ICD-10: B86

Scabies, classified under ICD-10 code B86, is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and treatment.

Clinical Presentation

Signs and Symptoms

The clinical presentation of scabies typically includes the following signs and symptoms:

• Intense Itching: The most prominent symptom, often worsening at night. This itching is a result of an allergic reaction to the mites and their waste products[1][2].
• Rash: A characteristic rash may develop, often appearing as small red bumps or blisters. The rash can be widespread but is commonly found in specific areas such as:
• Between the fingers
• Wrists
• Elbows
• Armpits
• Genital area
• Buttocks
• Breasts in women[3][4].
• Burrows: These are tiny, thread-like lines on the skin, which are the actual tunnels made by the mites as they burrow into the skin. They are often found in the webbing between fingers and on the wrists[1][3].
• Secondary Infections: Due to scratching, secondary bacterial infections can occur, leading to further complications such as cellulitis or impetigo[2][4].

Patient Characteristics

Scabies can affect individuals of all ages and backgrounds, but certain characteristics may influence its prevalence and presentation:

• Age: Scabies is common in children and young adults, particularly in crowded living conditions such as schools and daycare centers[1][2].
• Living Conditions: Individuals living in close quarters, such as nursing homes, shelters, or refugee camps, are at higher risk due to the ease of transmission[3][4].
• Immunocompromised Individuals: Those with weakened immune systems may experience more severe symptoms and complications due to scabies, including crusted scabies (Norwegian scabies), which is a more severe form characterized by thick crusts of skin[1][2].
• Socioeconomic Factors: Lower socioeconomic status can contribute to higher rates of scabies due to factors such as overcrowding, lack of access to healthcare, and inadequate hygiene practices[3][4].

Diagnosis

Diagnosis of scabies is primarily clinical, based on the history of exposure and characteristic signs and symptoms. In some cases, a skin scraping may be performed to identify mites or their eggs under a microscope[1][2].

Conclusion

Scabies is a common yet often overlooked condition that can significantly impact quality of life. Recognizing the clinical presentation, signs, symptoms, and patient characteristics associated with scabies is essential for timely diagnosis and treatment. Effective management not only alleviates symptoms but also helps prevent further transmission within communities. If you suspect scabies, it is advisable to seek medical attention for appropriate evaluation and treatment options.

ICD-10 code B86 specifically refers to "Scabies," a contagious skin condition caused by the infestation of the Sarcoptes scabiei mite. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some alternative names and related terms associated with ICD-10 code B86.

Alternative Names for Scabies

1. Sarcoptic Mange: This term is often used in veterinary medicine but can also refer to the same condition in humans, emphasizing the causative mite.
2. Scabiosis: A less common term that refers to the condition of having scabies.
3. Itch Mite Infestation: This term highlights the primary symptom of scabies, which is intense itching caused by the mite's presence.

Related Terms

1. Acariasis: This is a broader term that refers to any disease caused by mites, including scabies. It encompasses various mite infestations beyond just Sarcoptes scabiei.
2. Ectoparasitic Infestation: This term describes infestations by parasites that live on the skin's surface, which includes scabies.
3. Dermatitis: While not specific to scabies, dermatitis refers to inflammation of the skin, which can occur as a result of scabies infestation.
4. Pruritus: This term refers to itching, a primary symptom of scabies, and is often used in clinical settings to describe the sensation experienced by patients.

Clinical Context

In clinical practice, it is essential to use precise terminology to ensure accurate diagnosis and treatment. The use of alternative names and related terms can help healthcare professionals communicate effectively about scabies and its implications. For instance, when discussing treatment options, referring to "itch mite infestation" may help patients understand the cause of their symptoms better.

In summary, while ICD-10 code B86 is specifically designated for scabies, various alternative names and related terms exist that can aid in understanding and discussing this condition. These terms can be particularly useful in medical documentation, patient education, and interdisciplinary communication.

Scabies, classified under ICD-10 code B86, is a highly contagious skin condition caused by the infestation of the skin by the Sarcoptes scabiei mite. This condition is characterized by intense itching and a rash, which can lead to secondary infections if left untreated. Below is a detailed clinical description and relevant information regarding scabies.

Clinical Description of Scabies

Etiology

Scabies is caused by the Sarcoptes scabiei mite, which burrows into the upper layer of the skin, leading to an inflammatory response. The infestation is typically transmitted through prolonged skin-to-skin contact with an infected person, making it common in crowded living conditions, such as nursing homes, prisons, and among family members.

Symptoms

The primary symptoms of scabies include:

• Intense Itching: This is often worse at night and can be severe enough to disrupt sleep.
• Rash: The rash typically appears as small red bumps, blisters, or pustules. It may also present as thin, irregular burrow tracks made by the mites, which can be seen on the skin.
• Common Sites: The rash commonly affects areas such as the webbing between fingers, wrists, elbows, armpits, waist, buttocks, and genital area. In infants and young children, it may also appear on the scalp, face, and palms.

Diagnosis

Diagnosis of scabies is primarily clinical, based on the characteristic symptoms and the appearance of the rash. In some cases, a skin scraping may be performed to identify the mites or their eggs under a microscope.

Treatment

The treatment for scabies typically involves the use of topical scabicides, such as permethrin cream or benzyl benzoate, which are applied to the entire body from the neck down and left on for a specified period. Oral medications, such as ivermectin, may be prescribed in more severe cases or for outbreaks in communal settings.

Complications

If untreated, scabies can lead to complications such as:

• Secondary Bacterial Infections: Scratching the itchy rash can break the skin, allowing bacteria to enter and cause infections like impetigo.
• Crusted Scabies: A more severe form of scabies that can occur in immunocompromised individuals, characterized by thick crusts of skin that harbor large numbers of mites.

Epidemiology

Scabies is a global health issue, affecting individuals of all ages and socioeconomic backgrounds. It is particularly prevalent in areas with high population density and poor hygiene conditions. The World Health Organization recognizes scabies as a significant public health concern, especially in tropical and subtropical regions.

Conclusion

ICD-10 code B86 encapsulates the clinical aspects of scabies, a condition that, while often overlooked, can have significant implications for affected individuals. Early diagnosis and treatment are crucial to prevent complications and control outbreaks, particularly in communal living situations. Awareness and education about scabies transmission and prevention are essential in managing this condition effectively.

The diagnosis of scabies, classified under ICD-10 code B86, involves a combination of clinical evaluation, patient history, and specific diagnostic criteria. Here’s a detailed overview of the criteria used for diagnosing scabies:

Clinical Presentation

Symptoms

Patients typically present with the following symptoms:
- Intense Itching: This is often the most prominent symptom, particularly at night. The itching is caused by an allergic reaction to the mites and their waste products[2].
- Rash: A rash may develop, characterized by small red bumps, blisters, or pustules. The rash often appears in specific areas, such as between the fingers, on the wrists, elbows, armpits, and genital areas[3].
- Burrows: The presence of burrows, which are tiny, thread-like lines in the skin, is a classic sign of scabies. These burrows are created by the female mite as it tunnels into the skin[2][3].

Duration and Distribution

The distribution of the rash and the duration of symptoms can also aid in diagnosis. Scabies typically affects areas of the body that are warm and moist, and the symptoms can persist for weeks if untreated[3].

Patient History

Exposure History

A thorough patient history is crucial. This includes:
- Close Contact: Inquiring about recent close contact with individuals who have scabies or similar symptoms is essential, as scabies is highly contagious[2].
- Living Conditions: Information about living conditions, such as crowded environments or institutions (e.g., nursing homes, schools), can also indicate a higher risk of scabies transmission[3].

Diagnostic Tests

Microscopic Examination

While the diagnosis is primarily clinical, a skin scraping may be performed to identify the mites, eggs, or fecal matter under a microscope. This can confirm the diagnosis but is not always necessary if the clinical presentation is clear[2][3].

Differential Diagnosis

It is important to differentiate scabies from other skin conditions that may present similarly, such as eczema, contact dermatitis, or other parasitic infections. This may involve additional tests or evaluations based on the clinical findings[3].

Conclusion

In summary, the diagnosis of scabies (ICD-10 code B86) relies heavily on clinical symptoms, patient history, and, when necessary, laboratory confirmation through skin scraping. The combination of intense itching, characteristic rash, and exposure history plays a critical role in establishing the diagnosis. If you suspect scabies, it is advisable to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

Scabies, classified under ICD-10 code B86, is a highly contagious skin condition caused by the infestation of the Sarcoptes scabiei mite. The treatment of scabies focuses on eradicating the mites and alleviating symptoms such as itching and inflammation. Here’s a detailed overview of standard treatment approaches for scabies.

Pharmacological Treatments

1. Topical Scabicides

Topical treatments are the first line of defense against scabies. The most commonly used scabicides include:

• Permethrin Cream (5%): This is the most widely recommended treatment. It is applied to the entire body from the neck down and left on for 8-14 hours before washing off. A second application may be necessary after one week to ensure complete eradication of the mites[2][5].

• Benzyl Benzoate: This is another effective topical treatment, typically used in a 25% concentration for adults and a lower concentration for children. It is applied similarly to permethrin but may cause skin irritation[2][5].

• Crotamiton: Available as a cream or lotion, crotamiton is less effective than permethrin but can be used in cases where other treatments are not suitable. It is applied twice, 24 hours apart[2][5].

2. Oral Medications

In cases of severe scabies or crusted scabies (Norwegian scabies), oral medications may be necessary:

• Ivermectin: This oral medication is particularly useful for treating crusted scabies or in outbreaks where topical treatments may be impractical. A single dose is often effective, but a second dose may be required after one to two weeks[2][5].

Symptomatic Relief

1. Antihistamines

To alleviate itching, antihistamines such as diphenhydramine (Benadryl) can be used. These medications help reduce the allergic reaction to the mites and provide relief from itching, especially at night[2][5].

2. Topical Corticosteroids

For inflammation and severe itching, topical corticosteroids may be prescribed. These can help reduce inflammation and provide symptomatic relief, particularly in cases where the skin is irritated or inflamed due to scratching[2][5].

Environmental Measures

1. Cleaning and Disinfection

To prevent reinfestation, it is crucial to wash all clothing, bedding, and towels used by the infested person in hot water and dry them on a hot cycle. Items that cannot be washed should be sealed in plastic bags for at least 72 hours to kill any remaining mites[2][5].

2. Avoiding Close Contact

Individuals diagnosed with scabies should avoid close contact with others until treatment is completed and the infestation is resolved. This is particularly important in communal living situations, such as schools or nursing homes, to prevent outbreaks[2][5].

Conclusion

The standard treatment for scabies (ICD-10 code B86) primarily involves the use of topical scabicides, with oral medications reserved for more severe cases. Symptomatic relief through antihistamines and corticosteroids can enhance patient comfort during treatment. Additionally, thorough cleaning and preventive measures are essential to control the spread of scabies. If symptoms persist or worsen, it is advisable to consult a healthcare professional for further evaluation and management.