Scabies

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Template:DiseaseDisorder infobox

This page is about clinical aspects of the disease. For microbiologic aspects of the causative organism(s), see Sarcoptes scabiei.

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: Norwegian scabies

Overview

Historical Perspective

Pathophysiology

Pathogenesis

Microscopic Pathology

The histopathology of scabies consists of mites being surrounded by an inflammatory infiltrate of eosinophils, lymphocytes and histiocytes.^[1]^[2]^[3]

Causes

Differentiating Scabies from Other Diseases

Epidemiology and Demographics

Epidemiology

Demographics

Age

Race

Risk Factors

The following are believed to be risk factors for scabies:^[4]^[1]^[5]^[6]^[7]^[8]^[9]^[10]

Living in high-risk areas, such as Sub-Saharan Africa and indigenous communities in Australia and New Zealand
Living in crowded areas
Homeless or displaced children
Poor hygiene: the role of poor hygiene in the development of scabies is uncertain, as mites burrowed under the skin remain alive even after daily hot baths and are usually resistant to water and soap
Immunocompromised individuals, such as the elderly, malnourished and those with HIV, DM are at risk of developing Norwegian Scabies, which is the severe form

Natural History, Complications and Prognosis

Natural History

Complications

Major complications of scabies include:^[4]^[1]^[11]

Secondary bacterial infection of the skin and soft tissue, caused mainly by S. aureus and S. pyogenes, which include:
Secondary bacterial infection of the skin and soft tissue can progress to life-threatening complications such as:

Prognosis

Diagnosis

History and Symptoms

Physical Examination

In patients with scabies, skin should be carefully examined to look for:^[1]^[4]^[12]^[13]^[10]^[14]^[15]

Burrows: are the tunnels which the female mite penetrates into the skin. Initially, they are not clinically visible and can only be seen several days later, when the host immune system forms a local reaction around the tunnel. Burrows are characterized by short, wavy lines.
Papules: they are usually small and erythematous. The distribution of the papules is variable; they can be sparse or very close to each other. Over the course of the infection, papules can transform into vesicles and/or bullae. Characteristic distribution of scabies usually involves the web spaces of fingers and toes, the wrists and penis. The back is usually spared, while face and neck involvement are usually only seen in infants and children.
Excoriations: skin excoriations are commonly seen in patients with scabies, due to the intense itching associated with the infection.

Laboratory Findings

Peripheral IgE levels are elevated in patients with Norwegian Scabies.^[2]^[3]

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Heukelbach J, Feldmeier H (2006). "Scabies". Lancet. 367 (9524): 1767–74. doi:10.1016/S0140-6736(06)68772-2. PMID 16731272.
↑ ^2.0 ^2.1 Roberts LJ, Huffam SE, Walton SF, Currie BJ (2005). "Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature". J. Infect. 50 (5): 375–81. doi:10.1016/j.jinf.2004.08.033. PMID 15907543.
↑ ^3.0 ^3.1 Arlian LG, Morgan MS, Estes SA, Walton SF, Kemp DJ, Currie BJ (2004). "Circulating IgE in patients with ordinary and crusted scabies". J. Med. Entomol. 41 (1): 74–7. PMID 14989349.
↑ ^4.0 ^4.1 ^4.2 Romani L, Steer AC, Whitfeld MJ, Kaldor JM (2015). "Prevalence of scabies and impetigo worldwide: a systematic review". Lancet Infect Dis. 15 (8): 960–7. doi:10.1016/S1473-3099(15)00132-2. PMID 26088526.
↑ Kristensen JK (1991). "Scabies and Pyoderma in Lilongwe, Malawi. Prevalence and seasonal fluctuation". Int. J. Dermatol. 30 (10): 699–702. PMID 1955222.
↑ Estrada B (2003). "Ectoparasitic infestations in homeless children". Semin Pediatr Infect Dis. 14 (1): 20–4. doi:10.1053/spid.2003.127213. PMID 12748918.
↑ Currie BJ, Connors CM, Krause VL (1994). "Scabies programs in aboriginal communities". Med. J. Aust. 161 (10): 636–7. PMID 7968739.
↑ Terry BC, Kanjah F, Sahr F, Kortequee S, Dukulay I, Gbakima AA (2001). "Sarcoptes scabiei infestation among children in a displacement camp in Sierra Leone". Public Health. 115 (3): 208–11. doi:10.1038/sj/ph/1900748. PMID 11429717.
↑ Andrews JR, Tonkin SL (1989). "Scabies and pediculosis in Tokelau Island children in New Zealand". J R Soc Health. 109 (6): 199–203. PMID 2513405.
↑ ^10.0 ^10.1 Heukelbach J, Wilcke T, Winter B, Feldmeier H (2005). "Epidemiology and morbidity of scabies and pediculosis capitis in resource-poor communities in Brazil". Br. J. Dermatol. 153 (1): 150–6. doi:10.1111/j.1365-2133.2005.06591.x. PMID 16029341.
↑ Engelman D, Kiang K, Chosidow O, McCarthy J, Fuller C, Lammie P, Hay R, Steer A (2013). "Toward the global control of human scabies: introducing the International Alliance for the Control of Scabies". PLoS Negl Trop Dis. 7 (8): e2167. doi:10.1371/journal.pntd.0002167. PMC 3738445. PMID 23951369.
↑ Chakrabarti A (1985). "Some epidemiological aspects of animal scabies in human population". Int J Zoonoses. 12 (1): 39–52. PMID 4055268.
↑ Burgess I (1994). "Sarcoptes scabiei and scabies". Adv. Parasitol. 33: 235–92. PMID 8122567.
↑ Steer AC, Jenney AW, Kado J, Batzloff MR, La Vincente S, Waqatakirewa L, Mulholland EK, Carapetis JR (2009). "High burden of impetigo and scabies in a tropical country". PLoS Negl Trop Dis. 3 (6): e467. doi:10.1371/journal.pntd.0000467. PMC 2694270. PMID 19547749.
↑ Lawrence G, Leafasia J, Sheridan J, Hills S, Wate J, Wate C, Montgomery J, Pandeya N, Purdie D (2005). "Control of scabies, skin sores and haematuria in children in the Solomon Islands: another role for ivermectin". Bull. World Health Organ. 83 (1): 34–42. doi:/S0042-96862005000100012 Check |doi= value (help). PMC 2623469. PMID 15682247.

Template:WH Template:WS

[pmid16731272-1] 1.0 ^1.1 ^1.2 ^1.3 Heukelbach J, Feldmeier H (2006). "Scabies". Lancet. 367 (9524): 1767–74. doi:10.1016/S0140-6736(06)68772-2. PMID 16731272.

[pmid15907543-2] 2.0 ^2.1 Roberts LJ, Huffam SE, Walton SF, Currie BJ (2005). "Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature". J. Infect. 50 (5): 375–81. doi:10.1016/j.jinf.2004.08.033. PMID 15907543.

[pmid14989349-3] 3.0 ^3.1 Arlian LG, Morgan MS, Estes SA, Walton SF, Kemp DJ, Currie BJ (2004). "Circulating IgE in patients with ordinary and crusted scabies". J. Med. Entomol. 41 (1): 74–7. PMID 14989349.

[pmid26088526-4] 4.0 ^4.1 ^4.2 Romani L, Steer AC, Whitfeld MJ, Kaldor JM (2015). "Prevalence of scabies and impetigo worldwide: a systematic review". Lancet Infect Dis. 15 (8): 960–7. doi:10.1016/S1473-3099(15)00132-2. PMID 26088526.

[pmid1955222-5] Kristensen JK (1991). "Scabies and Pyoderma in Lilongwe, Malawi. Prevalence and seasonal fluctuation". Int. J. Dermatol. 30 (10): 699–702. PMID 1955222.

[pmid12748918-6] Estrada B (2003). "Ectoparasitic infestations in homeless children". Semin Pediatr Infect Dis. 14 (1): 20–4. doi:10.1053/spid.2003.127213. PMID 12748918.

[pmid7968739-7] Currie BJ, Connors CM, Krause VL (1994). "Scabies programs in aboriginal communities". Med. J. Aust. 161 (10): 636–7. PMID 7968739.

[pmid11429717-8] Terry BC, Kanjah F, Sahr F, Kortequee S, Dukulay I, Gbakima AA (2001). "Sarcoptes scabiei infestation among children in a displacement camp in Sierra Leone". Public Health. 115 (3): 208–11. doi:10.1038/sj/ph/1900748. PMID 11429717.

[pmid2513405-9] Andrews JR, Tonkin SL (1989). "Scabies and pediculosis in Tokelau Island children in New Zealand". J R Soc Health. 109 (6): 199–203. PMID 2513405.

[pmid16029341-10] 10.0 ^10.1 Heukelbach J, Wilcke T, Winter B, Feldmeier H (2005). "Epidemiology and morbidity of scabies and pediculosis capitis in resource-poor communities in Brazil". Br. J. Dermatol. 153 (1): 150–6. doi:10.1111/j.1365-2133.2005.06591.x. PMID 16029341.

[pmid23951369-11] Engelman D, Kiang K, Chosidow O, McCarthy J, Fuller C, Lammie P, Hay R, Steer A (2013). "Toward the global control of human scabies: introducing the International Alliance for the Control of Scabies". PLoS Negl Trop Dis. 7 (8): e2167. doi:10.1371/journal.pntd.0002167. PMC 3738445. PMID 23951369.

[pmid4055268-12] Chakrabarti A (1985). "Some epidemiological aspects of animal scabies in human population". Int J Zoonoses. 12 (1): 39–52. PMID 4055268.

[pmid8122567-13] Burgess I (1994). "Sarcoptes scabiei and scabies". Adv. Parasitol. 33: 235–92. PMID 8122567.

[pmid19547749-14] Steer AC, Jenney AW, Kado J, Batzloff MR, La Vincente S, Waqatakirewa L, Mulholland EK, Carapetis JR (2009). "High burden of impetigo and scabies in a tropical country". PLoS Negl Trop Dis. 3 (6): e467. doi:10.1371/journal.pntd.0000467. PMC 2694270. PMID 19547749.

[pmid15682247-15] Lawrence G, Leafasia J, Sheridan J, Hills S, Wate J, Wate C, Montgomery J, Pandeya N, Purdie D (2005). "Control of scabies, skin sores and haematuria in children in the Solomon Islands: another role for ivermectin". Bull. World Health Organ. 83 (1): 34–42. doi:/S0042-96862005000100012 Check |doi= value (help). PMC 2623469. PMID 15682247.

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