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