Scabies is an inflammatory disease of the skin. It is caused by a parasitic infection. Causative organism Sarcoptes scabiei – Itch mite egg. It is a highly contagious disease that spreads easily from person to person through direct skin contact. Apart from this, mite infestation can also be done through infected clothing or bedding. Intimate contact is not necessary. It is so contagious that it bothers the infected person a lot. But its mites can be cured by effective treatment of scabies. To treat this, the doctor has prescribed treatment of scabies. To use regular medicines (Permethrin Ointment) for a week. Along with this, all the family members who came in contact also have to take treatment. Bedding and other clothes are also advised to be disinfected.
Incubation period
The period between entry of microorganisms in the host body and showing clinical manifestations that are four to eight weeks.
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clinical manifestations/signs and symptoms of scabies
- Barrow’s line formation – It is a grayish line present on the skin under which Sarcoptes scabiei are present. They may appear as small raised or discolored lines.
- Itching in scabies gets worse at night. It is so much that the person wakes up even from sleep.
- Persistent itching causes sores to form in the infected area which can become infected. and if wounds become the need for additional treatment.
Common sites for scabies in older, children, and adults are listed below.
- Interdigits (the area between the fingers)
- Axilla (armpit)
- Groin
- Intertrigo (an inflammatory condition of skin folds)
- wrist
- elbow
- nipple
- penis
- waist
- buttocks
- knees
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Common sites of infection in infants and children are:
- On the scalp
- Facial area
- palms
- and soles of feet.
Diagnosis of scabies
- History collection and physical examination.
- Dermatoscopy.
- Search the legion + KOH preparation(lightly scraping the infected area).
- under microscopic examination.
- itch mite present.
- then confirm scabies.
Treatment of scabies
When scabies is confirmed, then, first of all, isolate the patient, and put the patient’s bedding in direct sunlight. Wash all other clothing with hot water and detergents.
After that use pharmacological management
Permethrin Ointment – drug of choice in scabies. (use once a week)
Instructions for using permethrin ointment –
- Take a bath to apply ointment on the whole body especially areas where legions are present.
- Stay the medicine for 8 to 14 hours.
- Take Rebath and wash all clothes (like undergarments, Pillow Cover, blankets, etc in lukewarm water.)
Ivermectin – Tab 12 mg once a week.
Lindane solution – Contraindicated < 2-year children. (Because high Absorption cause Neurotoxicity)
Antihistamine Agents – eg. levocetirizine dihydrochloride tablet, Cetirizine, Fexofenadine.
Short period steroids – for decreased immunity prone to infection eg. Methylprednisolone, Omnacortil.