Biology, Diagnosis and Management of Sarcoptic Mange: Article

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Biology, diagnosis and management of sarcoptic mange
Article · May 2015

DOI: 10.12968/vetn.2015.6.5.260
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Clinical
Biology, diagnosis and

management of sarcoptic mange
on animals, and occasionally infest humans include
Abstract S. scabiei var. canis (dogs), S. scabiei var. bovis (cat-
Scabies (also known as sarcoptic mange) is a common, highly contagious skin tle), S. scabiei var. caprae (goats), S. scabiei var. equi
disease in animals and humans. It is caused by the ecto-parasitic burrowing mite (horses), and S. scabiei var. suis (pigs).
Sarcoptes scabiei (family: Sarcoptidae), which has a worldwide distribution. Ani-
mals and humans can be infested by their own S. scabiei subtype; however cross- Life cycle
species transmission may occur. The socioeconomic and public health importance The life cycle of Sarcoptes mites occurs in the super-
of scabies is significant. The disease occurs when the mite burrows into the skin ficial (keratinaceous) layer of the animal’s epider-
and feeds on host epidermis. Disease manifestations are mediated via inflam- mis. Female mites create tiny burrows into the skin
matory and allergic responses to mite products, which result in severely pruritic in which they eggs over a period of 2–3 weeks. Eggs
lesions. Early diagnosis and prompt treatment is essential to minimise the spread hatch in about 3 days and the immature stages exit
of infestation. Veterinary nurses have a vital role to play in early recognition, diag- the burrow, mature, mate, and move on to make oth-
nosis and for providing owners with accurate accessible advice to prevent zoonotic er burrows. The entire life cycle from the egg through
transmission. This article summarises the latest data on the biology, diagnosis and one larval and two nymphal stages to the adult may
control of scabies. be completed in 14–21 days (Arlian and Vyszenski-
Moher, 1988). Sarcoptic mange is readily transmitted
Key words: scabies, infestation, itching, pruritus, sarcoptic mange between animal hosts by direct contact; infestation
by indirect contact is less frequent but occurs. Mites
can live off the host for 2–3 weeks in temperate humid
S
cabies (sarcoptic mange) is a highly contagious, conditions and so there is the potential for infection
pruritic skin disease in animals and humans to be transmitted through shared bedding or groom-
caused by the obligate ectoparasitic mite Sar- ing tools.
coptes scabiei. The term scabies is derived from the
Latin word scabere, meaning ‘to scratch’. S. scabiei is Clinical signs
an arthropod taxonomically belongs to class Arach- Intense pruritus/itching, a major characteristic mani-
nida and family Sarcoptidae. Adult mites are roughly festation, is probably due to hypersensitivity to mites,
circular in shape, without a distinctive head, but have mite eggs, and waste products (Figure 2). Primary le-
spine-like projections on the dorsal surface and four sions consist of papular eruptions that, due to self-
pairs of short legs (Figure 1). Females are almost twice trauma, develop into thick crusts. This allows second-
as large as males. The female measures about 0.3 to ary bacterial and yeast infections to occur. The initial
0.5 mm long by 0.3 mm wide, and the male is around lesions tend to occur on body parts with less hair such
0.25 mm long by 0.2 mm wide. S. scabiei mites infest as the ventral abdomen, chest, elbows, hocks (Figure
warm-blooded animals and tend to be host specific, 3), ear margin, axillary and inguinal regions. If these
with little transmission to other animal species or are left untreated, lesions rapidly coalesce and be-
humans. Human scabies is caused by S. scabiei var. come generalised. Dogs with chronic, generalised
hominis. Other sarcoptic mites that can be found disease may develop seborrhea, lichenification and
crust build-up, peripheral lymphadenopathy, emaci-
Hany Elsheikha BVSc MSc PhD FRSPH FHEA ation (Pin et al, 2006). Sarcoptes mites seem to cause
DipEVPC Associate Professor of Veterinary low-grade or sub-clinical infestations in Red fox pop-
Parasitology, University of Nottingham, School ulation, indicating that both mite and fox might have
of Veterinary Medicine and Science, Sutton co-evolved to adapt to each other over a long period
Bonington Campus, Leicestershire, LE12 5RD. of time (Davidson et al, 2008).
Ian wright BVMS BSc MSc MRCVS Veterinary
Surgeon and Parasitologist Withy Grove Diagnosis
Veterinary Surgery, Bamber Bridge, Preston Diagnosis is based on clinical presentation, history of
PR56QR pruritus, risk of exposure, and involvement of other
mammalian hosts, including humans. A characteris-
2 June 2015 • Vol 6 No 5 • The Veterinary Nurse

Clinical
Figure 1. Adult dog mite (Sarcoptes scabiei var. canis), taken from skin scraping. The mite is creamy white with brown
sclerotized legs and mouthparts.
tic clinical sign, although non-specific, is the pinnal- different sites at the margins of active lesions. Debris
pedal reflex (Mueller et al, 2001). If the affected pinna and thickening of the skin make scrapings less sen-
is gently manipulated this readily elicits a strong sitive at the centre of lesions or if clinically affected
scratch reflex. This reflex can be tested for in nurse areas are more chronic in nature. Scrapings may be
clinics where pets are presented for flea checks and taken with, and mounted in liquid paraffin. This has
the assumption is that dermatitis is associated with the advantage of the parasites being alive so move-
flea infestation. This can then act as an early diag- ment can be looked for but may result in substantial
nostic indicator that concurrent sarcoptic mange is skin debris obscuring the slide. This can be avoided
present. by dry scrapings being treated with 10% Potassium
Laboratory diagnosis of sarcoptic mange can be ac- hydroxide (KOH) before light microscopic examina-
complished by deep skin scrapings at a depth where tion, but this kills the parasite. The presence of a sin-
some bleeding occurs in order to find the mites. This gle mite is enough for diagnosis. However, mites are
can be carried out in house or scrapings can be sent often absent, even with multiple skin scrapings, mak-
to an external lab or done in house. In house diag- ing a definitive diagnosis difficult. Concentration and
nosis can be confidently carried out by veterinary flotation of multiple scrapings may increase chances
nurses and is useful as results are obtained very of finding the mites, eggs, or mite faeces. A serologic
quickly. Gloves must be worn to take scrapings due enzyme-linked immunosorbent assay (ELISA) is
to zoonotic risk and should be taken from at least 3 available and may be useful (Curtis, 2001; Lower et
The Veterinary Nurse • Vol 6 No 5 • June 2015 3
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