Introduction

A mite infestation causes the infectious skin disorder known as scabies. The Sarcoptes scabiei mite penetrates the skin and produces excruciating irritation. Itches like these are persistent, especially at night. Family members and other skin-to-skin contacts pose the most danger since skin-to-skin contact is how the infectious organism is spread. The World Health Organization (WHO) designated scabies as a neglected skin disease in 2009, and it is a serious health issue in many impoverished nations. People who are infected need to be identified and treated as soon as possible since a misdiagnosis can cause outbreaks, morbidity, and an increased financial burden.

What are scabies?

At any given time, there are approximately 200 million cases of scabies worldwide.It is an extremely infectious disease that is readily spread from one person to another by having direct skin contact.

Scabies can spread through close personal contact or the sharing of bedding or clothing, but it is not a sexually transmitted illness.

Scabies can be inconvenient, but the mites are typically curable. Medication that kills the mites and their eggs is frequently used as a treatment. Because scabies is highly contagious, doctors frequently advise treatment for those who frequently come into contact with a scabies patient.

You can discover treatment more quickly if you can identify scabies bites and the telltale red rash.

What are the symptoms of scabies?

A scabies infection might go unnoticed for four to six weeks before the red rash and lumps appear. The little patches may resemble bumps or zits.

Over the course of several weeks or months, the rash gradually spreads. Scabies' signs and symptoms, in addition to the rash, include:

• Itching that is severe and worse at night may make it difficult to fall asleep.
• bumps that can occasionally get infected from scratching.
• a rash that appears as gray or skin tone lines on the skin.

Children with scabies may itch all over their body and be grumpy or exhausted from not getting enough sleep due to nighttime itching.

Symptoms

The mature female scabies mite burrows into the epidermis' top layer and deposits her eggs there. In 3–4 days, the eggs hatch, and in 1–2 weeks, they mature into adult mites. After 4-6 weeks, the patient has a severe itch and rash due to an allergic reaction to the mite proteins and excrement present in the scabies burrow. Most people have between 10 and 15 mites on them.

Patients often have linear burrows, vesicles, and acute itching around the wrists, upper and lower limbs, and belt region. Infants and young children may get a more severe rash that occasionally involves the scalp, ankles, palms, and soles of the feet. Especially on the penis and scrotum of adult males and around the breasts of females, inflammatory scabies nodules may be seen. Burrows may be seen in contacts who have not yet had itch because of the delay between the initial infection and the development of symptoms.

Thick, peeling crusts that may be more widespread, particularly on the face, are found in those with crusted scabies.

Crusted (Norwegian) scabies is a rare symptom of scabies that can appear in immunosuppressed patients, such as those with HIV/AIDS. A hyper-infestation of thousands to millions of mites causes crust and extensive scale, frequently without any noticeable itching. Due to subsequent sepsis, this illness has a significant death rate if left untreated.

Impetigo (skin sores) can occur as a result of bacterial inoculation of the skin caused by mite impacts on immunity and the direct consequences of scratching, particularly in tropical climates. By developing deeper skin infections like abscesses or dangerous invasive diseases like septicemia, impetigo may become problematic. Skin infections brought on by scabies are frequently connected with renal disease and perhaps rheumatic heart disease in tropical regions. Up to 10% of children with scabies infestations in low-resource environments show signs of acute renal injury, and in many cases, this continues for years after infection, causing chronic kidney damage.

Treatment

Application of a topical scabicide such as 5% permethrin, 0.5% malathion in an aqueous base, 10–25% benzyl benzoate emulsion, or 5–10% sulfur ointment is the primary method of managing infected patients. Additionally, oral Ivecop is very effective and is authorized in many nations. Ivecop should not be used in these populations until more safety information is available for Ivecop in pregnant women or children under 15 kg of body weight. Effective itch therapy frequently causes the itching to worsen for 1-2 weeks, and patients should be made aware of this.

The best results are obtained by treating the entire household at the same time and repeating the treatment in the time frame appropriate for the chosen medication because people in the early stages of a new infestation may be asymptomatic and because the treatments for scabies do not kill the parasite's eggs.