What is Norwegian mange?

Norwegian or crustous scabies is a severe form of scabies that can occur in immunocompromised individuals (with a weak immune system), the elderly, disabled or debilitated.

People with Norwegian scabies have thick crusts on the skin that contain a lot of mites and scabies eggs.
People with scabs are very contagious and can transmit the infection to other people, both through direct skin-to-skin contact and through contamination of items such as clothing, beds and furniture.
People with crusts may not show the usual signs and symptoms of scabies, such as the characteristic rash or itching.
People with Norwegian mange should receive prompt and aggressive medical treatment to cure and prevent mange outbreaks.


How soon after the infection does Scabies begin?

If a person has never had mange, symptoms can occur up to 4-6 weeks later.
It is important to remember that an infected person can transmit scabies during this period, although not the symptoms.
In a person who has had scabies the symptoms usually appear very early, about 1-4 days after exposure.


How are they transmitted to Scabies?

Transmission can occur by direct skin-to-skin contact.
Scabies parasites are very sensitive to the environment. They can live outside the body of the host only for 24-36 hours.
The transmission of the parasites involves close contact of two people by the type of skin.
It is possible to get scabies even sharing lentils that had mites the night before.
Sexual contact is the most common form of transmission among sexually active youngsters and scabies was considered by many to be a sexually transmitted disease .
However, other forms of physical contact, such as the embrace between mother and child, are enough to spread the mites.
Over time, even friends and relatives may contract scabies.
School activities generally do not involve prolonged physical contact necessary for the transmission of parasites.


Is it possible to get scabies from a dog or a cat?

Dogs and cats are infected by different types of mites, not the ones that infect humans.
Animals are not a source of human scabies.
Scabies in dogs is called scabies.
When canine or feline parasites reach human skin, they stop thriving and produce only an itch that goes untreated.
This disorder is different from human scabies that worsen if left untreated.


What are the risk factors for scabies?

Scabies can infect any human that comes in contact with mites. The only known risk factor is direct skin contact with someone who is infested with mites. Contact occurs among people who attend, while at school mite transmission is unlikely. Sexual contact or other close contact (such as a hug) is necessary for the spread of scabies.
The disease appears in groups, so we can check the epidemics within a given community.


Symptoms of Scabies

Who has mange, there is probably irritated skin with itching that worsens until the mites die.
Itching is usually the first symptom.
It often becomes apparent at night or after bathing and is sometimes confused with dry skin .
Itching is caused by an allergic reaction to the scabies mite.
Sometimes the itching is very intense, especially in young children and older adults.
Often irritated skin presents skin sores and rash.
These symptoms are the result of the tunnel excavated from the mite under the upper layers of the skin.
Sometimes we can see a small bubble or even mite that looks like a small black dot at the end of a tunnel.
Banding can be difficult to see after scratching the surface.
Newborns may only have red, inflamed skin, sometimes with small wounds that look like boils.

The areas most affected by the symptoms are:

  • Between the fingers and the wrist in the palm of the hand,
  • On the outer surface of the elbows and armpits,
  • Around the waist,
  • In the navel,
  • In the buttocks,
  • Around the nipples, in the bra and breast line,
  • On the genitals.

In infants and children, skin irritation and itching may also occur:

  • On the scalp, neck and face.
  • On the palms of the hands and soles of the feet.

Often the first symptom of a child is located in these areas.


Other problems

Skin wounds, called secondary lesions, may develop later in the course of the disease.
Skin disorders caused by infestation with Sarcoptes scabiei can be:

  • Scratches, sometimes covered by a crust. Scratching the strings of the scabies parasite can irritate and break the skin.
  • Red , dry, scaly, irritated skin spots .
  • Nodular scabies, these are small areas of brown or reddish and raised skin(nodules).

Nodules can develop in covered areas such as the armpit, groin, buttock, scrotum and penis.
Nodules cause itching and may persist for weeks or months after scabies have been corrected.
Children and the elderly are particularly at risk for these injuries because they can not be treated immediately.
Early symptoms in children and the elderly are more likely to be confused with another disease.
Note: The itching and rash of scabies is caused by an allergy ( reaction ) to the parasites (their saliva, feces or eggs).
Symptoms of scabies usually take 2-6 weeks to appear after the person has been infected.
The itching and rash can develop on any part of the skin, far from where the mites are actually.
That means we can be contagious (we can spread scabies) before knowing where it is.


How have infestation diagnosed by scabies been diagnosed?

The diagnosis of scabies infestation is usually based on the typical appearance, distribution of the itching and the presence of a tunnel.
Whenever possible, the diagnosis of scabies should be confirmed to identify the mite, mite eggs or their feces.
This can be done carefully by removing a mite from the end of the tunnel using the tip of a needle or scraping the skin to examine it under a microscope to look for mites, eggs or feces from the mite.
It is important to remember that a person can be infested even if no mites, eggs or feces are found.
Usually less than 10 to 15 mites can be found throughout the body of an infested person who otherwise is healthy. However, people with crust can be infested with thousands of mites and should be considered highly contagious.


Differential diagnosis

Other diseases are often confused with scabies. The scabies mite has some relationships with body lice, although the treatment of skin diseases is sometimes the same.
Scabies can be mistaken for bedbug bite.
Unlike scabies, bed bugs are visible to the naked eye and can live for long periods of time without feeding.
Ticks are fleas that feed on human blood, but unlike scabies, they get caught in contact with the vegetation and stay for only a few days.
More rarely, rashes and other skin diseases such as ringworm, herpes zoster , eczema , dermatitis , allergic reactions ( urticaria ) and impetigocan be confused with scabies.


How long can scabies mites live?

In one person, scabies mites can live up to 1-2 months.
Outside the person, scabies mites usually do not survive for more than 48 hours. The parasites die if they are exposed to a temperature of 60 ° C (122 ° F) for 10 minutes.


Treatment for scabies, medications and guidelines

Treatment for scabies involves the removal of mites with medications. There are various creams and lotions. Usually the rémédio is applied throughout the body, from the neck down and it stays for at least eight hours.
A second treatment is necessary if the eruption remains or new tunnels are found.
Since scabies spread so easily, your doctor may recommend treatment to all family members and even more intimate friends, even if they show no signs of scabies infestation.
Generally, the medications that are prescribed for scabies are:

Permethrin 5% (Permanone, Nedax®).
The doctor may recommend applying this cream because it contains chemicals that kill scabies mites and their eggs.
The cream should be applied twice, with about a week between each application.
Permethrin is generally considered safe for children and adults of all ages, including women who are pregnant or breastfeeding.

This medicine is also a chemical treatment, it is available as a cream, lotion and shampoo. This medicine is not safe for children under 2 years of age, pregnant women or nursing mothers and people with impaired immune systems.

This medicine is given once a day for two to five days. Your doctor may recommend that your child have scabies.
Although these medications kill the parasites readily, the itching may not go through completely for several weeks.
There are scientific studies that show the effectiveness of a 10% sulfur oil in Vaseline to spread in the affected areas.
It is a non-prescription medicine that can also be used in newborns and pregnant women.
Sometimes doctors prescribe oral ivermectin medication for people with compromised immune systems, for people who have the scab or for people who do not respond to treatment with lotions and creams.


How long does scabies last?

Two treatments are carried out for one-day duration, the second is one week after the first.
The itching may last for a while, even if the treatment eliminated the mites.
It is normal for the itching to pass after 2-3 weeks (and sometimes up to six weeks) after mite elimination.
In addition, even after the end of treatment, in some cases some brownish-red lumps with an itch (nodules) up to 2 cm in diameter remain.
If these remain, they occur more frequently in the genitals and underarms.
These nodules are infectious, but this does not mean that the mite is still present.
They occur in some cases, such as a prolonged skin reaction to the scabies mite.
If they come from lumps, they usually disappear within three months, rarely last up to a year.


How long can the individual infect others?

While there are mites or eggs on the skin we can infect another person.
To be sure, it is best to wait a few days after finishing treatment, but if the symptoms persist, it is best to ask the doctor if you feel it necessary to do other tests.


Natural Remedies for Scabies

The itching may persist for a while after the application of drugs to kill the mites.
Some natural therapies can help you to alleviate the symptoms.
Cooling and soaking the skin in cold water or applying a wet cloth to the irritated areas of the skin can reduce the itching.

Apply a soothing lotion.
Calamine lotion (available over the counter) can effectively relieve pain and itching by skin irritations.

Take antihistamines.
At your physician’s suggestion, you can relieve allergic symptoms caused by mange with over -the-counter antihistamines .


Prevention and prophylaxis

The infection mainly occurs through a handshake.
Since the mite survives 2/3 days away from human skin, it is easy to infect another person who sleeps in the same bed or uses the same towels.
You must wash clothes, bedding and towels in water at high temperatures (above 60 ° C) after each use.
To avoid infection of the family it is necessary to follow scrupulously hygiene standards throughout the house.

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