![]() ![]() Symptoms reappear within 1-3 days if the person is re-infested due to prior sensitisation. Infected contacts may be asymptomatic for up to a month which is why empirical treatment of all significant contacts is suggested. In primary infestation, signs and symptoms only develop after 3-6 weeks.Examination findings include white lines, indicative of the mite burrowing, which classically occur in the interdigital web spaces, the areolae of female breasts, or the male genitalia, but may be found on other body sites. Important clues include severe pruritus that is worse at night, close contacts who have similar symptoms, and a history of exposure. Scabies can be difficult to diagnose as examination findings can be subtle. Therefore a high index of clinical suspicion for scabies is needed. Infection can be transmitted to others during the asymptomatic phase. Pruritus develops as an allergic reaction to infection, around 4-6 weeks after infestation. There is a period of asymptomatic infection. Crusted scabies (a more severe variety, see below) can also be transmitted via bedding, towels, clothes and furniture. Classical scabies is usually transmitted only via direct skin contact. It usually requires skin contact of 10-15 minutes for mites to be passed from one host to another. Female mites can move at up to 2.5 cm per minute but they do not jump or fly. Mites die after 4-6 weeks.Īn average host harbours 10-12 mites, but this may be greatly increased in immunocompromised patients. Adult mites then return to the skin surface to multiply. Development from egg to adult takes about 10-15 days. After mating on the skin surface, the male dies and the female mite tunnels into the epidermis, and deposits eggs along the burrow. The female scabies mite is about 0.4 mm long, and the male is about half this size. There are also concerns about increasing resistance to drugs currently available. Globally it is an enormous public health problem, causing significant morbidity and mortality in developing countries, and a feeling that it has been neglected prompted the formation of the International Alliance for the Control of Scabies (IACS). It is often difficult to diagnose due to the spectrum of associated signs and symptoms and its clinical mimicry of other conditions. The mite was identified in the 17th century, and described by an Italian physician, Giovanni Cosimo Bonomo, making it one of the first diseases to have a known cause. The word scabies is derived from the Latin word 'scabere', meaning 'to scratch'. ![]() The Romans used 'scabies' to describe any itchy skin disease. Scabies has caused pruritic infestation in humans for over 2,500 years, at least back to the Roman period. Scabies is an itchy rash caused by the parasitic mite Sarcoptes scabiei. ![]()
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