A 24-year-old female came in to Primary Care for evaluation of a rash that had started in her finger webbings and eventually extended to her arms and right hip. The rash was diagnosed as scabies, an infestation by the ectoparasite Sarcoptes scabiei that causes diffuse itchiness and excoriations. The rash typically affects interdigital web spaces, wrists, elbows, axilla, and the groin. Scabies is a highly infectious condition that is spread by skin-to-skin contact or, less frequently, through contact with shared clothes or linens. It can affect individuals of all ages, races, and genders. Immunocompromised individuals are particularly vulnerable and may experience a more severe form of the disease, known as Norwegian or crusted scabies. The mites are treated with permethrin 5 % cream applied from the neck to the feet once at night and washed off the following morning. A second treatment is repeated a week later. Oral ivermectin is the antiparasitic of choice for infestations that do not resolve after topical therapy.
KeywordsScabies Excoriation Pruritus Mites Sarcoptes scabiei Burrows Infestation Parasite Ectoparasite Contagious Neglected disease
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