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Scabies

Cause

Insect - A parasite mite called Sarcoptes scabiei.

Distribution

Worldwide

Transmission

  • Sexual - Prolonged close bodily contact during sex.
  • Non-sexual - May spread to other family members, especially those who share beds with the infected person.

Incubation

3 - 6 weeks.

Symptoms

  • Itch especially worse at night or with increased warmth.
  • Rash
    - Greyish tract marks between the fingers and the toes and on the wrists and elbows caused by mites burrowing under the skin.
    - A more generalised rash consisting of reddish bumps, especially in front of the armpits, around the waist, the buttocks, upper thighs and external genitals.

Diagnosis

  • Physical examination.
  • Microscopic examination fo skin scrappings for mites.

Treatment

  • Anti-scabies creams or lotions containing benzyl benzoate, gamma benzene hexachloride (not available in Singapore), malathion and permethrin.
  • Antihistamines by mouth to relieve itch.
  • Beddings and clothings need to be laundered after treatment.

Complications

Scratching may lead to impetigo, a bacterial skin infection.

Comments

Family contacts and sexual partners should be treated. Instructions on the method of application need to be followed to ensure cure. Itching may persisi for a  few weeks after successful treatment and is due to an  allergy to remnants of mites in the skin. Repeat anti-scabies treatment is not necessary.The itch  stops after a few weeks.