What is Scabies

  • scabies A communicable disease of the skin caused by Sarcopte Scabiei and characterized by the eruptive lesions produced from the burrowing of the parasite into the skin.

Etiologic Agent

  1. The mite is yellowish-white and can barely be seen by unaided eye.
  2. The female parasite burrows beneath the epidermis to lay her eggs and sets up an intense irritation.
  3. The males are smaller and reside at the surface of the skin.
  4. Scabies occurs worldwide, and is predisposed by overcrowding and poor hygiene.

Incubation

  • It occurs within 24 hours from the original contact, the length of time required from itch mite to (burrow) or infected skin lay ova.

Period of Communicability

  • The disease is communicable for the entire period that the host is infected.

Signs and Symptoms

  1. Itching
  2. When secondarily infected the skin may feel hot and burning but this is a minor discomfort.
  3. When large areas are involved and secondary infection is severe there will be fever, headache and malaise. Secondary dermatitis is common.

Mode of Transmission

  1. The disease is transmitted by direct transmission of infected individuals.
  2. The disease is also be transmitted through sleeping in an infected bed or wearing infected clothing.
  3. Anyone may become infected or re-infected.
  4. Infestation with mites may also result from contact with dogs, cats, and small animals.

Pathology

  1. The female mite burrows into the skin to lay her eggs, from which larvae emerge to copulate and re-burrow under the skin.
  2. While any part of the body maybe infected, the itch mite maybe found in the interdigital spaces of the fingers or in warm folds in the skin.
  3. Areas of friction, such as the crotch, axillae, or the belt line, around the nipple in women and the periumbilical region are sites of predilection.
  4. The external genitalia are most frequently involved in adult males.
  5. The lesions are slightly elevated, straight or twitching burrows, thread like that are either brown or black in color, that are about 5 to 6 mm in length.
  6. Severe inflammation with the development of the papules, blisters, pustules, and crusts may come as a result of infection from scratching.
  7. In infants, burrows may appear on the head or neck.
  8. The disease may become fully developed into two weeks; the eggs hatch in about 6 days, and the parasite grows very rapidly. It may persist for month or even years if not recognized or properly treated.

Diagnosis

  1. Appearance of lesion, and intense itching and finding of the causative mite.
  2. Scraping from its burrow with a hypodermic needle or curette, and then examined under low power of the microscope or by hard lens.

Treatment

  1. The whole family should be examined before undertaking treatment, as long as a member of family remains infected, other members will get the disease
  2. Treatment for scabies consists of application of pediculicide, like permethrin cream of lindane lotion in thin layer over the entire skin surface and is left for ten to twelve (10-12) hours.
  3. Crotamiton cream applied for five consecutive nights.
  4. Neosporin ointment rubbed into the affected skin four to five times a day.
  5. Eurax and kwell lotion also prove effective to some patients.
  6. All clothes used before and during the treatment period should be disinfected by dry cleaning or boiling.

Nursing Interventions

  1. Instruct patient to apply the cream at bedtime, from neck down to toes, covering the entire body.
  2. Advise patient to report any skin irritation.
  3. Suggest the family members and other close contact of the patient be checked for possible symptoms and be treated if necessary.
  4. If patient is hospitalized, practice good handwashing technique, or use gloves while performing nursing procedure.
  5. Terminal disinfection should be carried out after discharge of patient.

Prevention and Control

  1. Good personal hygiene daily bath; washing the hands before and after eating, and after using the toilet; cutting off fingernails.
  2. Regular changing of clean clothing beddings and towels.
  3. Eating the right kind of food like rich in Vitamin A and Vitamin C such as green leafy vegetable and plenty of fruits and fluids.
  4. Keeping the house clean.
  5. Improving the sanitation of the surroundings.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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