Scabies

• Sarcoptes scabiei var hominis
  • Obligate human parasite
• Transmission by direct physical contact or contact with infected clothes
• Highly contagious
• Incubation period 3 – 6 weeks
• Risk factors
  • Nursing homes
  • Childcare facilities
  • Prisons
• Pathomechanism
  • Female mites burrow into stratum corneum, lays eggs and feces
  • Feces and dead mites trigger type IV hypersensitivity
• Clinical features
  • Intense pruritus, especially at night
  • Skin lesions
    • Elongated erythematous papules
    • 2 – 10 mm burrows (elevations in the skin)
    • Vesicles
    • Excoriation due to itching
  • Predilection sites – warm areas with thin skin
    • Wrists
    • Fingers
    • Male genitalia
• Diagnosis
  • Dermoscope
  • Clinical
• Treatment
  • Permethrin 5% lotion
    • Applied to the whole body and left on the skin for 8 – 12 hours
    • The rest of the family should be treated too
  • Lindane 1% lotion
  • Oral ivermectin
  • Symptomatic treatment of pruritus
    • Oral antihistamines
    • Topical steroids