SCABIES Pelin özkan

Human scabies is a highly contagious disease caused by the mite Sarcoptes scabiei var. hominis. Scabies is not primarily a sexually transmitted disease but sexual transmission does occur. Scabies spreads in households and neighborhoods in which there is a high frequency of intimate personal contact or sharing of inanimate objects, and fomite transmission is a major factor in household and nosocomial passage of scabies.

Immunology A hypersensitivity reaction rather than a foreign-body response may be responsible for the lesions, which may delay recognition of symptoms of scabies.

Symptoms are minor at first and are attributed to a bite or dry skin. Scratching destroys burrows and removes mites, providing initial relief. The patient remains comfortable during the day but itches at night. Primary lesions are soon destroyed by scratching.

Primary Lesions Mites are found in burrows and at the edge of vesicles but rarely in papules. Burrow The linear, curved, or S-shaped burrows are approximately as wide as #2 suture material and are 2 to 15 mm long Vesicles and Papules. Vesicles are isolated and pinpoint and filled with serous rather than purulent fluid.

Secondary Lesions Secondary lesions result from infection or are caused by scratching. They often dominate the clinical picture. Pinpoint erosions are the most common secondary lesions

Distribution

Signs and Symptoms of Scabies • Nodules on the penis and scrotum • Sudden worsening of a rash present for 4 to 8 weeks • Pustules on the palms and soles of infants • Nocturnal itching • Generalized, severe itching • Pinpoint erosions and crusts on the buttocks

Signs and Symptoms of Scabies • Vesicles in the finger webs • Diffuse eruption sparing the face • Patient improves and then worsens after treatment with topical steroids • Rash present in several members of the same family • Patient (especially an infant) develops more extensive rash despite treatment with antibiotics and topical medications

Diagnosis Dermoscopy

Treatment and Management Permethrin (Elimite cream) Lindane Benzyl Benzoate Crotamiton (Eurax Lotion) Sulfur, Ivermectin (Stromectol)