SCABIES:

Prepared by
Muhammad Rehan Malik
Pharm-D Final Proff
Session: 2012-17
 CONTENTS:
Introduction / Etiology
History
Types of Scabies
Morphology
Transmission
Pathophysiology
Clinical Features
Treatment
 SARCOPTES SCABIEI:

Scabies (from Latin: scabere, "to scratch"),known colloquially as the

seven-year itch.
Sarcoptes scabiei or the itch mite is a parasitic arthropod, is a highly
contagious infestation of microscopic mites that burrows into skin and
causes scabies.
No one is safe from an infestation of scabies because it can affect any
race or social class.
Usually occurs in crowded areas where there is a chance of prolonged
contact.
 MORPHOLOGY:
It is eight legged arthropod with round body.
Scabies are a certain type of mite. Mites are related to the arachnid family the same
as ticks and spiders.
Scabies are creamy white with brown legs and mouthparts.
Adult male is smaller than female.
Scabies have “suckers” that allow them to attach to surfaces to walk upwards.
 HISTORY:
Scabies dates back about 2500 years ago (Scabies Homepage), and was
documented all over Europe; however, it wasn’t known as scabies to those who
experienced it. In these eras it was known as the “itch”. (Ramos).
In earlier times scabies was commonly found among the poor who exhibited bad
hygiene. In fact, Napoleon I was said to have suffered from the “itch” his whole life.
In 1687 an Italian man named Giovanni Cosimo Bonomo had finally discovered the
mite responsible for the inflictions.
 HISTORY CONT…
The treatment Bonomo found effective was a local therapy, Sulphur,
which was used up until now. He also realized that the local treatment
had to be applied for up to two or three days after the itching subsided
because un-hatched eggs could hatch and restart the cycle.
 DIFFERENT TYPES OF SCABIES:
• Clean Man’s Scabies: This is seen in individuals who bath regularly, and keep very
clean.
• Infant Scabies: This occurs in babies and young children, and is often misdiagnosed
or mistreated.
• Scabies Incognito: Normally, if a strong type of treatment, such as steroids, are
applied then the scabies are masked and the lesions are suppressed.
 SCABIES TYPES CONT…
• Norwegian Scabies: This is an intense case of crusted scabies. This occurs commonly
in autoimmune deficient individuals, or people who are mentally challenged.
• Animal Scabies: Animals are susceptible to scabies too. Domestic pets that contract
scabies are liable to pass it on to the other members of the household as well.
 TRANSMISSION:
SCABIES CAN BE PICKED UP
BY SEVERAL DIFFERENT WAYS.

Close contact.
Sharing clothes and bedding.
As with lice, scabies can be transmitted through sexual intercourse.
An individual who has scabies, but isn't exhibiting symptoms can still spread them
without knowing.
Most common places to contract scabies is:

Hospitals Prisons Child care facilities Nursing homes

 PATHOPHYSIOLOGY:
 Movement of mites within and on the skin
produces an intense itch, which has the
characteristics of a delayed cell-mediated
inflammatory response to allergens.
 IgE antibodies are present in the serum and
the site of infection, which react to multiple
protein allergens in the body of the mite.

A picture of a burrow
 SIGN AND SYMPTOMS:
Severe itching (pruritus).
Pimple-like rash (armpits, wrist, waist, nipple, buttocks,
elbow, penis).
Acropustulosis, or blisters.
Symptoms don’t usually show up until two to six weeks after contracted; however,
if someone has been re-infested then symptoms can show up in a week.
Sores caused by scratching.
Incubation period:
2-6 weeks without previous exposure.
1-4 days after re-infestation (usually milder).
 HEALTH COPLICATIONS:
Severe bacterial infection may occur from all the scratching.
Bacterial infections can lead to inflammation of the kidneys called post-
streptococcal glomerulonephritis.
Impetigo.
Lack of sleep.
Irritability.
Depression.
 DIAGNOSIS:
Physical signs. (assessment of the rash and appearance).
The classical sign of scabies is the burrows made by the mites within
the skin.
To detect the burrow the suspected area is rubbed with ink from a
fountain pen or a topical tetracycline solution, which glows under a
special light.
The skin is then wiped with an alcohol pad. If the person is infected
with scabies, the characteristic zigzag or "S" pattern of the burrow
will appear across the skin.
Skin biopsy (taking samples of the mite, mite eggs, and fecal matter
is important for proper diagnosis).
 TREATMENT:
Permethrin
• Treatment of choice
• Applied from the neck down usually before bedtime and left on for about 8 to 14 hours, then
showered off in the morning
• One application is normally sufficient for mild infections
• For moderate to severe cases, another dose is applied 7–14 days later
Ivermectin
• An oral medication, often used as a single dose.
• Treatment of choice for crusted scabies.
• Has also been useful for sarcoptic mange (the veterinary analog of human scabies)
Others
• Other treatments include lindane, benzyl benzoate, crotamiton, malathion, and sulfur preparations
 LIFESTYLE CHANGES:
Wash linen and clothes.
Vacuum carpets, cut nails, sofas, car interior etc.