Scabies (scabies)

Sca­bies is a high­ly con­ta­gious skin dise­a­se cau­sed by the sca­bies mite Sar­c­op­tes sca­bi­ei. This para­si­tic dise­a­se occurs world­wi­de and affects peo­p­le of all social clas­ses. Trans­mis­si­on occurs almost exclu­si­ve­ly through direct, pro­lon­ged skin-to-skin cont­act with an infec­ted per­son. Inten­si­ve phy­si­cal cont­act, such as during sexu­al inter­cour­se or cuddling, is par­ti­cu­lar­ly con­ta­gious. Trans­mis­si­on can also occur in com­mu­nal faci­li­ties. The fema­le itch mite bur­rows into the top lay­er of skin and lays eggs the­re. The­se mite bur­rows are cha­rac­te­ristic of the dise­a­se. The incu­ba­ti­on peri­od for initi­al infec­tion is two to six weeks. The main sym­ptom is inten­se itching, which increa­ses signi­fi­cant­ly at night and when the pati­ent is warm in bed. Cha­rac­te­ristic mite ducts appear on the skin as fine, red­dish-brow­nish lines. Pre­fer­red are­as are the spaces bet­ween the fin­gers, wrists, arm­pits, navel regi­on, geni­tal area and, in infants, the head and soles of the feet. Scrat­ching cau­ses addi­tio­nal scratch marks and can lead to bac­te­ri­al super­in­fec­tions. The dia­gno­sis is made cli­ni­cal­ly and can be con­firm­ed by micro­sco­pic detec­tion of mites, eggs or feces. Tre­at­ment is car­ri­ed out with anti­pa­ra­si­tic medi­ca­ti­on. Per­me­th­rin cream is most com­mon­ly used, which is appli­ed to the enti­re body and washed off after eight to twel­ve hours. The tre­at­ment should be repea­ted after one week. Alter­na­tively, iver­mec­tin can be taken as a tablet. It is important to co-tre­at all house­hold mem­bers and clo­se cont­acts. Clot­hing and bed linen should be washed at a tem­pe­ra­tu­re of at least 60 degrees. The occur­rence of sca­bies in com­mu­nal faci­li­ties must be reported.