Title: Mange

{{Short description|Type of skin disease caused by parasitic mites}}
{{Other uses}}
{{Infobox medical condition (new)
| name          = Mange
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| image         = Dogmangeeee.jpg
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| alt           = Close up photograph of the left front leg of an unspecified breed of dog. There are patches of missing fur of differing sizes, but no scale is included in the image. The leg is being held by the hand of a white person of unknown age and gender.
| caption       = Dog with hair loss caused by ''[[Demodex]]'' mites
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| specialty     = [[Veterinary medicine]], [[dermatology]]
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'''Mange''' ({{IPAc-en|ˈ|m|eɪ|n|dʒ}}, {{respell|MAYNJ}}) is a type of [[skin disease]] caused by parasitic [[mite]]s.&lt;ref name=&quot;mw&quot;&gt;{{cite web |url=http://www.merriam-webster.com/dictionary/Mange |title=Mange – Definition and More from the Free Merriam-Webster Dictionary |publisher=Merriam-webster.com |date=2010-08-13 |access-date=2010-11-14 |url-status=live |archive-url=https://web.archive.org/web/20110513193729/http://www.merriam-webster.com/dictionary/mange |archive-date=2011-05-13 }}&lt;/ref&gt; Because various species of mites also infect plants, birds and reptiles, the term &quot;mange&quot;, or colloquially &quot;the mange&quot;, 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 [[Psoroptes ovis|sheep scab]]), and in wild mammals (for example, [[fox]]es, [[coyote]]s, [[cougar]]s,&lt;ref&gt;{{cite news | title = Adult female P-65 is the first mountain lion in study to die of complications from mange | website = Santa Monica Mountains National Recreation Area | publisher = National Park Service | url = https://www.nps.gov/samo/learn/news/adult-female-p-65-is-the-first-mountain-lion-in-study-to-die-of-complications-from-mange.htm | date = 26 September 2022 | access-date = 18 December 2022}}&lt;/ref&gt; [[Tasmanian devil]]s,&lt;ref&gt;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 |&lt;/ref&gt; and [[wombats]]&lt;ref&gt;{{cite journal |last1=Old |first1=J. M. |last2=Sengupta |first2=C. |last3=Narayan |first3=E. |last4=Wolfenden |first4=J. |title=Sarcoptic mange in wombats-A review and future research directions |journal=Transboundary and Emerging Diseases |date=April 2018 |volume=65 |issue=2 |pages=399–407 |doi=10.1111/tbed.12770|doi-access=free |pmid=29150905 }}&lt;/ref&gt;&lt;ref&gt; {{Cite journal |last1=Mayadunnage |first1=Sujatha |last2=Stannard |first2=Hayley J. |last3=West |first3=Peter|last4=Old |first4=Julie M.| date=2023 |title=Spatial and temporal patterns of sarcoptic mange in wombats using the citizen science tool, WomSAT |journal=Integrative Zoology |volume=19 |issue=3 |pages=387–399 |language=en |doi=10.1111/1749-4877.12776|pmid=37865949 |doi-access=free }}&lt;/ref&gt;). Severe mange caused by mites has been observed in wild bears.&lt;ref&gt;{{cite web |title=Wild bear mange |url=https://dwr.virginia.gov/wp-content/uploads/media/Black-Bear-Mange-Brochure.pdf}}&lt;/ref&gt; 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 follicle]]s in the animal, depending upon their genus. ''[[Sarcoptes]]'' [[species|spp.]] burrow into skin, while ''[[Demodex]]'' spp. live in follicles.

In humans, these two types of mite infections, which would be known as &quot;mange&quot; in furry mammals, are instead known respectively as [[scabies]] and [[demodicosis]].

== Classification ==

=== Demodectic mange ===
[[File:Demodectic mange 2.jpg|thumbnail|A dog with severe demodectic mange]]
{{main|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 [[Zoonosis|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 ===&lt;!-- This section is linked from [[Scabies]] --&gt;
[[File:Street dog-Gianyar Bali-2009.jpeg|thumb|A street dog in [[Bali]], Indonesia, suffers from sarcoptic mange.]]
[[File:Canine scabies mite.JPG|thumb|''Sarcoptes scabiei'']]
[[File:Scabies puppy.jpg|thumb|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 &quot;seven-year itch&quot;).

Burrowing mites are in the [[Family (biology)|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 ==
[[Veterinarian]]s 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 &quot;pedal-[[pinna (anatomy)|pinna]] [[reflex]]&quot;, 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.&lt;ref&gt;{{cite web |url=http://www.thepetcenter.com/exa/mites.html |title=Sarcoptic Mites and Mange: Also Known As Scabies in Dogs and Cats |publisher=Thepetcenter.com |access-date=2010-11-14 |url-status=dead |archive-url=https://web.archive.org/web/19991008002522/http://www.thepetcenter.com/exa/mites.html |archive-date=1999-10-08 }}&lt;/ref&gt; 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]]s, an ear canal infection caused by a different but closely related mite (treatment is often the same). In some countries, an available [[Serology|serologic]] 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. [[lime sulfur|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 dog]]s, 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]].&lt;ref&gt;{{Cite book|title=Cat Owner's Home Veterinary Handbook|last=Eldredge|first=Debra M.|publisher=Howell Book House|year=2008|pages=145}}&lt;/ref&gt;

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|date=August 2021}} 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|date=August 2021}}

[[Afoxolaner]] (oral treatment with a chewable tablet containing afoxolaner 2.27% w/w) has been shown to be efficient against both sarcoptic&lt;ref name=&quot;Beugnetde Vos2016&quot;&gt;{{cite journal|last1=Beugnet|first1=Frédéric|last2=de Vos|first2=Christa|last3=Liebenberg|first3=Julian|last4=Halos|first4=Lénaïg|last5=Larsen|first5=Diane|last6=Fourie|first6=Josephus|title=Efficacy of afoxolaner in a clinical field study in dogs naturally infested with ''Sarcoptes scabiei''|journal=Parasite|volume=23|year=2016|pages=26|issn=1776-1042|doi=10.1051/parasite/2016026|url= https://www.parasite-journal.org/articles/parasite/full_html/2016/01/parasite160023/parasite160023.html|pmid=27317462|pmc=4912682|url-status=live|archive-url=https://web.archive.org/web/20180503173040/https://www.parasite-journal.org/articles/parasite/full_html/2016/01/parasite160023/parasite160023.html|archive-date=2018-05-03}} {{open access}}&lt;/ref&gt;&lt;ref name=&quot;HampelKnaus2018&quot;&gt;{{cite journal|last1=Hampel|first1=Verena|last2=Knaus|first2=Martin|last3=Schäfer|first3=Jürgen|last4=Beugnet|first4=Frederic|last5=Rehbein|first5=Steffen|title=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|journal=Parasite|volume=25|year=2018|pages=63|issn=1776-1042|doi=10.1051/parasite/2018064|pmid=30516132|url= |pmc=6280674}} {{open access}}&lt;/ref&gt; and demodectic&lt;ref name=&quot;BeugnetHalos2016&quot;&gt;{{cite journal|last1=Beugnet|first1=Frédéric|last2=Halos|first2=Lénaïg|last3=Larsen|first3=Diane|last4=de Vos|first4=Christa|title=Efficacy of oral afoxolaner for the treatment of canine generalised demodicosis|journal=Parasite|volume=23|year=2016|pages=14|issn=1776-1042|doi=10.1051/parasite/2016014|url=http://www.parasite-journal.org/articles/parasite/full_html/2016/01/parasite160008/parasite160008.html|pmid=27012161|pmc=4807374|url-status=live|archive-url=https://web.archive.org/web/20180503173040/https://www.parasite-journal.org/articles/parasite/full_html/2016/01/parasite160008/parasite160008.html|archive-date=2018-05-03}} {{open access}}&lt;/ref&gt; mange in dogs.

Free-ranging [[wombat]]s are commonly treated topically with [[moxidectin]] by wildlife carers in [[Australia]],&lt;ref&gt;{{cite journal |last1=Old |first1=Julie M. |last2=Skelton |first2=Candice J. A. |last3=Stannard |first3=Hayley J. |title=The use of Cydectin® by wildlife carers to treat sarcoptic mange in free-ranging [[Common wombat|bare-nosed wombats]] (Vombatus ursinus) |journal=Parasitology Research |date=March 2021 |volume=120 |issue=3 |pages=1077–1090 |doi=10.1007/s00436-020-07012-8|pmid=33438043 }}&lt;/ref&gt; because it poses a low risk.&lt;ref&gt;{{cite journal |last1=Schraven |first1=Andrea L. |last2=Stannard |first2=Hayley J. |last3=Old |first3=Julie M. |title=A systematic review of [[moxidectin]] as a treatment for parasitic infections in mammalian species |journal=Parasitology Research |date=April 2021 |volume=120 |issue=4 |pages=1167–1181 |doi=10.1007/s00436-021-07092-0 |pmid=33615411 }}&lt;/ref&gt; 

Sarcoptic mange is transmissible to humans who come into prolonged contact with infested animals,&lt;ref&gt;Borgman W (June 30, 2006). Dog mange called scabies can transfer to humans. [http://articles.orlandosentinel.com/2006-07-30/news/ORBORGMAN30_1_mites-tyson-scabies Orlando ''Sentinel'' archive] {{webarchive|url=https://web.archive.org/web/20150216215618/http://articles.orlandosentinel.com/2006-07-30/news/ORBORGMAN30_1_mites-tyson-scabies |date=2015-02-16 }}. Retrieved February 16, 2015.&lt;/ref&gt; 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|date=August 2021}}

== See also ==
* ''[[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 &quot;mange&quot;.
* [[Demodicosis]]
* [[Canine demodicosis|Canine Demodicosis]]
* [[Rabies]]

== References ==
{{Reflist|30em}}

== Further reading ==
* {{cite book |editor1-first=William M. |editor1-last=Samuel |editor2-first=Margo J. |editor2-last=Pybus |editor3-first=A. Alan |editor3-last=Kocan |first1=Set |last1=Bornstein |first2=Torsten |last2=Mörner |first3=William M. |last3=Samuel |chapter=''Sarcoptes scabiei'' and Sarcoptic Mange |chapter-url=https://books.google.com/books?id=mzOaXzmAytAC&amp;pg=PA107 |year=2001 |title=Parasitic Diseases of Wild Mammals |isbn=978-0-8138-2978-4 |pages=107–19|publisher=Wiley }}

==External links==
* {{Wiktionary inline}}

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{{Arthropod infestations|state=collapsed}}

[[Category:Arthropod infestations]]
[[Category:Dog diseases]]
[[Category:Veterinary entomology]]