Scabies: Pictures, Treatment, Complications, Diagnosis & Home Remedies of Scabies
Scabies is an intensely pruritic disease of the skin caused by the mite Sarcoptes scabei var horminis. Transmission to a new host is by contact and through infested clothes and linen Scabies is due to Acarus (Sacroptes) scabiei. The female Acarus is larger than the male and burrows in the epidermis, depositing eggs. These burrows should be looked for between the fingers, on the hands or wrists and sides of the feet. They are recognized with the naked eyes as short dark lines terminating in a shining spot of the skin.
Pathogenesis: Infection is initiated by the pregnant female mote which burrows into the superficial layers of the skin to lay eggs. The pruritic lesions develop about four weeks after the initial infection. The distribution of the lesions is characteristic.
Symptoms of Scabies
The most common symptom of scabies is intense itching particularly at night. Pruritus is worse at night, but in warm humid conditions pruritus may occur throughout the day. Itching in the early states is confined to the sites of lesion, but it becomes generalized later on. An early scabies rash will show up as little red or pus-filled bumps, tiny bites or pimples. In more advanced cases, the skin may be crusty or scaly.
Distribution: The lesions are seen in the webs of the fingers, flexor aspects of the wrist, extensor aspects of the elbow, anterior axillary fold, nipple and areola in the female, umbilicus and per umbilical regions, genitalia, upper thighs, knees and ankles. The lower part of the gluteal region is affected, but rest of the back is spared. In general the scalp, face, palms, and soles are spared. The mite makes curvilinear burrows at these sites and their openings appear as papules.
The lesions soon get secondarily infected and infection converts them into pustules. In some cases the lesions are crusted and scaly. This type is called Norwegian scabies. In this type, in addition to classical areas of involvement, the scalp, face, ear lobes, and back may also be affected.
When scabies affects infants, and children, it tends to involve the scalp, palms, and soles as well. Vesiculation, secondary pyoderma, and eczematization are common. Whenever an infant presents with a suggestive lesion, examination of mother is mandatory. The diagnosis of infantile scabies may be suggested by the presence of lesions in the mother.
Complications in Scabies
Occur in most cases. These include pyoderma, eczematization, and development of acute glomerulonephritis. One- third of the cases of acute glomerulonephritis in India, Africa, and many other tropical countries is attributable to scabies.
Diagnosis of Scabies
The diagnosis is made from the characteristic distribution of lesions and the presence in many members in the household. The parasite can be teased out with a pin and demonstrated under the microscope.
Treatment of Scabies
The effective drugs are 1 percent emulsion of gamma benzene hexachloride (BHC) or a 25 percent emulsion of benzyl benzoate. The patient is given a scrub bath and the medication is applied over the entire body below the neck. The drug is allowed to remain in contact with the skin for 24-28 hours after which the patient is bathed. All clothes and bed linen are disinfested by laundering or hot ironing. All the affected members in the family should receive treatment simultaneously.
Secondary infection is treated with procaine penicillin 500,00 units/day for 5-7 days. Antibiotic treatment is essential to prevent glomerulonephritis . When scabies s is infected , antiscabetic treatment should be given only after controlling the secondary infection.
Home remedies of Scabies
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