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Dr. Andrew Rynne
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What is scabies?

Answered by
Dr.
Dr. Muhammed Aslam

General & Family Physician

Practicing since :2010

Answered : 987 Questions

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Posted on Thu, 12 Feb 2015 in Skin Hair and Nails
Question: Please be in depth with these 2 answers:

1. What are SCABIES????


2.. HOW DO GET RID OF
SCABIES??
doctor
Answered by Dr. Muhammed Aslam 53 minutes later
Brief Answer:
Mite infestation, treated with scabicidal agents.

Detailed Answer:
Hi dear, welcome back.
Thanks for the query.

It will be more useful if you tell me what all symptoms you are suffering including duration and any treatment taken.

Anyhow, I will answer your questions.

1)Scabies is a highly contagious pruritic condition caused by skin infestation with a mite called "Sarcoptes scabiei".

The typical symptom is intensely itchy eruption in sites like interdigital spaces of hand, buttocks, genital areas, skin folds etc. Itching is usually worse at night.
More than one family members can be affected at the same time as this is spread by direct contact and via clothes and fomites.
Diagnosis can be helped by a direct physical examination and confirmed by microscopic examination of skin scrapings to reveal the mites.


2)This is treated with scabicidal agents.
For mild to moderate infestation, we give ointments like permethrin 5%, Lindane 1% etc; for severe condition, oral drug Ivermectin is also added. For itching, antihistamines like Levocetirizine is added for first 3 to 5 days.

Few things are important for successful therapy- (1)Ointment should reach throughout the body except face. It is applied after bathing and drying with towel and left for 10-12 hours.(2) Particular attention is needed for skin folds and intertrigos. (3)All contacts of infected person should be treated simultaneously even if asymptomatic. (4) Clothes and bed linens must be decontaminated by hot water wash(60 0C).
Failure in these can cause relapse.

Usually single treatment is enough. Anyhow for severe condition, we advise to repeat after 1 week.

Hope this will answer your query.
Be free to ask if you need further clarification.
Wishing you good health.
Thank you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Muhammed Aslam 37 minutes later
Ok so here's the reply as u stated above I do have itching more at night
Mainly on the arms and let's some of which have actually turned into scabs....
I'm almost positive it's looking like tiny Flea bites only on arms and legs however... The bites are going up down and diaganol the dog in my residents is carrying fleas however, it's not my dog it's my sisters.... My friend however had scabies before her husband is a theoretic surgeon he said he has seen and treated it before
So he said that before he reccomends or treats anything he wants me to follow up with my primary care physician so that he doesn't he doesn't write a prescription for the wrong reasons that's the purpose for asking you this question to see if that's even possible for flea's to even cause this problem,
Thanks
doctor
Answered by Dr. Muhammed Aslam 13 hours later
Brief Answer:
Kindly upload a photo

Detailed Answer:
Hi dear,
Thanks for the information given.
As you told, fleas also can cause this condition due to insect bite reaction. So let me clear few more points.

How many days you are suffering from this?
Can you please upload good quality pictures of a few lesions.
Also, let me know the exact distribution of these lesions. Does it concentrate on inter digital areas and around joints/skin folds?
When did your friend suffer from scabies? Had you direct contact with her that time?

Kindly get back with details.
Thank you.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Muhammed Aslam 58 minutes later
it looks like 4 or 5 flea bite right in a row all together it will not let me upload a picture this far into the thread if you would like I can open a new inquiry and just take a photo that way as I said they are not apart it's altogether.... My friend had them like a year ago I was not around her at the time that she had them
doctor
Answered by Dr. Muhammed Aslam 18 hours later
Brief Answer:
I dont think this is scabies

Detailed Answer:
Hi dear,
Thanks for the information.

Though a picture is important in assessing morphology of the lesion, 4-5 flea bite like lesions in a row (that means not in interdigital areas or creases) is not supportive of the diagnosis of scabies. As I already mentioned, scabies lesions appear in sites like web spaces, wrists, elbow, axilla, waistline and genitals.
Also, unless secondarily infected, scabies cause linear, wavy lesions rather than circular.
If you have difficulty in uploading picture, just email them to YYYY@YYYY with subject as ATTN: Dr Muhammed Aslam. No need to open new thread. Write back here that you have mailed me the picture. I will go through it and reply you back.

Another thing is that history of scabies in your friend one year back is not significant, even if there was contact.

So, in my opinion you are suffering from an IBR(insect bite reaction) which can be treated with antihistamines and topical antibiotics; oral antibiotics needed only if secondary infection is present.

For such cases, I usually give antihistamines like Levocetirizine 5 mg once daily and topical antibiotics like mupirocin for 5-7 days; I ask for follow up after 3 days to assess need for addition of oral antibiotics or steroids. It will be fine if you can have a direct evaluation with your primary physician or a dermatologist, so that we can have the exact diagnosis and treat accordingly.

Hope this answer will help.
Let me know if you need further clarification.
Thank you.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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