What do you know about scabies?

Infection occurs through direct contact with the patient, through bedding, clothing, and other items used by the patient. Children often become infected through shared toys in kindergarten. There is practically no incubation period.

The main clinical symptoms of scabies are:

- Expressed annoying itching, which becomes especially severe in the evening and at night, due to the period of pathogen activity, saliva and substances contained in the excrement that irritate nerve endings;
- The presence of scabies passages;
- Polymorphism of the skin rash (papulo-vesicles arranged in pairs and connected by scabies passages, papules, scabs, bloody crusts resulting from excoriation (scabs));
- Characteristic localization of the rash (interdigital areas of the hands, flexural surface of the forearms and elbows, anterior and posterior edges of the axillary depressions, lateral surface of the chest and abdomen, halos of the mammary glands in women, navel, buttocks and intergluteal folds, inner thighs and external genitals, i.e. places with a thin stratum corneum of the epidermis).  In infants and young children, manifestations of scabies can also be observed on the face, scalp, soles of the feet and palms of the hands.
Scabies is often complicated by secondary pyococcal infection as a result of scratching (impetigo, ecthyma, folliculitis, furuncles), and microbial eczema. 
The diagnosis is based on the characteristic clinical picture of the disease and the detection of the scabies mite and its movements during dermatoscopic examination of the lesions.

The treatment

To kill scabies mites, external antiparasitic agents are used to loosen the stratum corneum of the epidermis and kill the parasites (e.g., benzyl benzoate 20% emulsion). Before the skin treatment, the patient takes a shower, and after the treatment, puts on clean underwear and changes bed linen. The treatment is repeated for two more days.  At the same time, moisturizers are prescribed to reduce skin dryness due to the use of the emulsion. The quality of treatment is monitored three days after the end of therapy.
Primary prevention of scabies consists in avoiding places of "potential spread" of the scabies mite and careful observance of personal hygiene rules.

Author: Dermatologist Olga Bahriy