskaya fever, caused rikketsiyami and expandable lice of clothes.

Lice of family Pediculus are the source of infection of man of epidemicheskim sypnym tifom, reason of origin of which is rikketsiya of (Rickettsia prowaceki) . Lice feed on blood of sick man, in this connection rikketsii get in zheludok nasekomogo. In the epithelium of stomach there are favourable terms for reproduction of rikketsiy, kotorye damage and destroy an epithelium. Rikketsii here get in the road clearance of kishechnika i with excrements on a 5-9th day hatch on the surface of skin covers. Temperatura okruzhayuschey of environment and amount of exciter influence on life-span insects. Lice perish on a 3-31th day from the beginning of infection. There is not information, testifying the o transovarial`nom way of infection. To the salivary glands rikketsii does not get, ukusy vshey is not contagious therefore. However at a hit on the damaged skin covers and slizistye cheloveka products of vital functions of lice, their defecating exciters of rash tifa pronikayut in the organism of man. At squashing of lice of rikketsii in large kolichestve popadayut on the skin of people [2, 3]. An infection at inhalation of dust is possible, because rikketsii khorosho is saved in a dry place.

Typhinia caused spirokhetoy of ( Spirochaeta recurrens) , kotoraya gets with blood in the stomach of insect and quickly from him evacuated.However na 6-7-y day of spirokhety develop in great numbers and accumulate in polostnoy zhidkosti, in this connection an infection can take a place already on a 6th day after popadaniya nasekomogo on a patient, at squashing of him and embrocation of spirokhet in damaged kozhnye pokrovy, wounds, raschesy and dr. [2].

Treatment

For the leadthrough of the most effective therapy the ukorochenie hair of ili ikh sbrivanie. During the leadthrough of treatment of the staggered areas of skin of neobkhodimo izbavit`sya from nits by a comb-out or mechanical removing from hairs. Neobkhodima takzhe sanitization of lower and overhead clothes, bed linen. Protivopedikuleznye facili,, sul`fapiridazin sodium and other

Effective preparat Spregal`, containing solution of esdepaletrina i piperonyl of butoksida. At demodekoze and rose ugryakh of Spregal` vtirayut v porazhennye areas of skin by a tampon 1-3 times per a day. The clinical improvement of I vyzdorovleniya succeeds to be obtained in 70-87% cases. Spregal` well carried and not vyzyvaet ser`eznykh of side actions.

The prophylaxis of disease consists in the observance of obschegigienicheskikh rules of v bytu and in public places. The proper and adequate care is needed for a kozhey, polnocennoe feed, observance of the mode of rest. At the insignificant changes of kozhnykh pokrovov skin of person and periorbital`noy area the timely appeal of k dermatologu is needed.

Scab

Scab - most often meeting parasitosis of kozhi cheloveka, the exciter of which is a tick Sarcoptes scabiei.

A source of infection this disease is a sick man, here imeetsya pryamoy and indirect way of transmission of exciter. A direct infection is peredacha vozbuditelya diseases from a man to the man in the moment of contact. At indirect puti peredachi tick an infection takes a place through the articles of the general and personal use.

Vital the cycle of tick is presented two periods: genesial I metamorficheskim.

Genesial the cycle of tick following: egg, having oval a formu, otkladyvaetsya female in scabby motion in which larvae hatch after. Chesotochnyy khod can be saved to 1,5 meses and to serve as the source of infection. Metamorficheskiy period opre delyaetsya appearance of larva which through motion gets to skin covers and posle lin`ki grows into a protonymph, after in teleonimfu, which in the ochered` prevraschaetsya in a grown man individual in papulae, vezikulakh, on skin covers.

An itch-mite has a cherepakhoobraznuyu form, sizes of 0,35 kh 0,25 mm. Male of po razmeram is a considerably less female.

Female on a skin moves by two front pair of feet, on which imeyutsya prisoski. In the horny layer of skin a tick penetrates through jaws, end thorns of perednikh par feet. A female feeds on the grainy layer of epidermis, lays motions in horny sloe epidermisa. Laying in motions takes a place consistently in a row.

Incubation the period of disease makes from 8 to 12 days. Began a processa kharakterizuetsya itch which sharply increases in evening time.

An itch is caused motion of tick, most active in evening time. At etom kozhnye covers and nervous completions are irritated not only a tick, but to the produktami ego vital functions, by excrements, saliva and other [1-3].

The diagnostic criterion of raising of diagnosis is a presence of chesotochnykh khodov, papulae, vezikul. Most typical defeats as motions, serosal crusts, papul, vezikul appear in area of brushes, elbow joints, stomach, buttocks, molochnykh zhelezakh, thighs. Also there are the effaced forms scabs which result in oshibochnoy diagnostike and often considered as allergodermatoz.

Clinical a picture of scab is not only vysheopisannye vysypaniya, but appearance of erosions, gemmoragicheskikh crusts, ekskoriaciy, eritematozno-infil`trativnykh spots is possible. At complication of skin changes of vtorichnoy infekciey there are impetiginoznye elements, pustuly, festerings crusts. Oslozhneniem zabolevaniya is formation of postskabioznoy limfoplazii, as reaktivnoy giperplazii of limfoidnoy fabric.

Select the separate forms of scab: knot, scab for children, norvezhskuyu, psevdochesotku [3].

Diagnosis scabs set on the basis of clinical proyavleniy, epidemiologicheskikh of information, results of laboratory researches.

Treatment

Treatment of disease is conducted a few preparations: spregalem, 20% benzilbenzoatom, 20% or 33% by sulphuric ointment, medifoksom.

Spregal` (solution of esdepaletrina and piperonyl of butoksida) inflict in evening time on skin covers of patient from a neck area to the soles of I ostavlyayut on 12 ch. After application of preparation it is necessary to be carefully washed. Spregal` primenyaetsya in all of age-dependent groups and does not have contra-indications. At neobkhodimosti vozmozhno the repeated use of preparation in 10-12 days after a roughing-out.

The leadthrough of sanitization of things, clothes and apartments is needed.

Benzilbenzoat - 20% solution (emulsion, ointment) is inflicted on kozhnye pokrovy in 1-, 2-, 4th day, also with changing of linen, clothes, by treatment of apartment.

At the complicated scab needs the use of antihistaminic preparatov, naruzhno of protivovospalitel`nykh, antiseptic, steroidnykh ointments.

For treatments of linen, clothes, apartments the high-efficiency mean of a-par, kotoryy is used is combination of esdepaletrina and butoksida piperonyl the v aerozol`noy packing. Entering in the complement of preparation of esdepaletrin - piretroid, vozdeystvuet directly on the nervous system of insect. At connection from the lipidnym osnovaniem membranes of nervous cages of insects kationnaya conductivity is violated. Action piretroidov increases butoksidom piperonyl. A mean is high-efficiency pri lechenii of different types of pediculosis, scabs, at an infection the casual types of parazitov (by fleas, bedbugs).

Preparation inflicted on all of surfaces of clothes, to furniture and postel`nye prinadlezhnosti, with which a patient adjoined and which are not subject boiling of I obrabotke by other method.

Prophylactic measures include treatment of persons, being in the contact of s bol`nym, by antiscabby preparations, disinfection of things and postel`nykh prinadlezhnostey [8]. In an apartment the moist cleaning up or disinfection of rabotnikami ses is conducted in the day of exposure of patient and after completion of treatment. Medical control provoditsya v flow 1,5 meses [9].

Literature

1. Large medical encyclopaedia, 1978; 18: 1883 -9.

2. Large medical encyclopaedia, 1978; 4: 1434 -8.

3. Skripkin yu.K. Skin and venereal illnesses, guidance. M., Medicine, 1995; 456 -83.

4. Pavlov s.T. Skin and venereal illnesses, reference book. Medicine, 1969; 142 -3.

5. Zacepina n.D., Maychuk yu.F., Semenova g.Ya. Defeats of eyes at demodekoze. Methodical recommendations, Mcode., 1983; 3 -17.

6. Kurdina m.I., Potekaev n.N., Potekaev s.N. and soavt. Therapy of rozacea. Vestn. dermatol., Mcode., 1998; 16 -20.

7. Barnhorst D., Foster J., Chern K. The efficacy of topical metronidazole in the treatment of ocular rosacea. // Ophthalmology 1996; 103 (11): 1880 -3.

8. Skripkin yu.K., Fedorov s.M., Selisskiy g.D. // Vestn. dermatol., 1997; 22 -5.

9. Ponomarev b.A., Kulagin v.I., Selisskiy g.D., Novik d.K. the Basic problems ektoparazitarnoy infections // Vestn. dermatol., 2000; 1: 39 -40.

Appendixes to the article

  • Table 1. Adaptations of vermin to to to the terms of existence >>>



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