scabies

What is Scabies?

Scabies is an itchy skin rash caused by a tiny burrowing mite called Sarcoptes scabiei [1]. The mites set up shop in the outer layers of human skin, causing intense itching and a pimple-like skin rash [2].

Causes and Transmission

Scabies is not an infection, but an infestation. It spreads through direct contact with an infected person or contaminated items [4]. The microscopic mite, approximately 1/10th of a millimeter in length, burrows into the skin surface, causing discomfort and itching [8].

Symptoms

The symptoms of scabies include:

• Intense itching, especially at night
• A pimple-like skin rash, often on the hands, feet, wrists, elbows, and genital areas
• Redness and inflammation around the affected area

Treatment

Scabies is a readily treatable infestation. Topical or oral prescription medications are used to kill the mites and relieve symptoms [4]. Early treatment can help prevent complications and reduce the risk of transmission.

References: [1] - Scabies is an itchy skin rash caused by a tiny burrowing mite called Sarcoptes scabiei. [2] - The mites set up shop in the outer layers of human skin, causing intense itching and a pimple-like skin rash. [4] - Topical or oral prescription medications treat it. It spreads through direct contact. [8] - Scabies is caused by a parasitic infestation of the skin caused by a mite, Sarcoptes scabiei. The microscopic mite in the adult female stage is approximately 1/10th of a millimeter in length.

Common Signs and Symptoms of Scabies

Scabies is a skin infestation caused by the mite Sarcoptes scabiei, which leads to intense itching and a characteristic rash. The symptoms of scabies can vary from person to person, but there are some common signs that are often reported.

• Intense Itching: Itching is the most common symptom of scabies, and it's usually worse at night [1][2]. The itch can be so intense that it keeps a person awake.
• Skin Rash: A pimple-like (papular) itchy rash is another common symptom of scabies. The rash can look like hives, insect bites, or pimples [3].
• Thin, Wavy Tunnels: Scabies mites burrow into the skin, creating thin, wavy tunnels that can be felt as tiny blisters or bumps [1]. These tunnels are often more difficult to see on brown or black skin.
• Red, Brown, or Gray Rash: The rash caused by scabies can appear red, brown, or gray in color. It can look like a line across the skin or appear in patches [4].
• Scales or Blisters: In some cases, scabies can cause scales or blisters on the skin.
• Sores Caused by Scratching: The intense itching caused by scabies can lead to sores on the skin due to excessive scratching.

It's worth noting that people with crusted scabies may not show the usual signs and symptoms [5]. If you suspect you have scabies, it's essential to consult a healthcare professional for proper diagnosis and treatment.

Diagnosing Scabies: A Comprehensive Overview

Scabies, a skin infestation caused by the mite Sarcoptes scabiei, can be challenging to diagnose due to its similar symptoms with other skin conditions. However, various diagnostic tests and methods are employed to confirm the presence of scabies.

• Visual Examination: Dermatologists often diagnose scabies by visually examining a patient's skin from head to toe [2]. This method is effective in identifying the characteristic burrows or tracks left behind by the mites.
• Skin Biopsy: In some cases, a skin biopsy may be used to confirm a diagnosis of scabies. This procedure involves examining a small sample of skin under a microscope [3].
• Dermoscopy: Dermoscopy is a non-invasive test that can aid in confirming a diagnosis of scabies. It involves using a dermatoscope to examine the skin for signs of mites, larvae, or eggs [4].
• Skin Scrapings: Skin scrapings are a common diagnostic method used to confirm scabies. This procedure involves scraping off a small sample of skin and examining it under a microscope for evidence of mites, larvae, ova, or scybala (feces) [6][7].

Limitations of Diagnostic Tests

While these tests can aid in diagnosing scabies, there are no standardized laboratory tests available to confirm the presence of scabies [5]. This highlights the importance of a thorough clinical examination and visual inspection by a healthcare professional.

In conclusion, diagnosing scabies requires a combination of clinical expertise and diagnostic testing. While various methods are employed, there is still a need for more effective and standardized laboratory tests to aid in confirming a diagnosis.

References: [1] Not provided (search results) [2] Context #2 [3] Context #3 [4] Context #4 [5] Context #5 [6] Context #6 [7] Context #7

Treatment Options for Scabies

Scabies can be treated with various medications, including topical and oral antiparasitic agents.

• Topical Scabicides: Permethrin cream (5%) is often prescribed to treat scabies. This medication is FDA approved to treat patients 2 months of age and older and women who are pregnant or breastfeeding [5]. Crotamiton lotion 10% and crotamiton cream 10% are also approved by the US Food and Drug Administration (FDA) for the treatment of scabies [1].
• Oral Antiparasitic Agents: Ivermectin is the most common medication to treat scabies. This is an antiparasitic pill given in a single dose, followed by a second dose one to two weeks later [7]. Ivermectin can be used to treat scabies in patients of all ages, including children as young as 2 months old [5].

Additional Treatment Options

Other treatment options for scabies include:

• Scabicidal Agents: Scabies treatment includes administration of a scabicidal agent (eg, permethrin, lindane, or ivermectin), as well as an appropriate topical cream or lotion to apply to skin that kills scabies mites [6].
• Antihistamines and Topical Steroids: Antihistamines such as hydroxyzine hydrochloride (Atarax) and diphenhydramine hydrochloride (Benadryl) can be used to treat pruritus associated with scabies. Topical steroids may also be prescribed to reduce inflammation [2].

Prescription by Healthcare Professional

It's essential to note that a healthcare professional should prescribe medication for scabies treatment, as they will determine the best course of treatment based on individual patient needs.

References:

[1] Crotamiton lotion 10% and crotamiton cream 10%: FDA approval for scabies treatment. [2] Pruritus can be treated with an oral antihistamine, such as hydroxyzine hydrochloride (Atarax), diphenhydramine hydrochloride (Benadryl), or... [3] Your healthcare professional can prescribe a cream or lotion to apply to skin that kills scabies mites, called scabicides. [4] If you have scabies, your doctor will prescribe a medication called a “scabicide.” It contains permethrin, and it comes in a lotion or cream... [5] Permethrin cream (5%): Often prescribed to treat scabies, this medication is FDA approved to treat patients 2 months of age and older and women who are pregnant or breastfeeding. [6] Scabies treatment includes administration of a scabicidal agent (eg, permethrin, lindane, or ivermectin), as well as an appropriate topical cream or lotion to apply to skin that kills scabies mites. [7] Ivermectin is the most common medication to treat scabies. This is an antiparasitic pill given in a single dose, followed by a second dose one to two weeks later.

Differential Diagnosis of Scabies

Scabies, caused by the mite Sarcoptes scabiei var hominis, can be challenging to diagnose due to its similarity in presentation with other skin conditions. The differential diagnosis for scabies includes a variety of pruriginous skin diseases that may mimic the symptoms of scabies.

List of Differential Diagnoses:

• Atopic dermatitis
• Contact dermatitis
• Papular urticaria
• Folliculitis
• Dermatitis herpetiformis
• Prurigo nodularis
• Bites from mosquitoes, fleas, bed bugs, and chiggers or other mites
• Insect bites
• Bacterial infections (e.g. impetigo)
• Viral infections
• Eczema
• Lupus erythematosus

Key Points:

• A diagnosis of clinical or suspected scabies should only be made if other differential diagnoses are considered less likely than scabies [5][10].
• The 2020 IACS Criteria aim to standardize the diagnosis of common scabies, facilitating communication and comparison of epidemiological and clinical findings [10].
• Crusted scabies may resemble other conditions with extensive scale, such as psoriasis and seborrheic dermatitis [8].

References:

[1] Human scabies is an intensely pruritic skin infestation caused by the host-specific mite Sarcoptes scabiei var hominis. [2] Diagnosis can be made at one of the three levels (A, B or C). [3] The differential diagnosis of scabies includes a variety of pruriginous skin diseases... [4] May 7, 2022 — Consider differential diagnoses. Potential differential diagnoses for scabies include insect bites, bacterial infections, e.g. impetigo* or ... [5] by D Engelman · 2020 · Cited by 301 — Differential diagnoses. The diagnosis of clinical or suspected scabies (levels B or C) requires that conditions other than scabies are considered less likely. [6] May 21, 2024 — Nodular scabies, a less common variant, refers to the presence of pink-to-red or hyperpigmented nodules... [7] by BG Goldstein · Cited by 13 — The diagnosis of scabies is confirmed through the detection of scabies mites, eggs, or feces with microscopic examination. [8] Possible differential diagnoses for crusted scabies include other conditions that present with extensive scale... [9] Differential Diagnosis The clinical presentation of scabies may resemble infections caused by other sources such as bacteria, fungi, parasites, and viruses [3] . Scabies often gets misdiagnosed as eczema, dermatitis herpetiformis, prurigo nodularis, or bullous pemphigoid. [10] A diagnosis of clinical or suspected scabies should only be made if other differential diagnoses are considered less likely than scabies. The 2020 IACS Criteria are intended to standardize the diagnosis of common scabies... [11] Differential diagnosis of scabies. Differential diagnosis of scabies include the following conditions. Bullous pemphigoid. The urticarial phase of bullous pemphigoid can show similar features to scabies, though typically the infiltrate is superficial with lining up of the eosinophils along the basal layer of the epidermis and mild vacuolar...