skin : scabies 4 pathogenesis


Pathogenesis
Skin disorder that occurs from scabies was not only due to mites, but also by patients themselves, which is due to do scratching.
Mites (Committee) to move into the top layer of skin by removing the protease enzyme that can be thinned stratum korneum. They live from damaged tissue rather than blood sucking. Skibala (feces) are left behind when he passed the epidermis, forming lesions clinically shaped tunnel liner. Skibala causes sensitization of the skin, causing itching complaints (Cordoro, 2008).
The incubation period varies skabies, there are a couple of weeks and even months - months without showing symptoms. Sensitization of the mites will take approximately 4 to 6 weeks after the first mite infestations. Infestations of this first hipersentivitas reaction type IV, which is a reaction to the mites, eggs or skibala of these mites (Maskur, 2000). At this moment arises that resembles the skin disorder dermatitis with the finding papul, vesicles, hives, etc., which can occur with erosion scratching, ekskoriasi, krusta, even a secondary infection (Rikyanto, 2001).
At the time of this onset, the patient can infect at least within one month before being diagnosed with skabies. This means that transmission can occur in anyone who had contact with patients.
Scabies mites can not fly or jump away, but they can travel with average speed - average 2.5 cm / min in the warm skin. At room temperature with sufficient humidity, mites can survive 36 to 48 hours and still have the ability to infect and make a tunnel lesions (Chodisow, 2006). Was at a temperature of 20o C, the mites become immobile, but still can survive for a longer time (Cordoro, 2008).
Scabies transmission can occur either directly or indirectly. Direct transmission is due to skin contact with the skin (skin to skin contact). Because it did, it can be classified in scabies sexually transmitted diseases. According Chodisow (2006), from studies ever of the risk factors scabies transmission through sexual intercourse, that people at high risk for infection scabies on people - people who often relate the same sex (homosexual) or who frequently change - change partners. But there is no evidence that can be transmitted scabies with HIV.
Indirect transmission usually occurs through objects - objects related to the patient as the bedding, clothes, towels, pillows, and so forth.

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