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SCABIES

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Scabies is an itchy skin condition caused by a tiny burrowing mite called Sarcoptesscabiei

Types:

Nodular scabies: Nodules occur in 7-10% of patients with scabies, particularly young children. In neonates unable to scratch, pinkish brown nodules ranging in size from 2-20 mm in diameter may develop.

Crusted scabies: In crusted scabies, lesions are often hyperkeratotic and crusted and cover large areas. Marked scaling is common, and pruritus may be minimal or absent. Nail dystrophy and scalp lesions may be prominent. The hands and arms are the usual locations for lesions, but all sites are vulnerable.

Secondary lesions: These lesions result from scratching, secondary infection, and/or the host’s immune response against the scabies mites and their products. Characteristic findings include the following:

·         Excoriations

·         Widespread eczematous dermatitis

·         Honey-colored crusting

·         Postinflammatory hyperpigmentation

·         Erythroderma

·         Prurigo nodules

·         Frank pyoderma

Symptoms

Burrows are a pathognomonic sign and represent the intraepidermal tunnel created by the moving female mite. They appear as serpiginous, grayish, threadlike elevations in the superficial epidermis, ranging from 2-10 mm long. High-yield locations for burrows include the following:

  • Webbed spaces of the fingers
  • Flexor surfaces of the wrists
  • Elbows
  • Axillae
  • Belt line
  • Feet
  • Scrotum (men)
  • Areolae (women)

Diagnosis

Scabies may be diagnosed clinically in geographical areas where it is common when diffuse itching presents along with either lesions in two typical spots or there is itchiness of another household member.The classical sign of scabies is the burrows made by the mites within the skin.

 

Treatment

Specific treatment for scabies will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • Extent of the infestation
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the infestation

Scabies is treatable and usually all members in a family are treated at the same time. Treatment may include:

  • Applications of prescription creams and lotions, such as permethrin and lindane solutions
  • Oral antihistamine medication (to help relieve itching)
  • Clothes and bedding must be washed in hot water 
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