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Scabies: Causes, Symptoms, and Treatment

Scabies is caused by an infestation of the sarcoptes scabiei mite. It spreads through prolonged skin-to-skin contact and thrives in conditions of overcrowding and poor hygiene. The female mite burrows into the skin to lay eggs, causing an inflammatory response and intense itching after 1-2 months. Characteristic lesions form in skin folds and between fingers and toes. Diagnosis is made by identifying mites, eggs or feces under a microscope from skin scrapings. Treatment involves applying permethrin cream from neck to feet and showering after 8-12 hours to kill the mites. Retreatment is needed after 1-2 weeks to kill newly hat

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69 views2 pages

Scabies: Causes, Symptoms, and Treatment

Scabies is caused by an infestation of the sarcoptes scabiei mite. It spreads through prolonged skin-to-skin contact and thrives in conditions of overcrowding and poor hygiene. The female mite burrows into the skin to lay eggs, causing an inflammatory response and intense itching after 1-2 months. Characteristic lesions form in skin folds and between fingers and toes. Diagnosis is made by identifying mites, eggs or feces under a microscope from skin scrapings. Treatment involves applying permethrin cream from neck to feet and showering after 8-12 hours to kill the mites. Retreatment is needed after 1-2 weeks to kill newly hat

Uploaded by

AMOS MELI
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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SCABIES

Definition

Scabies is an endemic infestation with the mite sarcoptes scabiei. Outbreaks are typical in overcrowded
areas such as daycare centers, elementary schools and orphanages.

Risk factors

Overcrowding

Poor hygiene

Poverty

Transmission

Transmission occurs through prolonged skin-to-skin contact, rarely by indirect spread via infected
bedding, clothes etc. A person needs prolonged contact with the mite to become infested. It takes about
45 minutes for the mite to burrow under the skin; consequently, transient body contact is less likely to
cause transfer of the mite.

Pathogenesis

The lesions are created as the impregnated female burrows into the stratum corneum of the epidermis
(never into living tissue) to deposit her eggs and feces. The inflammatory response and itching occur after
the host has become sensitized to the mite, approximately 30-60days after initial contact. If the person has
been previously sensitized to the mite, the response occurs within 48 hrs. after exposure. After this time,
the areas over which the mite has travelled will begin to itch and develop the characteristic eruption.

Clinical Manifestations

The inflammatory response cause intense pruritus that leads to punctate discrete excoriations secondary to
the itching.

Maculopapular lesions are characteristically distributed in intertriginos areas (skin folds) i.e. popliteal
folds, inguinal region, the-axillary-cubital area and the iterdigital surfaces.

Infants often develop an eczematous eruption; therefore the observer must look for discrete, linear,
grayish-brown threadlike burrow.

Diagnosis

The diagnosis is made by microscopic identification from scrapings of the burrow using mineral oil or
KOH to help in identifying mites, ova or feces.

Through clinical manifestations

Therapeutic management
The drug of choice in infants older than 2 months is Permethrin 5% cream. Apply the cream after bathing;
from the neck down (avoiding orifices) leave it on for 8-12 hrs. (Preferably overnight) and shower off the
following morning.

Alternative drugs are crotamiton (cream or lotion) or oral ivermectin.

Oral ivermectin may be used to treat scabies with secondary excoriations for whom topical scabicides are
irritating and not well tolerated or whose infections are refractory. However, safety and efficacy of
ivermctin for children younger than 5 years old or weighing less than 15kgs has not been established.
Ivermectin is not ovicidal and must be repeated 1-2 weeks apart to be effective.

Precipitated sulfur 6% in petrolatum may be used in children under 2 years old; it should be applied to the
skin (and scalp in infants) for 3 days in a row, but it has an unpleasant smell and may cause skin irritation.

Because of the length of the time between infestation and physical symptoms (30-60days) all persons who
were in close contact with the affected child need treatment.

Nursing management

Involves patient teaching;

 Emphasize the importance of following directions carefully


 When Permethrin 5%is used, the cream should be thoroughly and gently massaged into all skin
surfaces from head to the sole of the feet and take care to avoid contact with the eyes
 Touching and holding the child should be minimized until treatment is completed and hands
should be washed carefully after contact is made.
 Families need to know that although the mite will be killed, the rash and the itching will not be
eliminated until the stratum corneum is replaced which takes approximately 2-3 weeks, therefore
soothing ointments, mild antihistamines (e.g. cetirizine, diphenhydramine) and topical
corticosteroids (e.g. hydrocortisone skin cream) can be used for itching.

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