- Intense itching, predominantly at night.
- In day time it is tolerable but persistent.
- In a person who has never had scabies before, symptoms take 6 weeks to appear because sensitivity begins about that period.
- In a person who was infected earlier before, symptoms appear sooner (1-4 days).
- SIGNS: Pruritic, papular or papulo-vesicular lesions, excoriations and burrows.
- “Burrow” is the pathognomonic lesion of scabies, a serpentine, thread like, greyish or dark line ranging from few mm to cm or more.
- Predominantly involves finger webs, wrist, axillae, areola, umbilicus, lower abdomen, genitalia and buttocks
- forming an imaginary circle –
- “circle of Hebra”.
- In adults usually spares face and scalp.
- In infants it involves entire skin.
- Ulcerations and impetiginization due to scratching.
- Secondary infection of ulcers with bacteria, like Stapylococcus aureus or beta hemolytic streptococci.
- Sometimes post - streptococcal gromerulonephitis
- Close person to person contact (even for 15-20 minutes).
- Occasionally via fomites (e.g bedding or clothing).
- In adults scabies is frequently sexually acquired.
- Cannot be transferred by pets and animals.
- Simultaneous treatment of all contacts, even if they are asymptomatic.
- Avoiding direct skin to skin contact with infected person.
- Bedding, clothing wash used at anytime during the 3 days before treatment should be washed and air dried.
- Rooms used should be thoroughly cleaned and vaccum cleaned after use.
- Environmental disinfection not necessary.
- High humidity, low temperature.
- Infested member in family or sexual partner.
- In crowded conditions like jail inmates, hostels, army barracks where close body and skin contact is common.
