Scalp Dermatitis Caused by Mites

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Elliot's Disease Research Library

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Re: Publications-Traver Part 1

Posted by Librarian on 4/2/2002, 12:12 pm

Proceedings of the Entomological Society of WashingtonVol. 53, February, 1951, No. 1.Unusual Scalp Dermatitis in Humans Caused by the Mite, Dermatophagoides (Acarina, epidermoptidae)By Jay Traver, Department of Zoology, University of Massachusetts, AmherstThe

writer and two other members of her immediate family, all of us adult

females, have been for the past several years the unwilling hosts to

the mite, Dermatophagoides scheremetewskyi Bogdanow. Since the

published reports on this mite as a parasite of humans are not

numerous, it seems desirable to present an account of the activities of

the mite from first hand information. Symptoms, treatment employed in

the attempt to control or eradicate the mite, reaction of certain

members of the medical profession to this problem, and the present

status of the situation are therefore set forth.It

is to Dr. Baker of the Division of Insect Identification, Bureau

of Entomology and Plant Quarantine, Washington, D.C., that we owe the

identification of this mite, and the synonymy herewith is presented. It

is to him also that the writer owes her contact with Dr. Gaines W. Eddy

of the same Bureau in Washington, who has suggested the use of certain

new synthetic organic compounds as scabicides in the treatment of this

mite. Had it not been for Dr. Baker's interest in this problem,

expressed in personal correspondence, it is quite possible that no

attempt would have been made to publish this personal account of an

infestation with the mite Dermatophagoides.Personal Observation of the Activity of the Mite.Small

itching red papules on the scalp were noted as early as 1934. This

condition persisted without much change in spite of sporadic efforts to

control it, until the spring and early summer of 1943. At this time,

the sensations as of some arthropod crawling, scratching and biting

became very pronounced, and occurred over wide areas of the scalp. The

idea that Pediculus humanus capitus might be the causative agent was

not borne out since at no time was it possible to 'comb out' a louse

nor to locate nits on the hairs. Further, the infestation did not yield

to treatment known to be effective against pediculosis. The itching and

crawling sensations were most pronounced between 10 p.m. and the early

hours of the morning.By

the middle of August, 1943, the annoyance had become excessive and more

strenuous efforts were made to clear up the infestation and to locate

the causative agent. Three areas of the scalp were principally

involved, a space as large as the palm of the hand above and behind

each ear, and an even larger area on the top of the head in the frontal

region. The sensations as of something biting, scratching, and crawling

from place to place were now almost continuous, becoming apparent as

early as 10 a.m. and continuing all day and far into the night,

increasing in intensity from 11 p.m. onward. Sound sleep was quite

impossible. The principal areas involved were also painful and swollen,

and as was discovered later, the epidermis over each of them was

extremely thickened. On the suggestion of a druggist, a soap containing

1% mercuric iodide was employed as a shampoo. This seemed to irritate

the mites, which became very active after the use of this soap. Many of

them began to move down out of the scalp, and some of the thickened

epidermis began to slough off.Those

that continued down on to the body soon became embedded in itching red

papules reminiscent of trombiculid infestations. Treated with strong

sulphur ointment, they apparently did no further damage. They could be

found on the shoulders, under the arms, beneath the breasts, on chest

and both upper and lower back, occasionally around the umbilicus. The

sensations of crawling and biting which were felt on legs and feet, in

the latter case often on but seldom between the toes, indicated that

some of the mites had migrated to the lower extremities.Others

of the mites, however, moved down on to the face, invading eyes, ears

and nostrils. It was the mites in these locations that did the most

damage. Both eyes became so badly swollen that it was impossible to

move the eyeballs; to look to right or left it was necessary to move

the entire head. Invasion of the eyes was not confined to the period

immediately following the use of the mercuric iodide soap, but

continued for many days thereafter, this invasion occurring mostly

between midnight and 3 a.m. The victim of their attack would have

fallen into a light sleep, when a sharp pin-prick-like sensation in one

eye, followed by an immediate response on the part of the already badly

swollen eye would drive sleep away quite effectively. The movements of

a mite that had entered under the eyelid could be felt as it crawled

slowly about, then began to 'dig in' at which moment the eye suddenly

became even more swollen than before. An almost continuous flow of

lachrymal secretion seemed to attract the mites and made vision

difficult. At no time, however, was there evidence of the formation of

pus in the affected eyes.Invasion

of the nostrils produced quite distressing symptoms, as of something

crawling and scratching in the mucus membrane; ofthen this accompanied

by a distinct irritation of the throat, trachea and bronchi. Early

invasions of the ears seemed confined to the region of the pinna, in

the folds of which the mites burrowed, producing the usual itching red

papules. Their prresence in the ears was the cause of some concern on

my part, as it is well known that certain species of mites may cause

great damage in the ears of small animals. Apparently we may consider

ourselves most fortunate that his particular mite did not choose to

invade the external auditory meatus, from which location it might

easily have pierced the eardrum. The difficulty of controlling such an

infestation in the ear, had it occurred, is at once apparent, since as

yet we have found no drug that is completely effective against the

mites. Even had such a drug been known, its use in the ears might have

been inadvisable. Unfortunately for humans, medical doctors ar much

less versed in dealing with such situations than are the veterinarians

who care for our dogs and cats.In

addition to the trouble caused directly by the mites, a certain amount

of allergic reaction and probably also of secondary bacterial or

fungicidal reaction were also present. It is difficult if not

impossible to determine how much additional injury and discomfort may

have resulted from these secondary infections.The

most acute phase of the infestation yielded to control measures within

six weeks. Henceforth, the symptoms previously mentioned became less

sever and somewhat chronic, exhibiting an increase in activity more or

less periodically every two and one-half to three months. This

condition has continued up to the present time. Even this summer (1950)

live mites have been taken from all three members of the family. July

and August are their periods of greatest activity.In

spite of my optimistm in regard to the limited activity of those mites

that invaded the ears, there is still a question as to whether or not

the difficulty I am now having with my ears, and the rather sudden

onset of deafness on the part of the other infested members of my

family, may have been aggravated at least by the presence of the mites.

Likewise, I wonder if the chronic sinusitis to which I have been heir

for some time may also have been increased by those mites which entered

the nostrils.

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