Mange

Type of skin disease caused by parasitic mites

For other uses, see Mange (disambiguation).

Medical condition

Mange

Dog with hair loss caused by Demodex mites
Specialty| Veterinary medicine, dermatology

Mange (/ˈmeɪndʒ/) is a type of skin disease caused by parasitic mites.[1] 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), and in wild mammals (for example, foxes, coyotes, cougars,[2] Tasmanian devils,[3] and wombats[4][5]). Severe mange caused by mites has been observed in wild bears.[6] 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 in either 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 be known as "mange" in furry mammals, are instead known respectively as scabies and demodicosis.

## Classification

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### Demodectic mange

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A dog with severe demodectic mange

Main article: Demodicosis

Also called demodicosis or red mange, demodectic mange is caused by a sensitivity to and overpopulation of Demodex spp. The two types of demodectic mange are localized and generalized. Localized consists of four spots or less. Demodex is not zoonotic 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.

### Sarcoptic mange

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A street dog in Bali, Indonesia, suffers from demodectic mange. Sarcoptes scabiei Puppy with sarcoptic mange

See also: Scabies

Sarcoptic mange, also known as canine scabies, is a highly contagious infestation of Sarcoptes scabiei 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 Sarcoptidae. 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 that in initially-healthy individuals.

## Diagnosis

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Veterinarians usually attempt diagnosis with skin scrapings from multiple areas, which are then examined under a microscope 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.[7] 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 mites, an ear canal infection caused by a different but closely related mite (treatment is often the same). In some countries, an available serologic test may be useful in diagnosis.

## Treatment

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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 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 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 dogs, however, due to possible homozygous MDR1 (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.[8]

Topical 0.01% ivermectin in oil (Acarexx) has been reported to be effective in humans, and all mite infections in many types of animals (especially in ear mite infections where the animal cannot lick the treated area), and is so poorly absorbed that systemic toxicity is less likely in these sites.[citation needed] 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 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 is also effective in both dogs and humans, but is toxic to cats.[citation needed]

Afoxolaner (oral treatment with a chewable tablet containing afoxolaner 2.27% w/w) has been shown to be efficient against both sarcoptic[9][10] and demodectic[11] mange in dogs.

Free-ranging wombats are commonly treated topically with moxidectin by wildlife carers in Australia,[12] because it poses a low risk.[13]

Sarcoptic mange is transmissible to humans who come into prolonged contact with infested animals,[14] 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.[citation needed]

## See also

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* Cheyletiella – 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".
* Demodicosis
* Canine Demodicosis
* Rabies

## References

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1. ^ "Mange – Definition and More from the Free Merriam-Webster Dictionary". Merriam-webster.com. 2010-08-13. Archived from the original on 2011-05-13. Retrieved 2010-11-14.
2. ^ "Adult female P-65 is the first mountain lion in study to die of complications from mange". Santa Monica Mountains National Recreation Area. National Park Service. 26 September 2022. Retrieved 18 December 2022.
3. ^ Russell GG, Wilkinson V, Pefanis S, et al. Sarcoptic Mange in a Tasmanian Devil (Sarcophilus harrisii) and Bennett’s Wallaby (Notamacropus rufogriseus). Journal of Wildlife Diseases 2024. |doi=10.7589/jwd-d-23-00192|doi-access=free |
4. ^ Old, J. M.; Sengupta, C.; Narayan, E.; Wolfenden, J. (April 2018). "Sarcoptic mange in wombats-A review and future research directions". Transboundary and Emerging Diseases. 65 (2): 399–407\. doi:10.1111/tbed.12770. PMID 29150905.
5. ^ Mayadunnage, Sujatha; Stannard, Hayley J.; West, Peter; Old, Julie M. (2023). "Spatial and temporal patterns of sarcoptic mange in wombats using the citizen science tool, WomSAT". Integrative Zoology. 19 (3): 387–399\. doi:10.1111/1749-4877.12776.
6. ^ "Wild bear mange" (PDF).
7. ^ "Sarcoptic Mites and Mange: Also Known As Scabies in Dogs and Cats". Thepetcenter.com. Archived from the original on 1999-10-08. Retrieved 2010-11-14.
8. ^ Eldredge, Debra M. (2008). Cat Owner's Home Veterinary Handbook. Howell Book House. p. 145.
9. ^ Beugnet, Frédéric; de Vos, Christa; Liebenberg, Julian; Halos, Lénaïg; Larsen, Diane; Fourie, Josephus (2016). "Efficacy of afoxolaner in a clinical field study in dogs naturally infested with Sarcoptes scabiei". Parasite. 23: 26. doi:10.1051/parasite/2016026. ISSN 1776-1042. PMC 4912682. PMID 27317462. Archived from the original on 2018-05-03.
10. ^ Hampel, Verena; Knaus, Martin; Schäfer, Jürgen; Beugnet, Frederic; Rehbein, Steffen (2018). "Treatment of canine sarcoptic mange with afoxolaner (NexGard®) and afoxolaner plus milbemycin oxime (NexGard Spectra®) chewable tablets: efficacy under field conditions in Portugal and Germany". Parasite. 25: 63. doi:10.1051/parasite/2018064. ISSN 1776-1042. PMC 6280674. PMID 30516132.
11. ^ Beugnet, Frédéric; Halos, Lénaïg; Larsen, Diane; de Vos, Christa (2016). "Efficacy of oral afoxolaner for the treatment of canine generalised demodicosis". Parasite. 23: 14. doi:10.1051/parasite/2016014. ISSN 1776-1042. PMC 4807374. PMID 27012161. Archived from the original on 2018-05-03.
12. ^ Old, Julie M.; Skelton, Candice J. A.; Stannard, Hayley J. (March 2021). "The use of Cydectin® by wildlife carers to treat sarcoptic mange in free-ranging bare-nosed wombats (Vombatus ursinus)". Parasitology Research. 120 (3): 1077–1090\. doi:10.1007/s00436-020-07012-8. PMID 33438043.
13. ^ Schraven, Andrea L.; Stannard, Hayley J.; Old, Julie M. (April 2021). "A systematic review of moxidectin as a treatment for parasitic infections in mammalian species". Parasitology Research. 120 (4): 1167–1181\. doi:10.1007/s00436-021-07092-0.
14. ^ Borgman W (June 30, 2006). Dog mange called scabies can transfer to humans. Orlando Sentinel archive Archived 2015-02-16 at the Wayback Machine. Retrieved February 16, 2015.

## Further reading

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* Bornstein, Set; Mörner, Torsten; Samuel, William M. (2001). "Sarcoptes scabiei and Sarcoptic Mange". In Samuel, William M.; Pybus, Margo J.; Kocan, A. Alan (eds.). Parasitic Diseases of Wild Mammals. Wiley. pp. 107–19\. ISBN 978-0-8138-2978-4.

## External links

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* The dictionary definition of mange at Wiktionary

Classification|

* ICD-10: B86, B88.0
* MeSH: D008924
* DiseasesDB: 33039

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External resources|

* eMedicine: article/1203895

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Arthropods and ectoparasite-borne diseases and infestations

Insecta|

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* Linguatula serrata (linguatulosis)
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