Question

Diagnosis and treatment of scabies

Hint:

For effective scabies treatment, ensure that all affected individuals and close contacts are treated simultaneously.

Answer 1

Step 1: Understanding scabies.
Scabies is a highly contagious skin infestation caused by the Sarcoptes scabiei mite. The mite burrows into the skin, leading to intense itching, especially at night. Common sites of infestation include the hands, wrists, elbows, and genital areas. The primary symptom is pruritus (itching), which is often accompanied by a rash and burrows in the skin.

Step 2: Diagnosis of scabies.
- Clinical Examination: The diagnosis of scabies is usually made clinically by identifying characteristic signs such as burrows, papules, and excoriations.
- Skin Scraping: In some cases, a skin scraping may be performed to identify the mites, eggs, or fecal matter under a microscope.
- Dermatoscopy: A dermatoscope can be used to enhance visualization of the burrows in the skin.

Step 3: Treatment of scabies.
- Topical Medications: The first-line treatment for scabies is the application of topical permethrin 5% cream, which is applied all over the body from the neck down and left on for 8-14 hours before washing off.
- Oral Medications: In cases of severe or crusted scabies, oral ivermectin may be prescribed.
- Symptomatic Treatment: Antihistamines or topical steroids may be used to relieve itching.
- Hygiene and Prevention: All close contacts should be treated simultaneously, and clothes, bedding, and towels should be washed in hot water to prevent re-infestation.

Step 4: Conclusion.
Scabies is a treatable condition, but it requires thorough treatment and prevention measures to avoid re-infestation. Early diagnosis and appropriate treatment are key to controlling the spread.