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Suggest treatment for scabies

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Posted on Sat, 26 Apr 2014
Question: Hi I have been to five doctors with scabies symptoms and no one seems to believe it is scabies. Samples were taken from one large sore I have on my knee and tested for fungus which came back negative, but no microscopic tests. I have itchy red sores that look like they have feint brown tracks that come out of them that loop around my arms and legs. Some zig zag. I also feel the pin prick bite and a crawly feeling all over. I also saw black specks come out of one of the sores, that started with a very white film. When the white crusty film went away, the black specks appeared. This happened after I used some scabies cream (I convinced an Urgent care to give me the cream, though they also didn't think it was scabies.) If it isn't scabies, what can it be?? I also feel itchy in my nose, eyes and ears so I think these things are spreading.
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Answered by Dr. Charu Bansal (25 minutes later)
Brief Answer: kindly upload some pics and reply to questions Detailed Answer: Hello dear, Welcome to healthcaremagic. I have read your query and understood your concern. If you firmly believe you have scabies, i will like to know following details: 1) Does itch exacerbate any particular time like morning or night? 2) What is your occupational status? 3) Any family history of similar symptoms? 4) What all sites are actually involved? 5) Does it start with fluid filled lesion ? Scabies unlikely involves the face except in children. Its a disease which usually occurs in hostelers, hospital workers, unhygienic conditions or contact with the people engaged in such work. Kindly attach some pics of the lesions so that i can actually visualize and help you to my best. Good luck
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Charu Bansal (53 minutes later)
I sent pics. This is the main sore. It started with a crusty oozy patch that grew in size. The crusty stuff went away and now it's more of a purple thickened patch. The elongated sore next to it is where I saw the white flaky stuff and then the black specks. Those are gone now. The sore remains. The little red sores pop up after feeling a prick sting which tells me it is some sort of bug. It itches and bleeds and white flaky crust drops off of it. Doctors are confused why no one else in my family has gotten it, including my husband. The sores were confined mainly to my legs but have spread to my arms and now my back and front and my neck. My ears are also itchy. I've read on the internet of folks having scabies on their faces as well as in their noses, maybe it is not likely but not impossible either. Something I just thought of, about five years ago, one of my blood tests came back high in the IGM protein and they told me that a high reading in that protein suggests a parasitic cause. They did not pursue this but I am wondering if this is connected to that in some way. I am unemployed at the moment but got symptoms while visiting relatives in Kentucky around the end of XXXXXXX Ooops missed two of your questions. I feel the crawly feeling mostly at night, but that could be because I'm not distracted. I do feel the itchy bitey and crawlies during the day as well. The sores aren't fluid filled, they just start as an itchy bump, I scratch it and a small white flake of skin comes off leaving a hole that bleeds. Once it bleeds it scabs over and it still very itchy. A light brown track comes out of the red sore. The doctor I saw this morning said that she didn't see the tracks. They are very hard to see but I know they are there, I can see them looping around my in little curly cues. Why she couldn't see them I don't know.
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Answered by Dr. Charu Bansal (26 hours later)
Brief Answer: Scabies can be a possibility Detailed Answer: Hello dear, Welcome again. I have seen all the attached pics. Thanks for the same. I could appreciate multiple erythematous scaly as well as excoriated raised lesions over the legs prominently over knees. Your fungal test is already being done, so that rules out the fungal etiology. The other likely possibility is dermatitis with secondary excoriations. It manifests in similar fashion. For that, i usually advise my patients to apply a cream containing a combination of moderate potency steroid like clobetasol and antibiotic like mupirocin to be applied over the lesions twice daily. For symptomatic relief, you may take tablet fexofenadine in morning and levocetrizine in night time. Additionally apply a good amount of moisturiser over whole body preferably after bath on semi wet body. But if you strongly feel like having scabies, there is no harm in doing a topical course of antiscabiecidal therapy. For that, you may apply permethrin cream/lotion 5 % once overnight application in addition to above mentioned treatment. Disinfect your all the clothes used within past 3 days. Don't worry. You may discuss my opinion with your doctor, i am sure he/she will agree with my opinion. I hope it helps. If you have further query, you may ask me. Stay healthy.
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Charu Bansal

Dermatologist

Practicing since :2010

Answered : 773 Questions

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Suggest treatment for scabies

Brief Answer: kindly upload some pics and reply to questions Detailed Answer: Hello dear, Welcome to healthcaremagic. I have read your query and understood your concern. If you firmly believe you have scabies, i will like to know following details: 1) Does itch exacerbate any particular time like morning or night? 2) What is your occupational status? 3) Any family history of similar symptoms? 4) What all sites are actually involved? 5) Does it start with fluid filled lesion ? Scabies unlikely involves the face except in children. Its a disease which usually occurs in hostelers, hospital workers, unhygienic conditions or contact with the people engaged in such work. Kindly attach some pics of the lesions so that i can actually visualize and help you to my best. Good luck