Scabies is prevalent among downtrodden people, as they live in overcrowded places, lives untidy. Scabies is caused by a mite known as Sarcoptes Scabiei Var Hominis. One mite is sufficient to cause the disease, on an average 11-12 mites are found to be present in adult human, and this figure has been found to be 20 in infants.
Adult female mite is big in size compared to adult male mite, this mite on getting fertilized make a burrow in upper layer of skin (stratum corneum) and lays their eggs, these burrows are ‘s-shaped’ , these burrows are mainly found in web spaces of fingers. At the inside end of burrow papulovesicle is seen. Watch out a crawling scabies mite under microscope on youtube below.
Since body react to mite via hypersensitive reaction leading to papular pruritic eruptions over the body. So clinically patient complains of itching during night and family history is there, mites gets transmitted to other people due to overcrowding or sharing same bed.
Sites of scabies: scabies is found in axilla, elbow, ulnar border of wrist, nipples, abdomen around umbilicus, scrotum, buttock and finger webs. How ever in infants it is also found on face and scalp but never seen in adults at these points. What is the reason? Leave your comments.
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Complications: various complications like post streptococcal glomerulonephritis, and secondary infection of skin like pyoderma forms. See the picture below showing scabies with secondry infectons at ulnar border of wrist joint.
click on pictures to see enlarged view
Treatment: Permethrin cream is found to be very effective, it has to be applied all over body below neck in evening for one night, but it must be applied by all family members. And all beddings should be kept in sunlight for one day, so as to kill the mite.
BHC benzene hexa chloride or lindane is applied below neck for 24 hours apply it after bathing till next day.
In cases of severe infection you can give 12mg Ivermectin tablets to adult.
Definitely antihistaminics are to be given to stop itching.
If you get the case where you see pyoderma or skin eczematization, you need to treat them before treating scabies.
Norwegian Scabies: is seen in those persons where loss of sensation is there like leprosy or immunocompromised. Generalised scaly rashes with crusting and hyperkeratosis is seen. So this is also known as crusted scabies or hyperkeratotic scabies. Here these lesions contain many mites. Mites give around 2-3 eggs per day and maturity is achieved in 15 days (approx).
You can get more information at home remedies for scabies