Scabies

Notes

## Basic introduction

  • This is a Neglected Tropical Diseases (NTD) that is caused by a parasite Sarcoptes scabiei (human itch mite).
  • The disease is spread through close personal contact, especially in places that are overcrowded and/or there is poor hygiene.
  • Sarcoptes scabiei does not survive for a long time without host contact.
  • Scabies predisposes affected children to sepsis and other non-suppurative invasive infections such as lymphadenopathy, acute post-streptococcal glomerulonephritis, and rheumatic fever.

## Statistics

  • Globally, 300 million people are infected by scabies annually.
  • The prevalence of scabies in Kenya in 1999 was 8.0%.
  • In some slums in Kenya, the prevalence of scabies has been noted to be as high as 24.31 % among under five-year-old children in 29.5 % households under study.
Symptoms
  • Itching that worsens at night or after a hot shower
  • Skin popular rashes that occur mainly on the finger webs, the wrist flexor surfaces, elbow, axillary folds, around areola of the breasts in female, genital area (especially in males), along the belt line, the buttock and the whole body in children.
  • Sometimes typical burrows may be evident on the lesion
  • Secondary infections are common and it is characterized by papules, crusts, and pustules.
Diagnosis
  • Clinical evaluation
  • Microscopy of skin scraps to detect the mite, oval or feces pallets
Differential
  • Allergic contact dermatitis
  • Bedbug Bites
  • Dermatitis herpetiformis
  • Eczema
  • Flea bites
  • Folliculitis
  • Impetigo
  • Xerotic dermatitis
Prevention
  • Maintaining good personal hygiene.
Management
  • Treat the whole family at the same time.
  • Sun-bathing of the clothes and beddings of the affected person.
  • 25% (or 12.5% for children) Benzyl benzoate (BBE) lotion apply the whole body from the neck down OD x 2/7 without bathing. Take a bath on day 3 and apply again.
  • 5-10% Sulphur ointment.
  • Malathion
  • 5% lindane (gamma BHC)
  • Monosulfiram soap
  • Ivermectin
  • Treatment of secondary bacterial infections.
  • Relief of pruritus with an antihistamine.
  • Counsel on the need to maintain good personal hygiene.
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