BMJ  2005;331:619-622 (17 September), doi:10.1136/bmj.331.7517.619

Clinical review

Scabies: diagnosis and treatment

Leicester Royal Infirmary

The first 150 words of the full text of this article appear below.

Introduction

Scabies is an intensely itchy dermatosis caused by the mite Sarcoptes scabiei. A patient with ordinary scabies may have an average of 12 mites; however, those with crusted scabies may have thousands of mites. The infestation occurs at all ages, but particularly in children. It is a common public health problem in poor communities and is widespread in many underdeveloped countries.

How is it spread?

Scabies is highly contagious, and person to person spread occurs via direct contact with the skin. Transfer from clothes and bedding occurs rarely and only if contaminated by infested people immediately beforehand.¹

Infestation occurs when the pregnant female mite burrows into the skin and lays eggs. After two or three days, the larvae emerge and dig new burrows. They mature, mate, and repeat this cycle every two weeks.

How do I diagnose it?

A history of itching in several family members over the same period is almost pathognomonic. However, lack of a history . . . [Full text of this article]

What are the symptoms and signs?
Is it different in very young children?
How do I confirm the diagnosis?

What is crusted scabies?

What about scabies in people with HIV infection?

How common is scabies?

What are the risk factors?

How do I treat it successfully?

What scabicide treatments are available?
Which should I use?
Is compliance important?
Does treatment fail?
Is there an oral treatment for scabies?
Is there any resistance to these treatments?
Are there any side effects?
What about treating scabies in pregnant women?
What if treatment fails despite correct treatment?
Do complementary treatments work?

What if itching persists after treatment?

What's the prognosis?

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