Scabies

Question 1

Etiology of scabies

Answer 1

Mite: sarcoptes scabiei var. hominis

Question 2

What layer of the epidermis is the burrow in

Answer 2

Normally just the stratum corneum except in Norwegian scabies

Question 3

Scybala

Answer 3

Scabies poop that may be part of the irritant associated with itching (hypersensitivity rxn)

Question 4

Timeline

Answer 4

Usually limited itching in the first month of infestation as number of mites increases

Question 5

Clinical manifestations

Answer 5

Burrows (wrists, finger webs, scrotum, anal region) and discrete vesicles causing nocturnal pruritus

• if vesicles on palms and soles in infant think scabies
• nodules are indicative of longterm infection and may persist after treatment (need ILK often)

Question 6

Patient characteristic in crusted scabies

Answer 6

Neurologic/mental disorders (Down syndrome)
Senile dementia
nutritional disorders
Leukemia
Immunosuppressed conditions (AIDS)

Question 7

Treatment options

Answer 7

Permethrin (2 applications 1 week apart applied to dry skin for 8-12 hours before washing)
2nd line: Lindane or oral ivermectin

Question 8

Post Scabietic pruritus

Answer 8

Often pruritus gradually decreases 1-2 weeks after treatment but should see dramatic improvement after initial treatment