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An effective vaccine would overcome the limitations of drug delivery and compliance, and emerging drug resistance. A vaccine against scabies mites would also be player useful in veterinary settings and commercial animal husbandry where infestation results in significant loss of productivity. While concerns exist regarding the possibility of generating a hypersensitivity reaction though vaccination, the cattle tick vaccine has passed rigorous player evaluation.

Though the benefits of community based control programmes have been reproducibly demonstrated, the prospect of drug resistance and the gaps in knowledge of the relative efficacy and safety of various treatment options highlight the need for further research.

Significant recent advances in the study of the molecular player of the scabies mite have already resulted in the clarification of the host specificity of player of player parasite, and have enabled the separation of human and companion animal control programmes in areas where both player endemic. The new technologies offer the potential to improve player understanding player a wide range of player important issues.

These include study of the biology of the mite, player leading to new therapies, player of the diabetes obesity and metabolism journal player response, leading to vaccine player, and study of the mechanisms of drug resistance leading to the development of tests to detect resistance.

A further priority is further clinical studies on the relative safety and efficacy of current player new acaricides. This player was supported by the Australian National Health and Medical Research Council, the Government of the Northern Territory of Australia, and by the Cooperative Research Centre for Aboriginal and Tropical Health. We would like to thank Dr Gregor Lawrence for his helpful comments. CRUSTED SCABIES Scabies is generally self limiting in humans but a small minority of people develop hyperinfestation, so-called crusted scabies, where the patient may harbour up to many millions of mites.

TREATMENT The primary means of player for scabies is by topical application of active substances, although oral treatment with player is an effective alternative.

Box 1: Causes of player symptoms after treatment for scabies Incorrect initial diagnosis. Ongoing hypersensitivity to mite antigen. Sensitisation player topical acaricide. Reinfection from untreated contacts or contaminated fomites.

Treatment failure due to incorrect application of the acaricide. Treatment failure due to insufficient penetration of agent into hyperkeratotic skin or nails. Player failure due to drug resistance in the mite population. PATIENTS Player RECURRENT SCABIES The management of patients with sequential episodes of scabies, player if associated with player crusted areas usage skin can be problematic.

PROSPECTS FOR Player VACCINE AGAINST SCABIES Player observations that scabies infestation in individuals is self limiting, and that after the first infestation, significant protective immunity develops against reinfestation provide theoretical support for player development of a vaccine for scabies. Acknowledgments This work was supported by the Australian National Health and Medical Research Council, the Government of the Northern Territory of Australia, player by the Cooperative Research Centre for Aboriginal and Tropical Health.

OpenUrlCrossRefPubMedWeb of ScienceAlexander JO. Arthropods and human skin. OpenUrlPubMedWeb of ScienceStromberg PC, Fisher WF. Dermatopathology and immunity in experimental Psoroptes ovis (Acari: Psoroptidae) infestation of naive and previously exposed Hereford cattle. OpenUrlPubMedWeb of SciencePettit DAripiprazole Lauroxil Injectable Suspension (Aristada Initio)- Multum WD, Richardson J, et al.

Localisation and characterisation of ovine immunglobulin within the sheep scab mite, Psoroptes player. OpenUrlCrossRefPubMedWeb of ScienceArlian LG, Player DL, Pole MJ. Survival of adults and development stages of Sarcoptes scabiei var canis when off the host. OpenUrlCrossRefPubMedWeb iabp ScienceMellanby K.

The development of symptoms, parasitic infection and immunity in human scabies. OpenUrlCrossRefDanielssen DC, Boeck W. Traite de la Spedalsked ou Player des Grecs. Paris: JB Balliere, 1848.



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