Scabies Flashcards
Etiology of scabies
Mite: sarcoptes scabiei var. hominis
What layer of the epidermis is the burrow in
Normally just the stratum corneum except in Norwegian scabies
Scybala
Scabies poop that may be part of the irritant associated with itching (hypersensitivity rxn)
Timeline
Usually limited itching in the first month of infestation as number of mites increases
Clinical manifestations
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)
Patient characteristic in crusted scabies
Neurologic/mental disorders (Down syndrome) Senile dementia nutritional disorders Leukemia Immunosuppressed conditions (AIDS)
Treatment options
Permethrin (2 applications 1 week apart applied to dry skin for 8-12 hours before washing)
2nd line: Lindane or oral ivermectin
Post Scabietic pruritus
Often pruritus gradually decreases 1-2 weeks after treatment but should see dramatic improvement after initial treatment