A Family Doctor's Tale - SCABIES

DOC I HAVE SCABIES

Scabies is a common disease in many patients often misdiagnosed for eczema. However the typical skin burrows appearance is very indicative of scabies. More commonly is lice infestation especially in the 1970 and 1980 where the nits are present on the hairs of many schoolgirls and rashes present on the under part of the thighs especially when sitting on wooden chairs or benches.
Treatment is the same as for scabies.

Scabies is a contagious skin disease caused by the mite Sarcoptes scabiei characterised by intraepidermal burrows,itchiness and secondary infections.
The female mite burrows into the skin and deposits her eggs and faeces.
The eggs hatch in 3-4 days into larvae which then becomes nymphs,moulting to adults in 14 days.
The skin becomes extremely itchy and red lesions appear in the skin.  Nursing homes are ideal breeding grounds for the parasite, which needs a human host to survive.


1.itching which is worse at night
2.characteristic burrow lines on the skin with papule at one end.
3.rashes and abrasions on the skin due to scratching and secondary infections.


Skin scrapings can be examined microscopically fot the scabies parasite.


Scabicides (chemicals to treat scabies) include:


Benzyl benzoate lotion
Gamma benzene hexachloride cream
Permethrin cream
Malathion lotion


Bathing is followed by application of the scabicide to the whole body from the neck to soles, left for 24 hours.
For some children under 2 years, the elderly in rest homes and others with reduced resistance, the scalp and face also needs to be treated.
A single overnight application of the scabicide(8 hours)  is washed off the following morning .
A second application four to seven days later is often recommended.


Treatment of contacts may be required if there is obvious signs of scabies.


While the scabies mite cannot live off the human skin for longer than 24 hours, each treatment with scabicide should be accompanied by washing, in hot water, of bedsheets, pillow cases and any clothes worn over the previous week.


Most people improve within a few days of treatment but it may take 4-6 weeks for the itch and rash of scabies to go away completely.