scabies

(skā′bēz)

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[L. scabies, itch]
A contagious infestation of the skin with the itch mite, Sarcoptes scabiei.
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SCABIES
scabieticscabetic (skā′bē-et′ĭk)
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(skă-bet′ĭk), adj.

INCIDENCE
Scabies is prevalent worldwide, but precise data on its incidence and prevalence in the U.S. are not available. The disease is common among the homeless, and outbreaks in day care centers, long-term care facilities, hospitals, and nursing homes occasionally occur.

SYMPTOMS AND SIGNS
It typically presents as an intensely pruritic rash, composed of scaly papules, insect burrows, and secondarily infected lesions distributed in the webs between the fingers and on the waistline, trunk (esp. the axillae), penis, and arms. It readily spreads in households, among playmates, and between sexual partners. An itchy rash that worsens at night and involves several members of the same household is a common presentation.

DIAGNOSIS
Because the disease is often missed and occasionally overdiagnosed, scrapings from suspected burrows are taken with a scalpel dipped in mineral oil. The material obtained is examined microscopically to confirm the presence of the mite, its eggs, or its excretions.

TREATMENT
Treatments for scabies include oral ivermectin or topical creams and ointments such as crotamiton, lindane, or permethrin.

PATIENT CARE
For children 2 months and older and nonpregnant adults, permethrin 5% cream is applied to the entire body surface. The eyes and mouth are avoided when the cream is being applied. The cream is thoroughly washed off after about 8 to 14 hr. Retreatment is sometimes required if the itch persists for more than a few weeks. Alternatively, nonpregnant patients may be treated with ivermectin. Pregnant women and infants under 2 months of age should be treated with 6% precipitated sulfur in petrolatum daily for 3 days. Infection control in the home includes the washing of all linens, towels, and clothing with hot water and drying them thoroughly.

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SCABIES

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