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Scabies Rash - Symptoms & Treatment

Alternative names :- Sarcoptes scabiei

An age-old skin infection, scabies results from infestation with Sarcoptes scabiei var. hominis (itch mite), which provokes a sensitivity reaction. It occurs worldwide, is predisposed by overcrowding and poor hygiene, and can be endemic.

Scabies is contagious and can spread quickly through close physical contact in a family, child-care group, school class or nursing home. Because of the contagious nature of scabies, doctors often recommend treatment for entire families or contact groups to eliminate the mite.

Medications applied to your skin kill the mites, although you may still experience some itching for several weeks.

Causes

Mites can live their entire life cycles in the skin of humans, causing chronic infection. The female mite burrows into the skin to lay her eggs, from which larvae emerge to copulate and then reburrow under the skin.

Transmission of scabies occurs through skin or sexual contact. The adult mite can survive without a human host for only 2 or 3 days.

Signs and symptoms

It may take between four to six weeks for a child to develop symptoms of scabies after coming in contact with an infected person.

In children younger than 2 years of age, the lesions caused by the mites tend to occur on the head, neck, palms, and soles. In older children, the lesions are usually on the hands, between the fingers, wrists, belt line, thighs, belly button, in the groin area, around the breasts, and in the armpits.

The following are the most common symptoms of scabies. However, each child may experience symptoms differently. Symptoms may include:

• itching, usually severe
• rash, with small pimples or red bumps
• scaly or crusty skin (with advanced conditions) 

Diagnosis

A drop of mineral oil placed over the burrow, followed by superficial scraping and examination of expressed material under a low-power microscope, may reveal the mite, ova, or mite feces. However, excoriation or inflammation of the burrow often makes such identification difficult.

If diagnostic tests offer no positive identification of the mite and if scabies is still suspected (for example, close contacts of the patient also report itching), skin clearing that occurs after a therapeutic trial of a pediculicide confirms the diagnosis.

Treatment

Generally, treatment of scabies consists of application of a pediculicide-permethrin cream or lindane lotion - in a thin layer over the entire skin surface. The pediculicide is left on for 8 to 12 hours. To make certain that all areas have been treated, this application should be repeated in approximately 1 week.

Another pediculicide, crotamiton cream, may be applied on 5 consecutive nights but is not as effective. Widespread bacterial infections require systemic antibiotics.

Persistent pruritus (from mite sensitization or contact dermatitis) may develop from repeated use of pediculicides rather than from continued infection. An antipruritic emollient or topical steroid can reduce itching; intralesional steroids may resolve erythematous nodules.

Prevention

Direct physical contact - like holding hands - is the most common way to transmit scabies, but because the mites that cause scabies can live as long as 2 to 3 days in clothing, bedding, or dust, it's possible for your child to catch scabies from another person who shares the same infected bed, linens, or towels. If someone in your family is being treated for scabies, all other members of the household should be treated, too. Clothing, sheets, and towels should be washed in hot water. Each room in the house should be vacuumed, and the vacuum cleaner bag should then be thrown away.