Sarcoptes scabiei (Scabies)

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Key Points

  • Sarcoptes scabiei
    • Characteristics
      • Ectoparasite (mite)
    • Transmission
      • Direct skin-to-skin contact (most common) or via fomites
        • Common in children, crowded populations (jails, nursing homes)
    • Presentation: Scabies
      • Pruritic rash
        • Type IV hypersensitivity reaction against mites burrowing into skin
        • May be worse at night
        • Involve flexor surfaces/skin folds of wrist, lateral surfaces of fingers, finger webs, genitals, umbilicus, etc.
      • Linear burrows 
        • Most specific, but are hard to appreciate
    • Diagnosis
      • Skin scrapings with mineral oil prep
        • Mites, ova, feces identified in microscopy
    • Treatment
      • Permethrin cream
      • Ivermectin for severe infection
      • Wash/dry all bedding