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Bullous scabies (BS) is a rare atypical clinical variant of scabies and is easily confused with bullous disorders. The diagnosis of BS is always a challenge, and physicians often misdiagnose BS patients. Patients with BS admitted from 2012 to 2020 were enrolled in this study. The clinical, dermoscopic, and pathological characteristics of the patients were analyzed retrospectively. Ten patients with BS were enrolled in this study. Seven of the 10 patients were male. The bullae were most commonly found on the thighs and arms (80% of patients). Only 30% of patients (3/10) tested positive for mites and/or eggs by the initial skin scraping, but 100% (5/5) of the patients who received dermoscopy tested positive. Among these 10 patients, only five received a skin biopsy. Subepidermal (4/5) and intraepidermal (1/5) bullae with eosinophil and neutrophil infiltration were observed in five patients. Direct immunofluorescence (DIF) indicated linear deposition of IgG in the basement membrane zone in three patients. Physicians should consider the possibility of BS in patients with blisters, pruritus, and poor response to corticosteroids. Dermoscopy should be prioritized for the differential diagnosis of BS to exclude other bullous disorders. Finally, a biopsy should be performed on each patient with bullae.

Competing Interests: Competing interests: None declared.

Nearly half of all infections are missed when first examined. Attentiveness to specific details, particularly in 3 common scenarios, can help ensure an accurate Dx.

Crusted scabies is a rare and severe form of infestation by Sarcoptes scabies var. hominis. It is characterized by profuse hyperkeratosis containing over 4000 mites per gram of skin, with treatment being long and difficult. The condition is both direct and indirectly contagious. It has a central role in epidemic cycles of scabies, the incidence of which is on the rise in economically stable countries. Recent discoveries concerning the biology of mites, the pathophysiology of hyperkeratosis and the key role of IL-17 in this severe form open up new therapeutic perspectives., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Parasitism has both direct and indirect effects on hosts. Indirect effects (such as behavioural changes) may be common, although are often poorly described. This study examined sarcoptic mange (caused by the mite Sarcoptes scabiei) in the common wombat (Vombatus ursinus), a species that shows severe symptoms of infection and often causes mortality. Wombats showed alterations to above ground behaviours associated with mange. Infected wombats were shown to be active outside of the burrow for longer than healthy individuals. Additionally, they spent more time scratching and drinking, and less time walking as a proportion of time spent above ground when compared with healthy individuals. They did not spend a higher proportion of time feeding, but did have a slower feeding rate and were in poorer body condition. Thermal images showed that wombats with mange lost considerably more heat to the environment due to a diminished insulation layer. Infection status did not have an effect on burrow emergence time, although this was strongly dependent on maximum daily temperature. This study, through the most detailed behavioural observations of wombats to date, contributes to a broader understanding of how mange affects wombat health and abundance, and also to our understanding of the evolution of host responses to this parasite. Despite being globally dispersed and impacting over 100 species with diverse intrinsic host traits, the effects of mange on hosts are relatively poorly understood, and it is possible that similar effects of this disease are conserved in other host species. The indirect effects that we observed may extend to other pathogen types.

The present study aimed to examine the status of antioxidant systems of the pigs naturally suffering from sarcoptic mange. Fifty nine pigs were divided into three groups, healthy control (group I, n=15), subclinical sarcoptic mange (group II, n=22) and clinical sarcoptic mange (group III, n=22). To assess the status of antioxidant systems; lipid peroxides (LPO), reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx), ascorbic acid, zinc and copper concentrations in the blood samples as well as LPO, SOD, CAT and glutathione-s-transferase (GST) activities in the skin were measured. The GSH, SOD, GPx, ascorbic acid, zinc, copper concentrations in blood were significantly lower in the pigs suffering from clinical and subclinical sarcoptic mange, when compared with the healthy control. However, LPO content of these infested pigs was significantly higher. The CAT, SOD and GST activities in the skin of the diseased pigs were significantly lower, whereas LPO was significantly higher as compared to the healthy control. From the present study, it may be concluded that sarcoptic mange bestows remarkable alterations in the oxidative stress markers and imposes compromisation of the antioxidant status of the infested pigs., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Scabies is caused by infestation with a parasitic mite Sarcoptes scabiei var hominis. The itch and rash appear to be largely the result of a delayed (type IV) allergic reaction to the mite, its eggs and excreta. Scabies is spread by a mite transferring to the skin surface of an unaffected person, usually by skin to skin contact with an infested person, but occasionally via contaminated bed linen, clothes or towels. In crusted scabies, mites are also dispersed within shed scales, enabling the condition to be contracted from contaminated surfaces. Patients with classical scabies usually present with an itchy non-specific rash. Often, the history alone can be 0032-6518 virtually diagnostic. An intense itch, affecting all body regions except the head, typically worse at night, appearing to be out of proportion to the physical evidence, with a close contact also itching, should prompt serious consideration of scabies. The generalised hypersensitivity rash consists of erythematous macules and papules with excoriation. Close inspection will reveal burrows usually up to 1 cm in length. The pathognomic sign of scabies is the presence of burrows. The crusted variant of scabies may not be itchy. It is characterised by areas of dry, scaly, hyperkeratotic and crusted skin, particularly on the extremities. Referral to secondary care should be considered in the following cases: diagnostic doubt; patient under two months of age; lack of response to two ourses of different insecticides; crusted scabies; or history suggests a isk of sexually transmitted infection. Outbreaks of scabies in institutions should be referred to the local health protection services.

Frequent outbreaks of Sarcoptes scabiei infestation in raccoon dogs (Nyctereutes procyonoides) have been reported in Japan. Although many raccoon dogs are brought to Kanazawa Zoological Garden (Yokohama, Kanagawa, Japan) because of S. scabiei infestation and debilitation, some of them die of asthenia. The clinical status of severely debilitated raccoon dogs must be determined to save their lives. In this study, we compared hematological and serum biochemical values between severely debilitated and nondebilitated raccoon dogs infested with S. scabiei. The total protein, albumin, glucose, and calcium values of debilitated raccoon dogs were significantly lower than those of nondebilitated raccoon dogs. On the other hand, debilitated raccoon dogs had significantly higher aspartate aminotransferase, total bilirubin, blood urea nitrogen, sodium, chloride, and phosphorus values than did nondebilitated raccoon dogs. The increase in the blood urea nitrogen value was particularly dramatic. The present study revealed that debilitated raccoon dogs infested with S. scabiei exhibited abnormal hematological values compared with nondebilitated raccoon dogs infested with S. scabiei. Clinically, the raccoon dogs developed malnutrition and sepsis if the mange infestation was untreated. Moreover, dehydration associated with appetite loss may have resulted in insufficient renal perfusion. These findings suggest that chronic S. scabiei infestations debilitated the raccoon dogs and resulted in physiological changes that were detected with hematological and serum biochemical tests., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

The objective of the present study was to investigate the hemato-biochemical changes and status of oxidative stress in goats with scabies infection. The study was conducted on 12 Jamunapari goats; six clinically infected with scabies (group I) and six healthy goats as control (group II). The examination of skin scraping revealed the presence of Sarcoptes scabiei in the infected group. In hemato-biochemical indicators, hemoglobin%, packed cell volume, total erythrocyte count, albumin and albumin: globulin ratio decreased whereas, globulin, alanine aminotransferase, bilirubin, creatinine, and blood urea nitrogen increased significantly (p<0.05) in group I animals as compared to group II healthy goats. Among the oxidative stress indices, plasma nitrate and erythrocytic lipid peroxidation were increased and reduced glutathione levels decreased significantly (p<0.05) in group I goats as compared to group II healthy goats. The results of the present study suggest that scabies infection alters the hemato-biochemical indicators, increases oxidative stress and decreases antioxidant status in goat.

Pruritus is synonymous with itching. Many medical conditions are complicated by chronic pruritus compromising the patient's quality of life. The majority of pruritic stimuli are transmitted through C fibers into the lateral spinothalamic tract and then into the somatic sensory cortex where the itching is detected. Histamine, substance P, and tumor necrosis factor a play significant roles in the perception of pruritus. Medical conditions in adults with significant pruritus will be defined in this review.

Scabies has been a scourge among human beings for thousands of years. Its worldwide occurrence with epidemics during war, famine, and overcrowding is responsible for an estimated 300 million people currently infested. Scabies refers to the various skin lesions produced by female mites, and their eggs and scybala that are deposited in the epidermis, leading to delayed-type hypersensitivity reaction. Recent immunological findings such as cross-reactivity with house dust mite allergens and an altered T-helper-1/T-helper-2 pattern contribute to a better understanding of the pathomechanism. Furthermore, progress in molecular biology and cloning of relevant antigens could enable the development of a diagnostic ELISA system and candidate vaccines in the near future. Typical and atypical clinical presentations with pruritus as a hallmark of scabies occur in young, pregnant, immunocompromised, and elderly patients and include bullous and crusted (Norwegian) manifestations as well as those masked by steroid use (scabies incognito). This article reviews scabies management strategies in developed countries and resource-poor communities as well as typical complications, including the emergence of resistance and drug-related adverse events. Other problems such as post-scabies eczema and reinfestation, and newer treatments such as ivermectin are also discussed.

Problem: Most nursing homes are aware of the pandemonium an outbreak of scabies can cause-the laundry alone occupies staff for days. Debilitated residents and those who have poor selfcare skills require considerable help with the activities associated with the eradication of Sarcoptes scabiei. How can a consultant pharmacist help?, Solution: Consultant pharmacists should cultivate a "high index of suspicion" for scabies. Scabies mites live their entire lives on the human host as obligate parasites. They are able to survive elsewhere for only up to 48 hours, making transmission via fomite (blankets, towels, or any object that can transmit infectious agents) possible, but unlikely. Transmission follows close personal contact, and passing contact like handshaking is insufficient to pass the mites. Crowded living conditions, such as those associated with emergency shelters, and close and repeated contact, like that which occurs in classrooms, fuel cluster outbreaks.

Scabies is a neglected parasitic disease that is a major public health problem in many resource-poor regions. It causes substantial morbidity from secondary infections and post-infective complications such as acute post-streptococcal glomerulonephritis. Disease control requires treatment of the affected individual and all people they have been in contact with, but is often hampered by inappropriate or delayed diagnosis, poor treatment compliance, and improper use of topical compounds such as permethrin, lindane, or benzyl benzoate. In addition to concerns over toxicity with such compounds, parasite resistance seems to be increasing. Oral ivermectin is an alternative that has been used successfully in community control programmes. Plant derivatives such as turmeric, neem, and tea tree oil are also promising future treatments. The disease is strongly associated with poverty and overcrowding, and the associated stigma can ostracise affected individuals. Treatment of scabies in poor countries needs to integrate drug treatment programmes with efforts to improve the socioeconomic conditions and education programmes to reduce stigma. We expect the future to bring more sensitive and specific clinical and laboratory-based diagnostic methods, as well as new therapeutic strategies.

Elderly individuals have an increased susceptibility to skin infections due to age-related anatomical, physiological and environmental factors. The types of organisms that cause primary skin and soft tissue infections are diverse, and include bacterial, viral and fungal pathogens as well as parasites. In the elderly, these infections and infestations may present with atypical signs and symptoms or may complicate underlying chronic skin disorders. Clinical features, investigations and management of the following important and common skin infections are described in more detail: cellulitis, erysipelas, necrotizing fasciitis, impetigo, folliculitis, furunculosis and carbunculosis, erythrasma, herpes zoster and postherpetic neuralgia, herpes simplex, warts, molluscum contagiosum, dermatophytosis of the skin, hair and nails, candidiasis, and scabies. Treatment should be based on the results of the appropriate diagnostic tests. Correct diagnosis and therapy of skin infections lead to satisfactory outcome in the majority of elderly patients.

Ivermectin, an anti-parasitic agent widely used for onchocerciasis in humans, is emerging as an oral antiscabietic that is as safe and effective as the topical antiscabietics. In the recent reports, all groups of population responded to ivermectin in the treatment of scabies, including immunocompetent, immunocompromised, and other high-risk populations such as individuals with Down's syndrome. This report reviews the efficacy, the mechanism of action, and the safety profile of ivermectin in the treatment of scabies, particularly its utility in crusted scabies and outbreaks of scabies in institutional settings.

A randomised block design study was conducted to evaluate the effects of mange on cattle. Twenty-four Simmentaler Fleckvieh bulls were formed into eight replicates of three bulls based on Day -56 body weight (288-414 kg). Within replicates bulls were randomly allocated to groups G1: uninfested control, G2: infested control or G3: infested, treated with 0.2mg ivermectin/kg (1% ivermectin injection; IVOMEC, Merial) on Day 0. The G2 and G3 bulls were infested with Sarcoptes/Chorioptes mites on Days -56 and -49. Feed consumption was recorded daily throughout the study (Days -56 to 56). Body weights were measured and serum samples collected. Mites were counted at bi-weekly intervals from Day -14 on. The carcasses of the bulls and the leather produced from their hides were evaluated. Differences between variables were declared significant if P

Common skin and soft tissue infections in nursing home patients include herpes zoster, cellulitis, pressure ulcer infections, and scables. Treatment of shingles with an oral antiviral should be started within 24 hours of symptom onset. Dissemination and bacterial superinfection require antibiotic therapy. Use of corticosteroids to prevent post-herpetic neuralgia remains controversial. Cellulitis is most often caused by Staphylococcus aureus and beta-hemolytic streptococci (groups A and B). Therapy for cellulitis is empiric; gram-negative bacilli should be covered in diabetic patients. Most pressure ulcers never become infected; for those that do, empiric therapy should cover S aureus, gram-negative bacilli, and anaerobes. Topical treatment of scables with 5% permethrin cream or 1% lindane lotion is recommended.

In each of two experiments, the reproductive performance of ewes naturally infested with sarcoptic mange and of uninfested ewes was assessed in in-season natural breeding conditions (experiment I) or in out-of-season controlled breeding conditions (experiment II). A statistically significant difference was observed in the total lambs born per ewe (infested ewes, 1.2; controls, 1.6), in the liveborn lambs per ewe (infested ewes, 1.2; controls, 1.5) and in the lamb body weight per ewe (infested ewes, 3.33kg; controls, 4.53kg) under natural breeding conditions, as well as in the lamb body weight per ewe (infested ewes, 3.37kg; controls, 4.14kg) among ewes under controlled breeding conditions. No adverse effects were observed in the other reproductive indices, cycling rate, mating rate, return-to-oestrus rate, abortion rate, lambing rate and stillbirth rate. Sarcoptic mange was observed in the offspring of infested ewes after 30 days and in the offspring of uninfested controls 60 days after their birth.

To evaluate the prophylactic and therapeutic effects of an ivermectin controlled-release capsule (IVM-CRC) on the productivity of growing sheep infested with Psoroptes ovis 24 male and 24 female Merino landrace lambs, 5-6 months old and weighing 21.2-35.0 kg, were used. Sixteen replicates of three animals were formed based on sex and Day 0 body weight. Within each replicate animals were randomly allocated to one of three groups: untreated control; IVM-CRC on Day 0; IVM-CRC on Day 84. For treatment an IVM-CRC for sheep weighing 20-45 kg was used which is designed to deliver ivermectin at a minimum dose of 20 microg/kg/day for 100 days. The lambs were infested with 50-60 P. ovis mites each on days 14 and 21. The animals were shorn on Day 126. After slaughter on Day 127 the quality of the leather produced from their skins was evaluated. The IVM-CRC treatment on Day 0 prevented the establishment of P. ovis. All untreated lambs became infested. The lambs treated with an IVM-CRC on Day 84 became mite-free from Day 112 onwards. The lambs which were treated on Day 0 had significantly (p<0.05) greater clean fleece weight (1.5 kg) and fleece yield (52.1%) than the untreated controls (0.9 kg and 34.1%, respectively) or than lambs treated on Day 84 (1.0 kg and 47.8%, respectively). Clean fleece weight and fleece yield were in the tendency (p=0.055) or significantly (p<0. 001) greater, respectively, for lambs treated on Day 84 than for the untreated controls. The chrome tanned dried crust leather of all untreated controls and six of the 16 lambs treated on Day 84 showed grain surface defects such as discolourations, indurations and coarse, pitted grain. The useful (defect-free) leather size was significantly (p<0.01) higher for the lambs treated on Day 0 (100%) than for the lambs treated on Day 84 (82.7%) and the untreated controls (7.8%). The physical testing revealed that the leather of sheep treated on Day 0 had significantly (p<0.05) higher thickness, elongation break and tear resistance than the leather of both untreated controls and sheep treated on Day 84. There were no significant differences in the physical characteristics of the leather of the untreated controls and the sheep treated on Day 84.

To evaluate the prophylactic and therapeutic effects of an ivermectin controlled-release capsule (IVM-CRC) on the productivity of growing sheep infested with Psoroptes ovis 24 male and 24 female Merino landrace lambs, 5-6 months old and weighing 21.2-35.0 kg, were used. Sixteen replicates of three animals were formed based on sex and Day 0 body weight. Within each replicate animals were randomly allocated to one of three groups: untreated control; IVM-CRC on Day 0; IVM-CRC on Day 84. For treatment an IVM-CRC for sheep weighing 20-45 kg was used which is designed to deliver ivermectin at a minimum dose of 20 microg/kg per day for 100 days. The lambs were infested with 50-60 P. ovis mites each on Days 14 and 21. Mites in skin scrapings were counted on Days 70, 84, 98, 112 and 126. Body weight and feed consumption were measured every 2 weeks from Day 0 to 126. The animals were slaughtered on Day 127 and their carcasses evaluated. The IVM-CRC treatment on Day 0 prevented the establishment of P. ovis. All untreated lambs became infested. The lambs treated with an IVM-CRC on Day 84 became mite-free from Day 112 onwards. The lambs treated on Day 0 had significantly (p<0.05) greater body weight gain from Day 0 to 84 (13.9 kg) and Day 0 to 126 (20.9 kg) than the untreated controls (9.6 and 12.8 kg, respectively) and the sheep treated on Day 84 (8.4 and 14.9 kg, respectively). Feed consumption (Days 0-126) for sheep treated with the IVM-CRC on Day 0 was higher than for sheep treated on Day 84 (p<0.05) and for the untreated controls (p<0.1). The carcasses of sheep treated with the IVM-CRC on Day 0 had significantly (p<0.05) higher warm and cold weights, carcass yield, rib eye area and back fat thickness than the untreated control group and the sheep treated with the IVM-CRC on Day 84. The sheep treated with the ivermectin CRC on either Day 0 or 84 had significantly (p<0.05) better muscle scores and lower muscle pH 1h post-slaughter than the untreated controls. There was no significant (p>0.1) difference between warm and cold carcass weights, carcass yield and rib eye area between sheep treated on Day 84 and untreated controls.

Reports on the effects of mange on the production performance of pigs are conflicting. So far, studies have used experimental infections, by depositing encrusted lesions from chronically infected pigs into the ears of experimental pigs. However, this is a poor representation of what happens under natural field conditions. The purpose of our study was to quantify the effects of sarcoptic mange on production performance and pruritus in pigs that were infected by contact with S. scabiei var. suis-infected pigs. A total of 80 piglets were matched by sex and weight and randomly divided between experimental and control compartments. In the experimental compartment, each of three naturally S. scabiei var. suis-infested pigs were randomly allocated to three pens with 13 susceptible pigs each. From day 0 to 35, the growth performance of pigs in the experimental compartment was significantly (P=0.04) worse (35 g/d) than of pigs in the control compartment. From day 35 to 112, there was a statistical trend (P=0.10) that the growth performance of pigs in the experimental compartment was lower (50 g/d) than that of pigs in the control compartment. For the complete fattening period (0-112 or more days), the growth performance of pigs in the experimental compartment was significantly (P=0.05) worse (41 g/d) than that of pigs in the control compartment. Mean feed conversion ratio (kg feed per kg gain) was 2% higher in the experimental compartment compared with the control compartment. Pigs in the experimental compartment had a nine times (95% CI: 2 - 44) higher chance of showing pruritic behaviour than pigs in the control compartment.

Forty-eight dairy ewes and 45 lambs naturally infested with sarcoptic mange, were divided into three equal groups and treated with moxidectin 1% inj. sol. at a dose rate of 0.2 mg moxidectin kg(-1) bodyweight once or twice ten days apart. During the study, the skin lesions were scored and the number of mites recovered in facial skin scrapings from the animals were recorded. Moxidectin was found to be effective against ovine sarcoptic mange, when given twice; the percentage reduction of mites was 100% (p < 0.0001) and the skin lesions disappeared completely (p = 0.0001). In sheep treated once only, the percentage reduction of mites varied from 75% to 92%. Treated ewes produced up to 22.4% more milk than the infested ones (p = 0.0001). Treated lambs had up to 15% greater final weight and up to 23.7% more growth than infested controls (p = 0.0001). It is concluded that two injections of moxidectin 1% inj. sol. at a dose rate of 0.2 mg kg(-1) bodyweight, given ten days apart, were effective against ovine sarcoptic mange. Furthermore, it is considered that sarcoptic mange adversely affects the production of the infested animals.

Seven of eight dogs that had been previously infested with Sarcoptes scabiei var. canis and then cured, expressed protective immunity when experimentally reinfested with scabies. All seven dogs that expressed resistance were spontaneously cleared of scabies by 64 days after they were experimentally reinfested. Five of the eight dogs were free of scabies by 24 days. The sequential changes in the inflammatory/immune cellular infiltrate in the scabietic lesions of each dog were determined during the sensitizing infestation, cure and the subsequent experimental reinfestation (challenge). During the initial infestation and in the subsequent challenge reinfestation, dogs developed mixed cellular infiltrates in their scabietic lesions that contained mononuclear cells, neutrophils, plasma cells and mast cells. Reinfestation induced more rapid increases in the densities of these cells than had occurred during the sensitizing infestation. Mononuclear and mast cells were the most numerous infiltrating cells during the sensitizing phase. During the challenge phase the most numerous infiltrating cells were mononuclear cells and neutrophils. The sensitizing and challenge infestations induced circulating scabies-specific antibody responses, but the response was more rapid during the reinfestation challenge. Both the cell-mediated response in the skin and the circulating antibody response waned in parallel with clearing of the mites following reinfestation.

Crusted (Norwegian) scabies, a rare variant of ordinary scabies, is a highly contagious infection in which the skin is infested with thousands to millions of mites. The infection is frequently overlooked because of its atypical presentations. Patients with cognitive deficiency or an immunodeficiency disorder (including immunosuppressive therapy) are predisposed to developing crusted scabies. The infection often presents as generalized dermatitis with crusted hyperkeratosis on the palms and soles. Diagnosis is made by examining skin scrapings from the crusted lesions. Lindane is the scabicide most widely used in the treatment of crusted scabies. Eradication frequently requires repeated applications, and care must be taken to avoid lindane toxicity. Permethrin cream is as efficacious as lindane in the treatment of ordinary scabies. Because of its wider margin of safety, permethrin may become the preferred treatment for crusted scabies.

Effects of infestation by Sarcoptes scabiei (De Geer) on pruritus and other behaviors of pigs for 9-13 wks after weaning were evaluated. Regardless of the dose of mites inoculated, pigs fed ad lib. spent approximately 60% of their time at rest. Within their average day, pigs spent more time eating in morning and evening, were more active and pruritic at midday, and rested more and spent the least time drinking water at night. Mite infestations increased total activity and time spent scratching and rubbing. Infested pigs sprayed with water rubbed and scratched 4-10 times more frequently than those left undisturbed or disturbed by other means. Pigs receiving inoculating doses of 1,000 mites became more pruritic than pigs receiving 100 mites, and both groups developed more pruritus than non-infested control pigs.

The impact of Sarcoptic mange on sows and on performance of their offspring from birth to slaughter was determined. Sows naturally infested with Sarcoptic mange were paired, mated to the same boar, and assigned randomly to treated or control farrowing groups. Treated sows received ivermectin s.c. at 300 micrograms/kg body weight; control sows received the vehicle s.c. Sow performance was evaluated via sow feed consumption, litter size, litter birth weights, litter weaning weights and piglet death loss from birth to weaning. Seven replicates (farrowing groups), each with six sow pairs, were included in the trial. Offspring from treated and control sows, 35 head/group, were fed to slaughter weights. Untreated sows had litters that weighed 4.14 kg less than ivermectin-treated sow litters at 21 d (P less than .07). Treated sows consumed 1.95 kg less feed per weaned piglet and .13 kg less feed per kilogram of weaned piglet (P less than .05). Piglets from treated sows were 5.79 kg/head heavier at slaughter (P less than .05) and had a .05 kg/d superior average daily gain (P less than .05).

This article summarizes the clinical presentation and treatment of common bites and infestations in the United States. A survey of this complex and interesting area of medicine should help the emergency physician to diagnose and treat many patients who present with "nonspecific" bites and rashes.

Scabies continues to be an important parasitic disease of humans, and other mammals. Suprisingly for a disease that has afflicted humans since antiquity, little is directly known about the basic biology of the parasite, the host-parasite interactions, the host immune response, and host susceptibility. Much more research in these areas is needed if we are to understand fully the occurrence, transmission, and epidemiology of both human and animal scabies.

The effects of a single artificial infestation with sarcoptic mite (Sarcoptes scabiei var. suis DeGeer) on weight gain and lymphocyte blastogenic responses were studied in untreated and fenvalerate-treated pigs. Average daily feed intake, average daily gain and feed efficiency were monitored for 5 weeks in 32 infested and 16 uninfested pigs. Total and differential leukocyte counts were determined and lymphocyte proliferative responses, using a mitogen-stimulated lymphocyte blastogenesis assay, were evaluated in 24 pigs. Sarcoptic mite infestation or treatment for sarcoptic mange did not affect total or differential leukocyte counts (P greater than 0.10). Differences were not observed in weight gain or lymphocyte blastogenic responses between infested and uninfested pigs.

Two of 3 red foxes became experimentally infected with Sarcoptes scabiei v. vulpes isolated from a naturally infected wild fox. The first clinical sign was seen after 10 days. After 30 days hairless patches were observed on the back of one of the foxes while general hair loss continued slowly. On the other fox the only macroscopical changes was tangling of the hair. The foxes died after 67 and 94 days, respectively. Both foxes were anaemic and in very poor condition. Scratching was seen in only 1 of the foxes.

A study on the development and effect of experimental Sarcoptes scabiei var suis infestations in growing pigs is described. Pigs were infested at either weekly or fortnightly intervals throughout each experimental and individual growth rates and feed conversion ratios were determined. The animals were fed diets which contained either optimal or sub-optimal levels of protein. They were housed either intensively or extensively. In all experiments the majority of infested animals developed a generalised hypersensitivity to sarcoptes mites and performed significantly less efficiently than non-infested littermates. Mean growth rates were depressed from 9.2 to 12.5 per cent and feed conversion efficiencies by a similar margin. Well fed, intensively housed pigs developed a more severe hypersensitivity reaction than poorly fed, extensively housed pigs.

Sarcoptes scabiei var. canis served as a suitable model for the study of S. scabiei var. hominis survival. S. scabiei var. canis and var. hominis mites were found to survive off the host for 24 to 36 hours at room conditions (21 degrees C and 40% to 80% relative humidity [RH]), and the canine variety survived 19 days at 10 degrees C and 97% RH. Female mites survived decidedly longer than male mites at comparable conditions. Generally, higher RH values and lower temperatures favored survival, whereas higher temperature and lower RH led to early death. Most canine scabies mites that were held off the host for 36 hours at 75% RH and 22 degrees to 24 degrees C remained infective and penetrated when returned to the host. Live mites of the human variety that were recovered from bed linen slept on by infested patients would also penetrate a host after being held off a host for 96 hours in alternating 12-hour periods of room conditions and refrigeration. Penetration required less than 30 minutes for all life stages of both varieties, and it was accomplished by a mite secretion that dissolved the host tissue. Dislodged mites, particularly those in close proximity to the source, can be a likely source of infestation.

Blood samples from sarcoptic mite-infested pigs were evaluated for effects of mite infestation and cold and ambient temperatures on lymphocyte blastogenic responses and for effects of mite infestation on serum cortisol concentrations. In experiment 1, sarcoptic mite-infested and noninfested pigs were housed in cold (5 to 15 C fluctuating) and thermoneural (25 C) environmental chambers for 5 weeks. Differences were not observed (P greater than 0.10) in blastogenic responses to phytohemagglutin or pokeweed mitogen between lymphocytes from infested and noninfested pigs on postinfestation days (PID) 7, 21, 28, and 35 in either environmental chamber. When lymphocytes from noninfested pigs were cultured with sera from infested pigs, alterations of blastogenic responses were not detected. Cortisol values were higher (P less than 0.05) in sera from sarcoptic mite-infested pigs, compared with those from noninfested pigs, at 4 PM on PID 14 and 4 AM and 10 AM on PID 15. Cortisol values were higher (P less than 0.05) in sera obtained at 10 AM on PID 14 and at 10 AM on PID 15 from pigs housed in cold chambers, compared with those from pigs housed in thermoneutral chambers. Interactive effects between sarcoptic mite infestation and cold ambient temperatures were not observed. At 4 AM on PID 15 (experiment 2), cortisol values were higher (P less than 0.05) in sera of infested pigs, compared with those in noninfested pigs. Seemingly, sarcoptic mange in pigs did not alter mitogen-induced lymphocyte blastogenic responses, but did increase serum cortisol concentrations, indicating that sarcoptic mange may be a stressor in pigs.