Scabies

Organism Infection of the skin is by a mite Sarcoptes scabiei.

Clinical features There is a skin rash and intense itching where the mite burrows into the superficial layers of the skin. It favours the wrists and hands, although in heavy infections, it may be found in almost any area of the body, but not the head or face. Due to scratching, the affected skin can become thickened and discoloured leading to a mistaken diagnosis of eczema. Secondary infection is common and glomerulo-nephritis can occur.

Diagnosis is made from clinical presentation, but skin scrapings can be made and the mite viewed microscopically.

Transmission of scabies is due to close personal contact, permitting the mite to pass from one person to another. It can be transmitted by shared clothing and is potentiated by poor hygiene. Where possible, infected individuals should be prevented from infecting others, for example by keeping children away from school until they are cured of the infections. Careful search should be made for unreported or unrecognized cases in the community. Scabies can be spread amongst adults as a STI. Intractable scabies in adults, not responding to treatment, can indicate HIV infection.

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