About modern methods of diagnostics of Acariases.

Autor: Rakhima D. Zhaxylykova

Source: EURAACnewsletter № 4, 2010, p. 9-11

About the presence of pandemic of acariases on our planet, caused by Demodexes sp., Dermatophagoideses sp., Sarcoptides sp. (the latent and atypical forms of illness) and other mites of household dust, we widely inform experts and the public during more than 30 years. This information is reflected in the article «The acarological problems of clinical medicine» on www.medlinks.ru/article.php? sid=35694 and www.allergy.kz/en/publish/. The history of discovery of Acariases and its documentary acknowledgement are illustrated in www.allergy.kz.

It is not difficult to prove the laboratory presence of disease which is accurately visible by simple eye (i.e. clinically) in a highly sophisticated technological century. For this purpose it is important to have the informative methods of diagnostics. The method of scrape, well known in scabiology for diagnostics of Sarcoptic Acariasis, demands the improvement because of the penetration of Sarcoptes scabiei deep into skin of the infected people. On the other hand the hygienic level of people of the XXIst century has improved. The existing epidemiological situation (the presence of AIDS, hepatitis B, C, Д, etc.) requires giving preference to the noninvasive methods of diagnostics. Below we can offer some methods for diagnostics of Acariases.

The peculiar behavior of Demodexes sp., Dermatophagoideses sp. and some other mites allow us to find them quite often on the skin surface. Diagnostics of this kind requires the presence of optical device with at least 70x magnification. The observation should be conducted in no less than 30 minutes in reflected light (for adaptation of mites). For simplification of the researcher’s work it is possible to use a video camera which can be programmed to determine the genus or species of the mite in the device. The given device will be ideal if focus of its optics automatically adjusts to the investigated surface. Since 1980 we (Zhaxylykova R. D and Masheeva R. G.) have use an ophthalmologic slot-hole lamp for research of the face skin. For observation of skin surface of other parts of human body we adapted an operational eye microscope and microscope МБС-9 on a special support. This method of diagnostics of acariasis in vivo allows finding the Demodexes sp. and Dermatophagoideses sp. on the surface of an integument of the infected people. To reduce the time of research it is necessary to treat the investigated surface with liquids such as kerosene, gasoline, etc., which accelerate the exit of mites on the skin surface from glands. The level of technological development allows to be firmly convinced that engineers can create such device with the specified parameters. This device will be irreplaceable for diagnostics of Acariasis in the conditions of big and small medical institutions. It is also possible to use the method of gluing of a transparent sticky tape on an investigated surface of babies’ skin and the subsequent observation of its surfaces under microscope.

The dwelling of mites by colonies in places of their permanent stay is widely known. The structure of these colonies is described in the literature. The infection of skin and human body by mites is always accompanied by the fact of escalating sensitivity. Therefore it is possible to provoke the local immuno-allergic reaction (within the capsules of colonies) and thus achieving visibility of colonies even at smooth, but the infected skin. The mechanism of this immuno-allergic reaction is described in our article “Acariases and Collagenoses”. The acaricides serve as provoking substances. The gaseous and vaporous acaricides, for example, atomic sulphur, gasoline, kerosene, liquid nitrogen, etc. are penetrating into the skin pores faster and better. The alcohol and water solutions, worse are the oil solutions and liniments penetrate into the skin pores more slowly. Visible colonies of mites look as pink papule with dot aperture in the centre - an external hole of gland channel occupied by the mites. In order to be convinced of the presence of mites in these papules it is necessary to conduct the second observation phase: with thin spoon of Folkman take away the contents of papule and observe them under the microscope. The mites on different phases of development are always found in the cases of proper material collection. The given method of diagnostic is protected by the copyright certificate and illustrated on www.allergy.kz. Because of finding the mites in all papules for diagnostics of Acariasis it is enough to conduct only the first stage of the given method. Besides that this observation phase is accessible in the conditions of the remote medical and medical assistant's sites. Now the researcher of any country, as the inhabitant of the planet, is infected by Acariasis too, and therefore they can conduct the given observation on themselves. The second part of described method of diagnostics should be conducted in the conditions of specialized establishments in an appropriate way by the prepared personnel.

The techniques of the first stage of provocative method of diagnostics of Acariasis are the following. On the clean dry innerside surface of the forearm from wrist to an elbow, vigorously rub in 60 % of Natrium hyposulfurosum within 3-5 minutes performing circular movements (the radius of circle must be not more than 1 cm). Then we must wait, while the skin surface dries up. After that three times for 2-3 minutes of intervals rub 8 % Acidum hydrochloricum of circular movement. The result is read in 5-10 minutes after the last rubbing in. The quantity of visible papules will be proportional to the number of glands which penetrate the rubbed means. The sizes of these papules will be proportional to the degree of sensitivity of an organism to mites’ allergens.

The actual method of detection of mites’ passage in the infected skin by means of 5 % of iodine or mechanical influence by the soaped rough bast whisp. But the method of detection of passages of mites in skin is informative only at I and II-a stages of Acariasis, when density of skin infection by mites is small. The system of Videoscan ( the Asus firm, USA) with video card and video camera may be used for detection of specific scab passages.

Our 38-years unique clinical observations allow us to offer engineers the idea of creation of the highly-sensitive electronic device, capable of finding the single mites which jump from surface of infected skin of patients with complicated Acariasis. It is the following clinical masks of Acariasis: Discoid Lupus Erythematosus, Rosacea II and III stages, Rhinophyma, Neurodermatitis, etc. The device screen should be established on distance no more than 100 cm from the infected surface of skin because from such distance the patients with the complicated Acariasis are dangerous to associates. The collection and subsequent research of the derivatives, poured from body of patient (during his preparation for medical examination) will allow to find considerable quantity of mites. As a result of these two researches it will be possible to make additional recommendations about a labour protection of the medical personnel and a corresponding sanitary regimen in clinic.

Formerly, we informed that mites infect the mucous membranes of the person. For detection of mites in mucous membranes it is possible to use a method of search of mites in washing waters of nose, pharynx, eyes mucous. This method is described by ornithologists (Zabludovsky, etc.) for studying of acarofauna of mucous membranes of birds.

Our observation and the numerous facts described in the literature prove that long symbiosis of mites with the person has outgrown not only in ekto - but also in endo-parasitism. Therefore the method of detection of mites described in the literature in bodies and fabrics of people is desirable for introducing in wide practice for searches of mites in operation, biopsy and dissector materials. Results of these researches finally will allow raising the health of contemporaries to a qualitative new level.

The century of sophisticated technology allows us to belief that up-to-date devices for Acariasis diagnostics will be discovered. Important value has clinical, biochemical and immunological blood research. However, it is necessary to remember, that any device will not replace the sense organs and logic of a doctor. Therefore, the thorough knowledge of Acariasis clinic should be obligatory for doctors of all clinical medical professions. And the most informative is positive result of method ex juvantibus treatment.