SCABIES AND HOMEOPATHIC MANAGEMENT

                                                                       SCABIES

                Scabies is an itching dermatosis caused by a mite called “sarcoptes scabiei”. The common sites of infection are the webs of fingers, ulnar border of the wrists, axillae, lower abdomen and the buttocks.

AETIOLOGY OR CAUSES:-

-          It is one of the commonest skin diseases in India and accounts for 10 to 30 percent of the case in any skin out patient’s clinic.

-          The disease is highly contagious and spreads from person to person by close contact.

-          Unhygienic way of living is the predisposing factor.

-          The disease is, therefore, more common in poorer class of people especially those living in city slums or other dirty places.

-          The disease is more common during the winter months. Often all members of a family are affected.

SYMPTOMS:-

-          The common sites of infection are the webs of fingers, ulnar border of the wrists, axillae, lower abdomen and the buttocks.

-          When infection is first contracted, a female mite digs up a wavy tunnel (‘burrow’) inside it. The eggs hatch out and produce tiny mites that crawl up to the surface and burrow through fresh areas over the adjoining skin surface.

-          The basic lesion in scabies is a burrow, a zigzag tunnel 0.5 to 1 cm long in epidermis.

-          Red papular eruptions form at the top of the burrow and soon change into vesicles.

-          Itching is intense, worst during the night.

-          Scratch marks are seen with surrounding areas of redness.

-          Scratching often leads to secondary infection with pyogenic organisms resulting in impetigo or multiple boils at the affected sites.

-          Less commonly, especially in cases of long standing, eczematous dermatitis may develop or there may be lichenification of the affected part of the skin.

Diagnosis can usually be made by naked eye examination. The typical site of involvement, the burrow with papulovesicular eruptions at the top and intense itching especially during the night resulting in scratch marks around the lesions are features typical of scabies. The mites can be seen by an ahand lens as small white dots at the top of the burrows. Scrapings from the burrows may be examined under the microscope for the presence of sarcoptes scabiei.

TREATMENT:-

-          A local application of 25% benzyl benzoate emulsion is the treatment of choice.

-          The affected parts should be washed with soap and tepid water. The parts should be dried and gently scrapped with a fine brush (to open up the mouths of the burrows).

-          The emulsion should then be applied liberally all over the skin surface below the neck.

-          Sulphur ointment may be used but it is far less effective than benzyl benzoate emulsion.

-          Any secondary infection should be treated with a suitable antibiotic prior to the application of the scabicidal drug.

-          Avoid oily foods, fish, sour things and brinjal.

HOMEOPATHIC TREATMENT;-

1.       ARSENICUM ALBUM:-

Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Malignant pustules. Ulcers with offensive discharge. Urticaria, with burning and restlessness. Icy coldness of body.

2.       PSORINUM:-

  Dirty, dingy look of the skin. Dry, lustreless, rough hair. Intolerable itching. Herpetic eruptions,    especially on scalp and bends of joints with itching; worse, from warmth of bed. Sebaceous glands secrete excessively; oily skin. Indolent ulcers slow to heal. Eczema behind ears. Crusty eruptions all over. Pustules near finger-nails.

3.       SELENIUM:-

Dry, scaly eruption in palms, with itching, Itching about the ankles and folds of skin, between fingers. Hair falls out from brows, beard, and genitals. Itching about finger-joints and between fingers; in palms. Vesicular eruption between fingers. [Rhus; Anac.]. Seborrhoea oleosa; comedones with an oily surface of the skin; alopecia.

4.       SEPIA:-

Herpes circinatus in isolated spots. Itching; not relieved by scratching; worse in bends of elbows and knees. Chloasma; herpetic eruption on lips, about mouth and nose. Ringworm-like eruption every spring. Urticaria on going in open air; better in warm room. Sweat on feet, worse on toes; intolerable odor. Ichthyosis with offensive odor of skin.

5.       SULPHUR:-

Dry, scaly, unhealthy; every little injury suppurates. Itching, burning; worse scratching and washing. Pimply eruption, pustules, rhagades, hang-nails. Excoriation, especially in folds. [Lyc.]. Skin affections after local medication. Pruritus, especially from warmth, is evening, often recurs in spring-time, in damp weather.

6.       DUL CAMARA:-

Pruritus, always worse in cold, wet weather. Herpes zoster, pemphigus. Swelling and indurated glands from cold. Vesicular eruptions. Red spots, Urticaria, brought on by exposure, or sour stomach. Humid eruptions on face, genitals, hands, etc. Warts, large, smooth, on face and palmar surface of hands. Thick, brown-yellow crusts, bleeding when scratched.

7.       GRAPHITIS:-

Rough, hard, persistent dryness of portions of skin unaffected by eczema. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin; every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Cracks in nipples, mouth, between toes, anus. Phlegmonous erysipelas of face; burning and stinging pain.

Some of other drugs for scabies are clematis, hepar sulph, kreosotum, Lachesis, lycopodium, merc soul, natrum carb, acid phos, silicea, veratraum album and zinc met.