Swimmer’s itch, cercarial or schitosomal dermatitis, is an allergic skin reaction to cercariae, which are the larvae of a waterfowl parasite (bird schistosomes).
It is a condition that has been little studied, but about which there is growing interest, since the World Health Organization (WHO) lists it as an emerging disease . There are case reports and outbreaks of swimmer’s itch in all parts of the world, including North and South America, Europe and Asia.
In an investigation carried out by Lashaki and collaborators, in which 41 studies carried out between 1937 and 2017 in different countries were reviewed, they determined that at least 34% of waterfowl worldwide are infected with schistosomes.
Main symptoms
As mentioned, swimmer’s itch is, in essence, an allergy. So there is an initial phase in which one comes into contact with the parasite and sensitization to it occurs.
In subsequent episodes, dermatitis itself will occur, due to the reaction of the immune system against something it recognizes, that is, cercaria.
As the name implies, the main symptom of swimmer’s itch is itching or itching. It ranges from tolerable to unbearable, to the point that it does not allow you to sleep.
Chronology of skin lesions
Swimmer’s itch produces a series of injuries that occur in characteristic times:
Immediately after contact, itching, tingling, and burning may occur where the cercaria entered.
Then, in this same place, a spot or macula of 1 to 2 millimeters in diameter appears that can persist for several hours.
After 10 to 15 hours there is a skin rash with hives, small pimples, blisters and papules, three to five millimeters in diameter.
Vesicles appear between the second and third day .
One week after penetration, the papules disappear and a small red dot remains.
Scratching causes symptoms to increase. If you scratch, more histamine is released and the itchiness increases. In addition, the lesions can become infected by bacteria, making the situation worse.
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