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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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The superficial burrows of scabies usually occur in the area of the finger webs, feet, ventral wrists, elbows, back, buttocks, and external genitals. Except in infants and the immunosuppressed, infection generally does not occur in the skin of the face or scalp. The burrows are created by excavation of the adult mite in the epidermis.
In most people, the trails of the burrowing mites are linear or S-shaped tracks in the skin often accompanied by rows of small, pimple-like mosquito or insect bites. These signs are often found in crevices of the body, such as on the webs of fingers and toes, around the genital area, in stomach folds of the skin, and under the breasts of women.
Symptoms typically appear two to six weeks after infestation for individuals never before exposed to scabies. For those having been previously exposed, the symptoms can appear within several days after infestation. However, symptoms may appear after several months or years. Acropustulosis, or blisters and pustules on the palms and soles of the feet, are characteristic symptoms of scabies in infants.
The characteristic symptoms of a scabies infection include intense itching and superficial burrows. The burrow tracks are often linear, to the point that a neat "line" of four or more closely placed and equally developed mosquito-like "bites" is almost diagnostic of the disease. Because the host develops the symptoms as a reaction to the mites' presence over time, typically a delay of four to six weeks occurs between the onset of infestation and the onset of itching. Similarly, symptoms often persist for one to several weeks after successful eradication of the mites. As noted, those re-exposed to scabies after successful treatment may exhibit symptoms of the new infestation in a much shorter period—as little as one to four days.
Sarcoptic mange, also known as canine scabies, is a highly contagious infestation of "Sarcoptes scabiei canis", a burrowing mite. The canine sarcoptic mite can also infest cats, pigs, horses, sheep, and various other species. The human analog of burrowing mite infection, due to a closely related species, is called scabies (the "seven year itch").
All these burrowing mites are in the family Sarcoptidae. They dig into and through the skin, causing intense itching from an allergic reaction to the mite, and crusting that can quickly become infected. Hair loss and crusting frequently appear first on elbows and ears. Skin damage can occur from the dog's intense scratching and biting. Secondary skin infection is also common. Dogs with chronic sarcoptic mange are often in poor condition, and in both animals and humans, immune suppression from starvation or any other disease causes this type of mange to develop into a highly crusted form in which the burden of mites is far higher than in healthy specimens.
Mange is a class of skin diseases caused by parasitic mites. Since mites also infect plants, birds, and reptiles, the term "mange", suggesting poor condition of the hairy coat due to the infection, is sometimes reserved only for pathological mite-infestation of nonhuman mammals. Thus, mange includes mite-associated skin disease in domestic animals (cats and dogs), in livestock (such as sheep scab), and in wild animals (for example, coyotes, cougars, and bears). Since mites belong to the arachnid subclass Acari (also called Acarina), another term for mite infestation is acariasis.
Parasitic mites that cause mange in mammals embed themselves either in skin or hair follicles in the animal, depending upon their genus. "Sarcoptes" spp. burrow into skin, while "Demodex" spp. live in follicles.
In humans, these two types of mite infections, which would otherwise be known as "mange" in furry mammals, are instead known respectively as scabies and demodicosis.
Infections on the body may give rise to typical enlarging raised red rings of ringworm. Infection on the skin of the feet may cause athlete's foot and in the groin, jock itch. Involvement of the nails is termed onychomycosis, and they may thicken, discolour, and finally crumble and fall off. They are common in most adult people, with up to 20% of the population having one of these infections at any given moment.
Animals such as dogs and cats can also be affected by ringworm, and the disease can be transmitted between animals and humans, making it a zoonotic disease.
Specific signs can be:
- red, scaly, itchy or raised patches
- patches may be redder on outside edges or resemble a ring
- patches that begin to ooze or develop blister
- bald patches may develop, when the scalp is affected
- nails may thicken, discolour or begin to crack
To diagnose infestation, the entire scalp should be combed thoroughly with a louse comb and the teeth of the comb should be examined for the presence of living lice after each time the comb passes through the hair. The use of a louse comb is the most effective way to detect living lice.
The most characteristic symptom of infestation is pruritus (itching) on the head which normally intensifies 3 to 4 weeks after the initial infestation. The bite reaction is very mild and it can be rarely seen between the hairs. Excessive scratching of the infested areas can cause sores, which may become infected.
Head-lice infestation is most frequent on children aged 3–10 and their families. Approximately 3% of school children in the United States contract head lice. Females are more frequently infested than males. Those of African descent rarely suffer infestation due to differences in hair texture.
Head lice are spread through direct head-to-head contact with an infested person. From each egg or "nit" may hatch one nymph that will grow and develop to the adult louse. Lice feed on blood once or more often each day by piercing the skin with their tiny needle-like mouthparts. While feeding they excrete saliva, which irritates the skin and causes itching. Lice cannot burrow into the skin.
Flea allergy dermatitis, FAD, is an eczematous itchy skin disease of dogs and cats. For both of these domestic species, flea allergy dermatitis is the most common cause of skin disease. Affected animals develop allergic reactions to chemicals in flea saliva. Symptoms of this reaction include erythema (redness), papules (bumps), pustules (pus-filled bumps), and crusts (scabs). If severe, hair loss will occur in the affected area. Dogs with flea allergy dermatitis often show hair loss and eczematous skin rash on the lower back, upper tail, neck, and down the back of the legs. Cats with flea allergy dermatitis may develop a variety of skin problems, including feline eosinophilic granuloma, miliary dermatitis, or self-inflicted alopecia from excessive grooming.
Individual responses to bites vary, ranging from no visible effect (in about 20–70%), to small macular spots, to prominent wheals and bullae formations along with intense itching that may last several days. The bites often occur in a line. A central hemorrhagic spot may also occur due to the release of anticoagulants in the saliva.
Symptoms may not appear until some days after the bites have occurred. Reactions often become more brisk after multiple bites due to possible sensitization to the salivary proteins of the bed bug. The skin reaction usually occurs in the area of the bite which is most commonly the arms, shoulders and legs as they are more frequently exposed at night. Numerous bites may lead to an erythematous rash or urticaria.
Serious infestations and chronic attacks can cause anxiety, stress, and insomnia. Development of refractory delusional parasitosis is possible, as a person develops an overwhelming obsession with bed bugs.
Most of the mites which cause this affliction to humans are from the order Acari, hence the name Acariasis. The entire taxonomic classification to order would be:
- Kingdom: Animalia
- Phylum: Arthropoda
- Subphylum: Chelicerata
- Class: Arachnida
- Order: Acari (At the order level, there is still substantial argument among researchers as to how to categorize Acari. Some call it a subclass, others a superorder, "Acarina".)
Specific species involved include:
- Acariformes
- Trombidiformes
- "Trombicula" species (trombiculosis or chiggers)
- "Demodex" species (Demodicosis)
- "Pyemotes tritici"
- "Cheyletiella"
- Sarcoptiformes
- "Sarcoptes scabiei" (Scabies)
- Parasitiformes
- "Dermanyssus gallinae"
- "Liponyssoides sanguineus"
- "Ornithonyssus bacoti", "Ornithonyssus bursa", "Ornithonyssus sylviarum"
- Another candidate is "Androlaelaps casalis". However, based on this mite's life style as a predator on other mite species (such as the previously-mentioned "Dermanyssus gallinae"), it is highly unlikely to be a cause of acariasis.
Some of these reflect reports existing of human infestation by mites previously believed not to prey on humans.
The flea found most commonly on both dogs and cats with a flea infestation is the cat flea, "Ctenocephalides felis". Pets that develop FAD have an allergic response to flea saliva injected during flea feeding. The itch associated with just one flea bite persists long after that flea is gone and leads to significant self-trauma.
Head lice are generally uncomfortable, but typically do not constitute a serious condition. The most common symptom is itching of the head, which normally worsens 3 to 4 weeks after the initial infestation. The bite reaction is very mild, and it can be rarely seen between the hairs. Bites can be seen, especially in the neck of long-haired individuals when the hair is pushed aside. Swelling of the local lymph nodes and fever are rare. Itching may cause skin breakdown and uncommonly result in a bacterial infection.
In Ethiopia, head lice appear to be able to spread louse-born epidemic typhus and "Bartonella quintana". In Europe, the head lice do not appear to carry these infections.
Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.
About 40 types of fungi can cause ringworm. They are typically of the "Trichophyton", "Microsporum", or "Epidermophyton" type. Risk factors include using public showers, contact sports such as wrestling, excessive sweating, contact with animals, obesity, and poor immune function. Ringworm can spread from other animals or between people. Diagnosis is often based on the appearance and symptoms. It may be confirmed by either culturing or looking at a skin scraping under a microscope.
Prevention is by keeping the skin dry, not walking barefoot in public, and not sharing personal items. Treatment is typically with antifungal creams such as clotrimazole or miconazole. If the scalp is involved, antifungals by mouth such as fluconazole may be needed.
Up to 20% of the population may be infected by ringworm at any given time. Infections of the groin are more common in males, while infections of the scalp and body occur equally in both sexes. Infections of the scalp are most common in children while infections of the groin are most common in the elderly. Description of ringworm date back to ancient history.
The rabbit ear mite, "Psoroptes cuniculi", is larger than "Otodectes cynotis". It causes thick firm debris to form in the ear canal, and can eventually migrate to the skin of the outer ear and face. Symptoms include scratching and shaking of the head. Treatment includes topical selamectin, or injections of ivermectin and frequent cleanings of the rabbit's environment.
The ear mite is the most common cause of ear infections in cats, quickly spreading from one cat to another through direct contact. Ear mites cause inflammatory symptoms, similar to bacterial and yeast infections. Symptoms include itching and redness of the ears. Other, more serious problems can result from untreated infections, such as skin disease in areas other than the ear like the neck and tail, and deafness.
Medical doctors and dermatologists can still misdiagnose this rash as many are unfamiliar with parasitism, not trained in it, or if they do consider it, cannot see the mites.
Different methods for detection are recognized for different acariasis infections. Human acariasis with mites can occur in the gastrointestinal tract, lungs, urinary tracts and other organs which not have been well-studied. For intestinal acariasis with symptoms such as abdominal pain, diarrhea, and phohemefecia (is this hemafecia?), human acariasis is diagnosed by detection of mites in stools. For pulmonary acariasis, the presence of mites in sputum is determined by identifying the presence and number of mites in the sputum of patients with respiratory symptoms. Both physical and chemical methods for liquefaction of sputum have been developed.
Head lice infestation, also known as pediculosis capitis and nits, is the infection of the head hair and scalp by the head louse ("Pediculus humanus capitis"). Itching from lice bites is common. During a person's first infection, the itch may not develop for up to six weeks. If a person is infected again, symptoms may begin much more quickly. The itch may cause problems with sleeping. Generally, however, it is not a serious condition. While head lice appear to spread some other diseases in Africa, they do not appear to do so in Europe or North America.
Head lice are spread by direct contact with the hair of someone who is infected. The cause of head lice infestations are not related to cleanliness. Other animals, such as cats and dogs, do not play a role in transmission. Head lice feed only on human blood and are only able to survive on human head hair. When adults, they are about 2 to 3 mm long. When not attached to a human, they are unable to live beyond three days. Humans can also become infected with two other lice – the body louse and the crab louse. To make the diagnosis, live lice must be found. Using a comb can help with detection. Empty eggshells (known as nits) are not sufficient for the diagnosis.
Possible treatments include: combing the hair frequently with a fine tooth comb or shaving the head completely. A number of topical medications are also effective, including malathion, ivermectin, and dimethicone. Dimethicone, which is a silicone oil, is often preferred due to the low risk of side effects. Pyrethroids such as permethrin have been commonly used; however, have become less effective due to increasing pesticide resistance. There is little evidence for alternative medicines.
Head-lice infestations are common, especially in children. In Europe, they infect between 1 and 20% of different groups of people. In the United States, between 6 and 12 million children are infected a year. They occur more often in girls than boys. It has been suggested that historically, head lice infection were beneficial, as they protected against the more dangerous body louse. Infestations may cause stigmatization of the infected individual.
Demodex mite bite is a cutaneous condition caused by infestation by "Demodex folliculorum".
Body lice are a nuisance in themselves and cause intense itching. They are also vectors (transmitters) of other diseases and can spread epidemic typhus, trench fever, and louse-borne relapsing fever.
The main symptom is itching, usually in the pubic-hair area, resulting from hypersensitivity to louse saliva, which can become stronger over two or more weeks following initial infestation. In some infestations, a characteristic grey-blue or slate coloration macule appears ("maculae caeruleae") at the feeding site, which may last for days. Nits or live lice may also be visible to the unaided eye. Adult lice can sometimes be seen crawling on the skin.
Body lice are spread through prolonged direct physical contact with a person who has them or through contact with articles such as clothing, beds, bed linens, or towels that have been in contact with an infested person. In the United States, body lice infestations are rare, typically found mainly in homeless transient populations who do not have access to bathing and regular changes of clean clothes. Infestation is unlikely to persist on anyone who bathes regularly and who has at least weekly access to freshly laundered clothing and bedding.
Although louse-borne (epidemic) typhus is no longer widespread, outbreaks of this disease still occur during times of war, civil unrest, natural or man-made disasters, and in prisons where people live together in unsanitary conditions. Louse-borne typhus still exists in places where climate, chronic poverty, and social customs or war and social upheaval prevent regular changes and laundering of clothing.
Myiasis is a parasitic infestation caused by larvae of several fly species. Diagnosis and treatment are generally quite simple. This infestation is, however, rarely seen in the vulvar area. Infestation of vulvar area with larvae and maggots is called vulvar myiasis. Very few cases have been described in literature.
Pubic lice are usually acquired by sexual activity Adults are more frequently infested than children. As with most sexually transmitted pathogens, they can only survive a short time away from the warmth and humidity of the human body.
Infestation in a young child or teenager may indicate sexual abuse.
An ectoparasitic infestation is a parasitic disease caused by organisms that live primarily on the surface of the host.
Examples:
- Scabies
- Crab louse (pubic lice)
- Pediculosis (head lice)
- "Lernaeocera branchialis" (cod worm)