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Mange is a type of
skin disease A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this ...
caused by parasitic
mite Mites are small arachnids (eight-legged arthropods). Mites span two large orders of arachnids, the Acariformes and the Parasitiformes, which were historically grouped together in the subclass Acari, but genetic analysis does not show clear evid ...
s. Because various species of mites also infect plants, birds and reptiles, the term "mange", or colloquially "the mange", suggesting poor condition of the skin and fur due to the infection, is sometimes reserved for pathological mite-infestation of nonhuman mammals. Thus, mange includes mite-associated skin disease in domestic mammals (cats and dogs), in livestock (such as
sheep scab ''Psoroptes'' is a genus of mites, including the agents that cause psoroptic mange. Psoroptic mange ''Psoroptes'' mites are responsible for causing psoroptic mange in various animals, leading to economic losses among farmers of cattle, sheep ...
), and in wild mammals (for example,
fox Foxes are small to medium-sized, omnivorous mammals belonging to several genera of the family Canidae. They have a flattened skull, upright, triangular ears, a pointed, slightly upturned snout, and a long bushy tail (or ''brush''). Twelve sp ...
es,
coyote The coyote (''Canis latrans'') is a species of canis, canine native to North America. It is smaller than its close relative, the wolf, and slightly smaller than the closely related eastern wolf and red wolf. It fills much of the same ecologica ...
s,
cougar The cougar (''Puma concolor'') is a large Felidae, cat native to the Americas. Its Species distribution, range spans from the Canadian Yukon to the southern Andes in South America and is the most widespread of any large wild terrestrial mamm ...
s, and
bear Bears are carnivoran mammals of the family Ursidae. They are classified as caniforms, or doglike carnivorans. Although only eight species of bears are extant, they are widespread, appearing in a wide variety of habitats throughout the Nor ...
s). Since mites belong to the arachnid subclass Acari (also called Acarina), another term for mite infestation is
acariasis Acariasis is an infestation with mites. Terminology There are several complications with the terminology: Acariasis is a term for a rash, caused by mites, sometimes with a papillae (pruritic dermatitis) or papule (papular urticaria), and usua ...
. Parasitic mites that cause mange in mammals embed themselves in either skin or
hair follicle The hair follicle is an organ found in mammalian skin. It resides in the dermal layer of the skin and is made up of 20 different cell types, each with distinct functions. The hair follicle regulates hair growth via a complex interaction between h ...
s in the animal, depending upon their genus. ''
Sarcoptes ''Sarcoptes'' is a genus of mites. In some contexts, the types are all considered subordinate to ''Sarcoptes scabiei ''Sarcoptes scabiei'' or the itch mite is a parasitic mite that burrows into skin and causes scabies. The mite is found ...
''
spp. In biology, a species is the basic unit of classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of the appropriate se ...
burrow into skin, while ''
Demodex ''Demodex'' is a genus of tiny mites that live in or near hair follicles of mammals. Around 65 species of ''Demodex'' are known. Two species live on humans: '' Demodex folliculorum'' and '' Demodex brevis'', both frequently referred to as eyela ...
'' spp. live in follicles. In humans, these two types of mite infections, which would be known as "mange" in furry mammals, are instead known respectively as scabies and
demodicosis Demodicosis , also called Demodex folliculitis in humans and demodectic mange () or red mange in animals, is caused by a sensitivity to and overpopulation of '' Demodex spp.'' as the host's immune system is unable to keep the mites under control. ...
.


Classification


Demodectic mange

Also called demodicosis or red mange, demodectic mange is caused by a sensitivity to and overpopulation of ''
Demodex ''Demodex'' is a genus of tiny mites that live in or near hair follicles of mammals. Around 65 species of ''Demodex'' are known. Two species live on humans: '' Demodex folliculorum'' and '' Demodex brevis'', both frequently referred to as eyela ...
'' spp. The two types of demodectic mange are localized and generalized. Localized consists of four spots or less. ''Demodex'' is not
zoonotic A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
and is not transferable across species. Each host species has its own species of ''Demodex''. For example, dogs are hosts to ''Demodex canis'' and cats are hosts to ''Demodex cati''. A type of demodectic infection in humans is known, but is less commonly symptomatic. See ''
Demodex folliculorum ''Demodex folliculorum'' is a microscopic mite that can only survive on the skin of humans. Most people have ''D.folliculorum'' on their skin. Usually, the mites do not cause any harm, so are considered an example of commensalism rather than par ...
''.


Sarcoptic mange

Sarcoptic mange, also known as canine scabies, is a highly contagious infestation of ''
Sarcoptes scabiei ''Sarcoptes scabiei'' or the itch mite is a parasitic mite that burrows into skin and causes scabies. The mite is found in all parts of the world. Humans are not the only mammals that can become infected. Other mammals, such as wild and domesti ...
var.'' ''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"). Burrowing mites are in the
family Family (from la, familia) is a Social group, group of people related either by consanguinity (by recognized birth) or Affinity (law), affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its ...
Sarcoptidae The Sarcoptidae family of mites contains the genus ''Sarcoptes''. Sarcoptic mange Mange is a type of skin disease caused by parasitic mites. Because various species of mites also infect plants, birds and reptiles, the term "mange", or colloqu ...
. They dig into and through the skin, causing intense itching from an allergic reaction to the mite's feces, 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.


Diagnosis

Veterinarian A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, vet ...
s usually attempt diagnosis with skin scrapings from multiple areas, which are then examined under a
microscope A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisibl ...
for mites. ''Sarcoptes'' mites, because they may be present in relatively low numbers, and because they are often removed by dogs chewing at themselves, may be difficult to demonstrate. As a result, diagnosis in sarcoptic mange is often based on symptoms rather than actual confirmation of the presence of mites. A common and simple way of determining if a dog has mange is if it displays what is called a "pedal- pinna reflex", which is when the dog moves one of its hind legs in a scratching motion as the ear is being manipulated and scratched gently by the examiner; because the mites proliferate on the ear margins in nearly all cases at some point, this method works over 95% of the time. It is helpful in cases where all symptoms of mange are present but no mites are observed with a microscope. The test is also positive in animals with
ear mite Ear mites are mites that live in the ears of animals and humans. The most commonly seen species in veterinary medicine is '' Otodectes cynotis'' (Gk. ''oto''=ear, ''dectes''=biter, ''cynotis''=of the dog). This species, despite its name, is also ...
s, an ear canal infection caused by a different but closely related mite (treatment is often the same). In some countries, an available
serologic Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given mic ...
test may be useful in diagnosis.


Treatment

Affected dogs are sometimes isolated from other dogs and their bedding, and places they have occupied must be thoroughly cleaned. Other dogs in contact with a diagnosed case should be evaluated and treated. A number of parasitical treatments are useful in treating canine scabies. Sulfurated lime (a mixture of calcium polysulfides) rinses applied weekly or biweekly are effective (the concentrated form for use on plants as a fungicide must be diluted 1:16 or 1:32 for use on animal skin).
Selamectin Selamectin (trade names Revolution and Stronghold manufactured by Zoetis, and Revolt manufactured by Aurora Pharmaceuticals, among others) is a topical parasiticide and anthelminthic used on dogs and cats. It treats and prevents infections of ...
is licensed for treatment in dogs by veterinary prescription in several countries; it is applied as a dose directly to the skin, once per month (the drug does not wash off). A related and older drug
ivermectin Ivermectin (, '' EYE-vər-MEK-tin'') is an antiparasitic drug. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, today it is used to treat i ...
is also effective and can be given by mouth for two to four weekly treatments or until two negative skin scrapings are achieved. Oral ivermectin is not safe to use on some collie-like
herding dog A herding dog, also known as a stock dog, shepherd dog, sheep dog or working dog, is a Dog type, type of dog that either has been trained in herding or belongs to dog breed, breeds that are developed for herding. Herding behavior All herd ...
s, however, due to possible homozygous
MDR1 P-glycoprotein 1 (permeability glycoprotein, abbreviated as P-gp or Pgp) also known as multidrug resistance protein 1 (MDR1) or ATP-binding cassette sub-family B member 1 (ABCB1) or cluster of differentiation 243 (CD243) is an important protein ...
( P-glycoprotein) mutations that increase its toxicity by allowing it into the brain. Ivermectin injections are also effective and given either weekly or every two weeks in one to four doses, although the same MDR1 dog restrictions apply. Affected cats can be treated with fipronil and milbemycin oxime. Topical 0.01% ivermectin in oil (
Acarexx Ivermectin (, '' EYE-vər-MEK-tin'') is an antiparasitic drug. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, today it is used to treat inf ...
) has been reported to be effective in humans, and all mite infections in many types of animals (especially in
ear mite Ear mites are mites that live in the ears of animals and humans. The most commonly seen species in veterinary medicine is '' Otodectes cynotis'' (Gk. ''oto''=ear, ''dectes''=biter, ''cynotis''=of the dog). This species, despite its name, is also ...
infections where the animal cannot lick the treated area), and is so poorly absorbed that systemic toxicity is less likely in these sites. Nevertheless, topical ivermectin has not been well enough tested to be approved for this use in dogs, and is theoretically much more dangerous in zones where the animal can potentially lick the treated area.
Selamectin Selamectin (trade names Revolution and Stronghold manufactured by Zoetis, and Revolt manufactured by Aurora Pharmaceuticals, among others) is a topical parasiticide and anthelminthic used on dogs and cats. It treats and prevents infections of ...
applied to the skin (topically) has some of the same theoretical problems in collies and MDR1 dogs as ivermectin, but it has nevertheless been approved for use for all dogs provided that the animal can be observed for eight hours after the first monthly treatment. Topical
permethrin Permethrin is a medication and an insecticide. As a medication, it is used to treat scabies and lice. It is applied to the skin as a cream or lotion. As an insecticide, it can be sprayed onto clothing or mosquito nets to kill the insects th ...
is also effective in both dogs and humans, but is toxic to cats.
Afoxolaner Afoxolaner (INN) is an insecticide and acaricide that belongs to the isoxazoline chemical compound group. It acts as an antagonist at ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid ...
(oral treatment with a chewable tablet containing afoxolaner 2.27% w/w) has been shown to be efficient against both sarcoptic and demodectic mange in dogs. Sarcoptic mange is transmissible to humans who come into prolonged contact with infested animals,Borgman W (June 30, 2006). Dog mange called scabies can transfer to humans
Orlando ''Sentinel'' archive
. Retrieved February 16, 2015.
and is distinguished from human scabies by its distribution on skin surfaces covered by clothing. For treatment of sarcoptic infection in humans, see scabies. For demodetic infection in humans, which is not as severe as it is in animals with thicker coats (such as dogs), see ''
Demodex folliculorum ''Demodex folliculorum'' is a microscopic mite that can only survive on the skin of humans. Most people have ''D.folliculorum'' on their skin. Usually, the mites do not cause any harm, so are considered an example of commensalism rather than par ...
''.


See also

* ''
Cheyletiella ''Cheyletiella'' is a genus of mites that live on the skin surface of dogs, cats, and rabbits. The adult mites are about 0.385 millimeters long, have eight legs with combs instead of claws, and have palpi that end in prominent hooks. They do n ...
'' – This genus of mites causes dermatitis and itching in many groups of mammals, including pets and humans, but rarely causes hair loss, so is not usually considered clinically to cause "mange".


References


Further reading

*


External links

* {{Arthropod infestations, state=collapsed Arthropod infestations Dog diseases Veterinary entomology