Scabies is a skin disease caused by the parasitic mite Sarcoptes Scabiei.

This disease is very contagious and therefore the treatment must be prescribed to all the people who live in the same house. In young adults, sexually transmitted infection is common. Overcrowding conditions increase their prevalence in the population, and can even occur epidemic in institutions. It is more frequent in winter, probably by the greater agglomeration of people and survival of the mite in cold temperatures with high humidity.

Symptoms are severe stinging and lesions in generalized excoriations with small pruriginous vesicles, pustules and “galleries” (short and irregular mark, perhaps of 2-3 mm length and the width of a hair) to the sides of the fingers and in the eminences of the palms of the hands, wrists, elbows and around the armpits. The characteristic lesions can be manifested in nipples of women and as pruritic papules in the scrotum or penis of the male.

A diagnosis is confirmed under the microscope when the mites eggs and brown spots of excrement are observed.

TREATMENT:

• Lindane 1% cream, applying it from the neck to the feet.
• Permethrin 5% cream, one application during 8 to 12 hr.
• Crotamiton cream; apply at night, for 4 nights.
• Benzyl benzoate emulsion, apply from the shoulders to the feet an application per week (two doses).
• Triamcinolone cream, for dermatitis.

PREVENTIVE MEASURES: The mite can live up to thirty hours on clothing and hair.

• Disinfect objects (combs, brushes, etc.).
• Those objects that cannot be disinfected, seal them in a plastic bag for 72 hours.
• All bedding must be soaked in water with detergent for one hour and then washed; Expose it to the sun all day long.
• Avoid promiscuity and overcrowding.
• Personal grooming (hand washing, clean and cut nails).
• Washing and exposing clothes to heat / sun, otherwise ironing clothes.
• Avoiding the exchange of personal clothing.
• Ventilate rooms, clean sheets, pillows, and covers.
• Put mattress in the sun.

Source: Diagnostico Clínico y Tratamiento, Manual Moderno, 36 a Edición, Lawrence M Tierney, Stephen McPhee, Maxine Papadakis. Wikipedia, org.

Dr. Azucena Hernández
Clinic, NPH Mexico