What Is Scabies?
The human itch mite, Sarcoptes scabiei var. hominis, is the source of human scabies when it infests the skin. The microscopic scabies mite lives and lays its eggs in the upper layer of the skin, where it burrows. Scabies is most commonly characterized by severe itching and a rash on the skin that resembles pimples. The most common way for the scabies mite to spread is through prolonged, direct skin-to-skin contact with an infected individual. People of many races and all groups are susceptible to scabies, which is a global disease. In crowded settings with frequent close body contact, scabies can spread quickly. Scabies epidemics frequently occur in institutional settings, including prisons, extended-care facilities, and nursing homes.
Scabies Causative Organism
The itch mite is Sarcoptes scabiei var hominis. It has an oval-shaped body with four pairs of short legs. The female mite is larger than the male. In a usual patient with scabies, the average number of mites is 10 to 12. However, in crusted scabies, it can be up to two million.
Mode of Transmission
Transmission is facilitated by overcrowding and poor hygiene. It also spreads by close physical contact including sex. As the mite does not survive for more than two days away from a moist environment, transmission through clothing is unlikely.
What Are Norwegian (Crusted) Scabies?
Crusted scabies are a severe type of scabies that can affect those with weak immune systems, the elderly, people with disabilities, or people who are debilitated. Another name for it is Norwegian scabies. People who have crusted scabies have skin with thick crusts that are packed with scabies eggs and mites. People who have crusted scabies are very infectious and can readily infect others by contaminating objects like bedding, clothing, and furniture as well as by direct skin-to-skin contact. Individuals who have crusted scabies might not exhibit the typical pruritus (itching) or rash associated with scabies. To stop scabies epidemics, people with crusted scabies need prompt, intensive medical attention for their infection.
What Are the Causes of Scabies?
A few of the reasons are as follows
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Direct, continuous skin-to-skin contact with an infected person is typically the means of spreading scabies.
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Scabies usually cannot be transferred by a brief handshake or embrace. Instead, contact must be sustained.
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It is easy for scabies to spread to family members and sexual partners.
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Adults with scabies often contract it through sexual activity.
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Sharing items used by an infected person, such as clothes, towels, or bedding, can occasionally result in the indirect spread of scabies; however, this is far more likely to happen when the infected person has crusted scabies.
What Are the Clinical Features of Scabies?
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Extreme itching, which is more at night is usually considered a herald of scabies.
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The most common sites of involvement are webs of the fingers, wrists, elbows, anterior axillary folds, nipples, umbilical area, and groins.
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The primary lesion of scabies is a burrow. It appears as a wavy dark line with a papule or vesicle at the open end. The mite may be seen as a whitish dot at the closed end of the burrow.
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The other lesions that may be seen are larval papules, nodules, pustules, and vesicles.
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Other members of the family are commonly affected.
How Can Scabies Be Diagnosed?
Scabies should be suspected in case of,
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Itchy papules or nodules involving the classical sites.
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History of itching at night.
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History of similar complaints in other family members.
Diagnosis is confirmed by the demonstration of the mite, its eggs, or fecal pellets.
What Are the Treatment Modalities for Scabies?
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Permethrin 5 percent is the drug of choice, which can be used for all ages and on all body areas. It is used as a single application, washed off after 8 to 12 hours, and may be repeated after one week.
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GBHC 1 percent (Gamma benzene hexachloride) can be used once in 12 hours. But, it is not recommended for children, pregnant women, lactating women, and those with neurological and extensive cutaneous diseases.
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Benzyl benzoate lotion 25 percent (12.5 percent in case of children) can be used. It should be applied and left on the body for at least 48 hours or its application is repeated for three consecutive nights and is then washed off.
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Sulfur (6 percent precipitated sulfur in petrolatum) is another option for treatment. It should be applied to the entire body below the neck daily for three days and the patient should take a bath after 24 hours of each application. It is the drug of choice in pregnant women.
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After therapy, clothes, and bed linen used should be washed in warm water.
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Itching may persist for up to four weeks and usually 7 to 10 days after treatment.
Guidelines for Treating Scabies:
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It is crucial to keep in mind that people typically have no symptoms when they initially contract scabies. After becoming infected, symptoms might take 4 to 8 weeks to appear, but throughout this time, they can still spread scabies.
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Treatment is advised for sexual partners and household members in addition to the infected individual, especially if there has been extended direct skin-to-skin contact. People who have had direct, prolonged skin-to-skin contact with an infected individual within the last month, whether through sexual activity or intimate personal relationships, should be evaluated and treated. To stop reinfestation, everyone should receive treatment at the same time.
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During the three days before treatment, bedding, clothes, and towels used by infected individuals or their close, domestic, and sexual contacts (as previously defined) should be decontaminated by either washing in hot water and drying in a hot dryer, dry cleaning, or sealing in a plastic bag for a minimum of 72 hours. In general, scabies mites cannot survive more than two to three days separated from human skin.
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It is not advised to use fumigants or insecticide sprays.
How Can Scabies Be Prevented?
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Avoiding close skin-to-skin contact with an infected individual or with objects like bedding or clothing used by an infected person is one way to prevent scabies.
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Treatment for scabies is typically advised for family members, especially if there has been extensive skin-to-skin contact.
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To avoid future reexposure and reinfestation, all members of the household and other individuals who may have been exposed should be treated concurrently with the infected person.
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During the three days before treatment, bedding and clothing that are worn or used near the skin should either be dry cleaned or machine washed and dried with hot water and hot dryer cycles.
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Clothes that cannot be washed or dry cleaned can be kept in a zipped plastic bag for a few days to a week to help get rid of insects.
Usually, scabies mites can only endure two to three days separated from human skin. Both adults and children can typically resume work, school, or child care the day following therapy.
Conclusion:
Scabies are most commonly characterized by severe itching and a rash on the skin that resembles pimples. The most common way for the scabies mite to spread is through prolonged, direct skin-to-skin contact with an infected individual. People of many races and all groups are susceptible to scabies, which is a global disease. In crowded settings with frequent close body contact, scabies can spread quickly. Scabies epidemics frequently occur in institutional settings, including prisons, extended-care facilities, and nursing homes. Scabies infestations are also frequently found in childcare centers.
