Scabies is a common problem in society. It is caused by an itch mite acquired through intimate contact with someone who has the disease. It is common among school children, nursing homes, hospital personnel, hospitalized patients and those with multiple sexual partners.
Once acquired, symptoms of a rash and severe itching develop within thirty days. The itching becomes progressively worse particularly at night and the rash spreads to involve the hands, between the fingers, wrists, elbows, axillae, genitals in men, knees, ankles and toes. This is one of the few diseases where itching of the nipples occurs in women.
The key to diagnosis is the characteristic history and the fact that others in the family, sexual partners, associates at work, friends or other associates are also itching. Diagnosis is confirmed by identifying the burrows of the active mites in the skin. It takes an experienced clinician to find these lesions. Scabies is often diagnosed when not actually present and not diagnosed when it’s obviously present.
Therapy is very effective. All people exposed must be treated at the same time or recurrences are common. This is usually the cause of treatment failure.