SCABIES

SCABIES

scabies

Scabies is a contagious skin infestation caused by the human itch mite known as the Sarcoptes scabiei characterized by intensive itching and rashes.  Female microscopic eight legged mites burrow into upper layer of skin where they live and lay eggs (three or less) per day. The infestation is transmitted from one person to another host through intimate contact (crowded area, poor hygiene, and sexual contact), sharing contaminated clothing, towel and bedding. Sites for outbreak of scabies includes school, hospital, nursing homes, prison and other extended care institution. Effective recommended treatment of scabies involves entire group of people who are at risk of develop scabies in the infected area.

SYMPTOMS AND SIGNS OF SCABIES.

It takes up to six weeks for signs and symptoms of scabies to manifest for new infected person but for those who had infection before symptoms will appear quickly. The diagnostic symptoms of scabies infestation is due to allergic reaction of the skin against mites under the skin, their eggs and waste materials they produce, includes:

• Itching

The itching is worsen during night (restlessness type of itch) and it become severe in a warmth environment, though it less common in elders.

• Red Rashes 

When the mite burrows into the skin, it forms burrow tracks, or lines, which are most commonly found in skin folds, and resemble hives, bites, knots, pimples, or patches of scaly skin. Blisters may also be present.

• Sores

 These occur in infested areas where a person has scratched at the skin. Open sores can lead to impetigo, commonly caused by secondary infection with Staphylococcus aureus

• Crusted (Norwegian) scabies

crusted scabies

Crusted scabies is a severe form of scabies that can affect the elder people and person who is immuno-compromised (HIV or AIDS patients and those who are long term use of steroids medications). Crusted scabies is characterized by vesicles and thick crusted over the skin that can contain many mites and their eggs, make it to be highly contagious form of scabies. Rashes and itching are not common in crusted scabies. Crusted scabies can also appear as thick, gray, easy to crumble when touched.

Common sites for scabies include the:

• wrist
• head in babies
• face in babies
• elbow
• hands
• armpit
• nipple
• soles of the feet in babies
• private area in both male and female
• waist
• buttocks
• area between the fingers

How do scabies diagnosed?

Diagnosis of a scabies infestation usually is by physical examination in area where there are obvious manifestations on the skin and clinical history through the customary appearance and distribution of the the rash and the presence of burrows. Whenever possible, the diagnosis of scabies should be confirmed by identifying the mite or mite eggs or fecal matter (scybala) in the laboratory by aid of microscope.  However, a person can still be infested even if mites, eggs, or fecal matter can not be found; fewer then 10-15 mites may be present on an infested person who is otherwise healthy.

TREATMENT FOR SCABIES

Treatment for scabies usually involves getting rid of the infestation with prescription ointments, creams, and lotions that can be applied directly to the skin, the topical treatment is within seven days and patient should make sure they follow doctor's instructions very carefully. Oral medications are also available. According to the American Academy of Dermatologists (AAD), some common medicines used to treat scabies include:

• 5 percent permethrin cream,
• 25 percent benzyl benzoate lotion,
• 10 percent sulfur ointment,
• 10 percent crotamiton cream,
• 1 percent lindane lotion.

Other medications are very helpful in relieve of scabies symptoms, these medications include:

• antihistamines, such as Benadryl (diphenhydramine) or pramoxine lotion to help control the itching,
• antibiotics to kill any infections that develop as a result of constantly scratching your skin,
• steroid creams to relieve swelling and itching.

More aggressive treatment may be needed for severe or widespread scabies. An oral tablet called ivermectin (Stromectol) can be prescribe for crusted scabies.

PREVENTION FOR SCABIES

The best way to prevent getting scabies is to avoid direct skin-to-skin contact with a person known to have scabies. It’s also best to avoid unwashed clothing or bedding that has been used by a person infested with scabies. Scabies mites can live for 48 to 72 hours after falling off your body, so you need to take certain precautions to prevent reinfestation. Make sure to wash all of the following in hot water that reaches 122°F (50°C): clothing, bedding, towels,pillows. These items should then be dried in the dryer on very high heat for at least 10 to 30 minutes.When a person is infested with scabies mites the first time, symptoms may not appear for up to two months after being infested. However, an infested person can transmit scabies, even if they do not have symptoms. Scabies usually is passed by direct, prolonged skin-to-skin contact with an infested person. However, a person with crusted (Norwegian) scabies can spread the infestation by brief skin-to-skin contact or by exposure to bedding, clothing, or even furniture that he/she has used.