Scabies Quiz

Comprehensive Guide to Scabies

This guide provides essential information about scabies, a contagious skin condition caused by a microscopic mite. Understanding its symptoms, transmission, diagnosis, and treatment is crucial for healthcare professionals, students, and the general public.

What is Scabies?

Scabies is an infestation of the skin by the human itch mite, *Sarcoptes scabiei var. hominis*. The microscopic mite burrows into the upper layer of the skin where it lives and lays its eggs. The most common symptoms of scabies are intense itching (pruritus), especially at night, and a pimple-like skin rash. The scabies mite is usually spread by direct, prolonged, skin-to-skin contact with a person who has scabies.

Symptoms and Clinical Presentation

The hallmark symptom of scabies is severe and relentless itching, which is often worse at night. This itching is the result of a hypersensitivity reaction to the mites, their eggs, and their feces (scybala). The characteristic rash includes:

• Burrows: These appear as short, thin, wavy lines on the skin surface. They are grayish-white or skin-colored and are most often found in the webbing between fingers, on the wrists, elbows, armpits, and around the waist.
• Papules and Vesicles: Small, red bumps or blisters may also appear.
• Nodules: In some cases, reddish-brown nodules can develop, particularly on the groin or in the armpits.

Transmission and Risk Factors

Scabies is highly contagious and spreads primarily through direct, prolonged skin-to-skin contact with an infected individual. A quick handshake or hug usually does not spread scabies. It can also be spread, though less commonly, by sharing clothing, towels, or bedding. Outbreaks are more frequent in crowded conditions where close body and skin contact is common, such as:

• Nursing homes and extended-care facilities
• Child care centers
• Prisons
• Households with an infected person

Diagnosis and Testing

Diagnosis is typically based on the patient’s symptoms and the appearance of the rash. A definitive diagnosis is made by identifying the mite, its eggs, or fecal matter. This is done by a healthcare provider who scrapes a small area of skin where a burrow is visible and examines the sample under a microscope.

Treatment and Management

Scabies is treatable. The first-line treatment is typically a prescription scabicide cream or lotion. The most commonly prescribed medications include:

1. 5% Permethrin Cream: Applied to the entire body from the neck down, left on for 8-14 hours, and then washed off.
2. Ivermectin (Oral): An oral medication that may be prescribed for people with crusted scabies, those who don’t respond to creams, or for institutional outbreaks.

In addition to medical treatment, it’s crucial to decontaminate the environment by washing all clothing, bedding, and towels used by the infected person within the last 3 days in hot water and drying them on a high heat setting.

Crusted (Norwegian) Scabies

This is a severe and highly contagious form of scabies that can occur in people with a weakened immune system (e.g., HIV/AIDS, organ transplant recipients), the elderly, or those with certain medical conditions. Individuals with crusted scabies have thick crusts of skin that contain large numbers of scabies mites and eggs. They may not show the usual signs of itching and rash, making diagnosis challenging.

This information is for educational purposes and should not be considered medical advice. Always consult a healthcare professional for diagnosis and treatment.