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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Allergy Prone Skin. Dry, Itchy Skin. How Likely Is It That I Have Scabies?

I am 23, 5 8 , and 144 pounds. I have skin very prone to allergies especially during the winter and the summer. My symptoms began as an allergic reaction to I m not sure what but have changed over the course of two weeks. About two weeks ago I had a very bad rash around my neck and chest and on the inside of my arm and it looked like contact dermatitis which I get often. The skin was very dry and itchy. There were some bumps but it was mainly just all raised. They seemed to get a little better but at night the itching on my chest continued. Little red bumps also appeared on my chest about a week ago and they are on my arm but those only appeared after scratching and do not itch very much at all. I finally went to the doctor yesterday and he told me it may be scabies because I also have a small rash in between my pinky and ring finger on one hand and a few spots on my belly button. However, he said to wait and take a pack of prednisone and if it did not improve then use the scabies medicine. There has been cracked and dry skin on my hand in the same spot for over a month though and only when I scratch does the rash come up, which also happens if I scratch my legs. The dry skin on my legs is bad and the bumps there have been there for over two months leading me to believe that it is not scabies. I have one area on my arm that could possibly resemble a burrow but I think it is just scabs in a row. How likely is it that I have scabies? There are small red bumps that itch but the itch is not constant. It does seem to worsen in the night but so does contact dermatitis. It does not itch if nothing is irritating it. There is also eczema present that itches. The rash has lessened in redness over the past two days and has not spread to any other parts of the body. The itching is not constant and barely at all during the day unless it is irritated by a hot sweater. If I do wake up at night I m usually easily able to go back to sleep if I let my skin air out. I know no one with scabies and haven t been anywhere recently that I m suspicious of. My sexual partner shows no symptoms and neither does anyone else in my family. The red bumps that look a little different from my previous rash have been on my body for more than a week and I ve slept in the same bed with someone every night and they have no symptoms. I don t want to use the cream if it isn t necessary and require every one in my house to do the same.
Tue, 22 Jan 2013
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Dermatologist 's  Response
Hi there Kat.

I read your very detailed history & description of your clinical findings with interest.

I do believe that you are extrapolating your text-book knowledge into fitting it in with your clinical problem including the 'burrow' et al.

In either case, i suggest treating yourself first with a Permethrin based creme'-rinse to be applied to the entire body over a 6 hr period as a single application. This is perfectly safe & well tolerated & will rid you of your itch if indeed scaboes is implicated. In addition, it can be purchased over the counter in most countries.

An alternative is to pick up a 10% crotamiton cream, mix it 1:1 along with a topical hydrocortisone preparation & apply it liberally to the lesions twice/daily over a 3 day period & this should be helpful.

Having given all these suggestions, i still would like to stress that dermatology is a very visual field & please do visit your nearest dermatologist on the ground.

Cheers & Good Luck.

Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist
Bangalore, India
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Allergy Prone Skin. Dry, Itchy Skin. How Likely Is It That I Have Scabies?

Hi there Kat. I read your very detailed history & description of your clinical findings with interest. I do believe that you are extrapolating your text-book knowledge into fitting it in with your clinical problem including the burrow et al. In either case, i suggest treating yourself first with a Permethrin based creme -rinse to be applied to the entire body over a 6 hr period as a single application. This is perfectly safe & well tolerated & will rid you of your itch if indeed scaboes is implicated. In addition, it can be purchased over the counter in most countries. An alternative is to pick up a 10% crotamiton cream, mix it 1:1 along with a topical hydrocortisone preparation & apply it liberally to the lesions twice/daily over a 3 day period & this should be helpful. Having given all these suggestions, i still would like to stress that dermatology is a very visual field & please do visit your nearest dermatologist on the ground. Cheers & Good Luck. Dr Praveen Rodrigues MD Dermatologist, Cosmetologist, Venereologist Bangalore, India