Scabies


Scabies is a highly contagious skin infestation caused by the mite Sarcoptes scabiei var. hominis. It results in intense itching and a characteristic rash due to the mite burrowing into the skin.

Signs and Symptoms

  • Intense itching (worse at night)
  • Rash with small, red papules or burrows
  • Sores from scratching, which may become infected
  • Thickened, scaly skin in severe cases (crusted scabies)
  • Commonly affected areas: between fingers, wrists, elbows, armpits, waist, buttocks, genitals, and breasts

Complications

  • Secondary bacterial infections (e.g., impetigo, cellulitis)
  • Crusted scabies (Norwegian scabies) in immunocompromised individuals
  • Post-scabies eczema or dermatitis
  • Kidney complications (post-streptococcal glomerulonephritis in severe cases)

Transmission

  • Direct skin-to-skin contact (most common)
  • Prolonged close contact (e.g., household members, sexual partners)
  • Indirect transmission via contaminated clothing, bedding, or furniture (less common)

Causative Agent

  • Sarcoptes scabiei var. hominis, a microscopic parasitic mite

Incubation Period

  • First-time exposure: 2–6 weeks before symptoms appear
  • Re-infection: 1–4 days due to prior sensitization

Reservoir

  • Humans are the only known reservoir for Sarcoptes scabiei var. hominis

Prevention and Control Measures

  • Early diagnosis and treatment of affected individuals
  • Treating close contacts simultaneously, even if asymptomatic
  • Maintaining good personal hygiene
  • Washing clothing, bedding, and towels in hot water and drying at high temperatures
  • Vacuuming carpets and furniture to remove mites
  • Avoiding close contact with infected individuals

Laboratory Diagnosis

  • Skin scraping and microscopy: Identifies mites, eggs, or fecal pellets
  • Dermatoscopy: Shows characteristic burrows with mites at the end
  • Adhesive tape test: Collects mites for microscopic examination
  • PCR (Polymerase Chain Reaction): Confirms the presence of Sarcoptes scabiei DNA (used in research or specialized labs)

Treatment

  1. Topical Medications:
    • Permethrin 5% cream (first-line treatment)
    • Benzyl benzoate 25% lotion (alternative)
    • Sulfur ointment (safe for infants and pregnant women)
    • Crotamiton 10% cream/lotion
  2. Oral Medications:
    • Ivermectin (single or repeated doses for severe cases)
  3. Symptomatic Treatment:
    • Antihistamines or corticosteroids to reduce itching
    • Antibiotics for secondary bacterial infections

Proper adherence to treatment and hygiene measures helps eliminate scabies effectively.

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