by Gunwant S.Dhaliwal, M.D. Astoria General Hospital, NY
Scabies is an itchy skin disease Caused by mite a tiny, eight legged creature. More than 300 million Cases of scabies occur worldwide very year. The disease can strike anyone, regardless of class, race Orage and irrespective of personal hygiene.
Human scabies is almost always Contracted from another person, Attracted to warmth and odor, the female mite transfers to her new host, making a burrow, laying eggs and producing toxic secretions that are highly allergenic to humans. It May be up to a month before a newly infested individual will notice the itching or inflammation that can indicate the presence of Scabies.
Signs and symptoms:
The earliest and most common symptom of scabies is itching, particularly at night and often un controllably. An early scabies rash will show up as little red papules, like hives, tiny bites or pimples. In more advanced cases, the skin may be crusty or scaly. Itching usually begin in the folds and crevices of the body particularly between the fingers, on the elbows or wrists, buttocks or belt line, around the nipples for women and around the penis for men. Mites also tend to hide in, or on, the skin under rings, bracelets or watch bands,
In children, there is usually a more generalized itching, and infestation may involve the entire body surface, including the palms, scalp and soles of the feet. The child may also be tired and irritable as a result of sleep deprivation from itching or scratching all night long.
If you look closely, you may just barely see the mite beneath the skin white or cream white and Small enough to fit on the point of a needle,
Secondary bacterial infection can often be a problem with scabies, particularly in the warm climates. In many cases, children are brought to clinics because of bacterially infected skin lesions rather than for the scabies itself,
Crusted scabies describes a form of the disease in which the symptoms are far more severe than usual, Large areas of the body may be scaly and crusted and these crusts hide thousands of live mites and their eggs. This type occurs mostly among the elderly and where immune defenses are weakened, as in AIDS patients. These cases are extremely infectious, and a hazard to medical personnel and others in close contact with the patient.
Diagnosis:
Many cases of scabies can be diagnosed by through examination alone, If there is still a doubt, a couple of simple, painless tests e.g. mineral oil scrape and an ink test can be used to diagnose scabies.
Risk Factors:
The disease is far more common among groups living in crowded conditions, Among the general population, scabies is most common in children under two years of age followed by mothers and older female siblings and then by other family members who have frequent, close physical contact.
Scabies among resident patients of nursing homes and extended care facilities has become a common problem, particularly in recent years. A few of the several reasons may be lowered immunity, close physical contact by institutional staff and delayed diagnosis,
Treatment:
Scabies is easy and quick to treat with a new topical drug, 5% perimeter in cream, available by perception only. A single overnight head-to-toe treatment applied at bedtime and washed off the next morning is quite effective. A second treatment may be recommended for infants with scabies of the palms and soles, or if new lesions appear after treatment. All lesions should be healed within a 4week period after the single application,
Another effective treatment is linden 1% lotion, the standard therapy for many years, available by prescription only. Sulfur ointment and Crotamiton are further options.
The critical factor in the treatment of scabies is eradicating the mite from each individual in the group, whether obviously infected or not, In a family, all members should be treated at the same time, as well as others who are in close contact.
Wash clothing, bed linens and towels in hot water and machine dry.
Vacuum the entire house and dis card the bag, just to be on the safe side,
Don’t attempt to treat scabies with home remedies, Scrubbing with laundry detergent or hard soaps, or applying kerosene will only serve to make the condition much worse,
This information provides a general overview on scabies and may not apply in each individual case. Consult your physician to deter mine whether this information can be applied to your personal situation and to obtain additional information.
Article extracted from this publication >> August 27, 1993
