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Scabies transmitted by close contact, shared personal items

Posted Mar 04 2010 12:00am - Scabies is another common infestation caused by a tiny, round eight-legged mite that burrows in the skin and can cause intense itching. Little red bumps similar to hives, tiny bites or pimples usually appear with scabies and, in some cases, the skin can become crusty or scaly, especially between fingers and toes. Some people also can develop nodular lesions from a hypersensitivity reaction, which can be seen in the armpit or genital areas.

Dermatologists estimate that more than 300 million cases of scabies occur around the world every year, and it is easily transmitted from person to person by close contact. Although everyone is susceptible to scabies, crowded living conditions and poor hygiene are two of the most common associations.

“Dermatologists can diagnose scabies by doing a thorough examination of the patient, and sometimes the diagnosis can be confirmed by scraping the lesions to identify the scabies mites or its eggs,” said Dr. Albert C. Yan, MD, FAAD, chief of dermatology at the Children’s Hospital of Philadelphia. “Recently, use of epiluminescence microscopy (dermatoscopy) also has demonstrated good sensitivity for identifying mites by looking for a specific pattern that indicates the pigmented areas of mites, as well as looking for corroborating air bubbles associated with the mite’s presence.”

The gold standard treatment for scabies remains topical 5 percent permethrin cream for most patients who are three months old or older. For younger children or pregnant women, sulfur compounds in petrolatum can be effective in treating scabies. Dr. Yan added that the oral medication ivermectin also has been shown to be effective, particularly for resistant cases or those with extensive infestations, but should not be used for pregnant women or young children. New therapies on the horizon focusing on the use of terpineols and tea tree oil have shown promise in early studies.

Not having close skin-to-skin contact with someone who has scabies or with their personal items (such as clothes, towels, and brushes) will help avoid contracting the condition.

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