Скачать или смотреть Scabies: Causes, Symptoms, Diagnosis, and Treatment - Dr Risata

Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. Though microscopic in size, this parasite can cause intense discomfort and spread rapidly through close personal contact. Scabies affects people of all ages, ethnicities, and socioeconomic backgrounds and remains a global public health concern, particularly in overcrowded or resource-limited settings.

What Causes Scabies?
Scabies is caused by female mites burrowing into the upper layer of the skin, where they lay eggs. The body’s immune response to the mites, their eggs, and waste products causes intense itching and a rash.

The mites are transmitted mainly through:

Prolonged skin-to-skin contact (e.g., among family members, sexual partners)

Sharing infested clothing, bedding, or towels

Overcrowded environments such as nursing homes, prisons, refugee camps, and childcare centers

Signs and Symptoms
The hallmark of scabies is severe itching, especially at night. Other symptoms include:

Rash: Small, red papules or blisters, often arranged in lines or tracks

Burrows: Thin, grayish-white, raised lines on the skin

Common sites affected:

Webs of fingers

Wrists

Elbows

Armpits

Waist

Genital area

Buttocks

In infants: face, scalp, palms, and soles may be involved

Itching and rash typically appear 4–6 weeks after the initial infestation but can appear sooner in people previously exposed.

Types of Scabies
Classic Scabies: The most common form, seen in otherwise healthy individuals.

Nodular Scabies: Persistent nodules that remain after treatment due to hypersensitivity.

Crusted Scabies (Norwegian Scabies): A severe form found in immunocompromised individuals; characterized by thick crusts teeming with mites and highly contagious.

Diagnosis
Scabies is primarily diagnosed through clinical evaluation. A healthcare provider may identify the burrows or rash pattern and consider the patient’s history of contact and symptoms. Confirmatory tests include:

Skin scraping: Mite, egg, or fecal pellet identification under a microscope

Dermatoscopy: May help visualize burrows and mites

Ink test or burrow ink test: Sometimes used to highlight burrows

Treatment
Topical Medications
Permethrin 5% cream: First-line treatment; applied from the neck down (or head-to-toe in infants) and left for 8–14 hours before washing off.

Benzyl benzoate, sulfur ointment, crotamiton: Alternatives in certain populations.

Lindane: Less commonly used due to potential neurotoxicity.

Oral Medication
Ivermectin: An oral antiparasitic used in severe cases, outbreaks, or crusted scabies; often given as two doses, 1–2 weeks apart.

Additional Measures
Treat all close contacts simultaneously, even if asymptomatic.

Launder all clothing, bedding, and towels in hot water and dry on high heat.

Items that cannot be washed can be sealed in plastic bags for at least 72 hours.

Antihistamines or topical steroids may help relieve itching after treatment, which can persist for weeks.

Prevention and Public Health Considerations
Early detection and prompt treatment are critical to preventing outbreaks.

In institutional settings, such as hospitals or care homes, infection control protocols must be enforced.

Community education, access to medication, and addressing overcrowding are essential in endemic regions.


Scabies is a manageable but highly transmissible condition that requires coordinated treatment of patients and contacts. With effective diagnosis, appropriate treatment, and preventive strategies, scabies can be controlled and eliminated from both individual households and wider communities.

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