Scabies


Scabies

Description, Causes and Risk Factors:

Scabies is an infestation of the skin by the microscopic mite Sarcoptes scabei (Formerly Acarus scabiei, the itch mite, varieties of which are distributed worldwide and affect humans, horses, cattle, swine, sheep, dogs, cats, and many wild animals). It is an exceedingly common disease of worldwide distribution. It is endemic in many developing countries. Although scabies is more common where overcrowded conditions prevail, it can affect any individual irrespective of social status, personal hygiene, profession, gender, age or ethnic origin. Scabies is very contagious. It spreads rapidly under crowded conditions, especially where there is frequent skin-to-skin contact between people, such as in hospitals, institutions, childcare facilities, and nursing homes.

The scabies mite tends to burrow in the interdigital folds, flexor aspects of the wrists, extensor surfaces of the elbows, axillary folds, belt line, navel, abdomen, intergluteal cleft and buttocks. An infestation begins when an egg-bearing female scabies mite tunnels under the skin and lays eggs in the burrow. After an incubation time of 3-10 days, eggs hatch into immature mites which develop under the skin.

Types may include:

Classical scabies:

    Found in people with normal immune systems.

  • Mites may be few in numbers.

  • Itch starts about 2-6 weeks following infection.

  • Sites of the rash may not correspond to sites of the mites.

Norwegian scabies (crusted scabies):

    It affects individuals with severely impaired immune systems.

  • It is also commonly found in people with Downs Syndrome. Numerous mites are found in crusted scabies.

  • There may be an absence of the generalized itchy rash.

  • Skin becomes scaled, crusted and unsightly due to the number of mites present.

Mode of transmission:

    Scabies mites are transferred by any direct skin-to-skin contact.

  • Indirect transfer from undergarments or bedding can occur only when these items have been in contact with an infected person immediately beforehand.

  • Scabies can also be transmitted during sexual contact.

Symptoms:

    The primary symptom of scabies is intense pruritus (itching), which oftenintensifies at night or after a hot shower.

  • Round, symmetrical, 2 - 3 mm diameter papulovesicular (bumpy, fluid-filled)lesions are often present on the body.

  • The hands and feet usually have a less intense reaction when compared to thesofter parts of the body.

  • Young children and infants may develop bullous (blister) lesions on any bodysurface, including the scalp, neck, palms, and soles of the feet.

  • Other symptoms may include erythematous (red rash) and papular (bumpy)eruptions, pustules (pus-filled lesions), and nodules.

Diagnosis:

Scabies must bediagnosed by a medical doctor (dermatologist), who looks at theburrows or rash. A skin scraping isoften done to look for mites, eggs,or mite fecal matter to confirm the scabies diagnosis.The use of ahand-held magnification lens and good lighting are often required foridentifying lesions to be sampled.The mitesburrow into the skin, but never below the outer layer of the epidermis.

Treatment:

Prescription medicated creams are commonly used to treat scabies infections. The most commonly used cream is permethrin 5%. Other creams and medications may include benzyl benzoate and sulfur in petrolatum, Elimite, Acticin, Stromectol, Eurax. For difficult cases, some health care providers may also prescribe medication taken by mouth to kill the scabies mites. Ivermectin is a pill that may be used.

Preventive Measure:

Treatment of scabies on individuals and reduction of skin-to-skin contact with infested individuals is recommended as the primary means of eliminating the infestation. Although transmission via fomites (any inanimate object such as a towel, money, clothing, dishes, books or toys etc that can transmit infectious agents from one person to another) is possible, regular housekeeping and hygienic measures such as changing and washing of bedding in hot water followed by drying materials in a mechanical dryer at the highest temperature setting (preferably 120º F or hotter) should be adequate to prevent further spread.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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