Scabies

1. SUBMITTED TO:
MADAM SADIA UMER
SUBMITTED BY:
INSHRAH KHAID
BSN 3RD YEAR

2. At the end of the session the learner will be able to:
 Define scabies
 Explain epidemiology
 Discuss types of scabies
 Describe clinical manifestations
 Discuss complications of scabies
 Describe diagnostic evaluation
 Discuss treatment of scabies
 Demonstrate prevention and control of scabies
 Discuss nursing management

3. It is a skin infection caused by
burrowing action of female
parasites
AGENT:Sarcoptes scabiei
Scabies is an itchy skin rash
caused by a tiny burrowing mite
called Sarcoptes scabiei. Intense
itching occurs in the area where
the mite burrows.
Scabies is contagious and can
spread quickly through close
person-to-person contact in a
family, child care group, school
class, nursing home or prison.

4. The infection is universal and age, sex and color play no part . All
persons are susceptible. It is commonly occurs when cleanliness is
lacking. It has been also observed in homes of well-to-do people. It
is commoner in poorer countries with social overcrowding.
EPIDEMIOLOGY TRIAD

5.  Determinants:
 Primary determinant
Agent: Sarcoptes scabiei
 Secondary determinant
Overcrowding
Tropical season
Poverty
Poor resources
Contact with infection person
 Frequency:
Scabies has been estimated to be more prevalent
in Pakistan, i.e. 38.15%, compared to
neighbouring countries, such as India, where its
prevalence is 21.54% and Iran, 4.1%.
 Distribution:
 By time
Tropical climate
Poor cleaning
 By place
Overcrowding
Poor countries
 By person
All person are susceptible
Immunocompromized person

6. Direct: prolonged close contact
such as with in households or
institution and by sexual contact
Indirct: contact with soiled bed
linen, clothing and other
contaminated objects

7. Indeterminate, extending from
1 or 2 days to 2 weeks .
The eggs hatch in 3–4 days
and develop into adult mites in
1–2 weeks. After 4–6 weeks the
patient develops an allergic
reaction to the presence of mite
proteins and faeces in the
scabies burrow, causing
intense itch and rash.

8. The telltale lesion is the burrow which is commonly
noted on the webs of finger. Other frequent sites are
natural folds of skin or pressure areas. Lesions are
often noted about the genitalia in adults (only
female mite burrows into superficial layer of the
skin to deposit her eggs).

12.  Crusted (Norwegian) Scabies:
Crusted scabies predominantly
affects individuals with weakened
or faulty immune systems. It is
characterized by the formation of
thick, crusted areas covering a
large portion of the skin.
 Nodular Scabies: Nodular scabies
is more commonly observed among
children. In this type, brown-red
nodules may persist on the skin
even after the mite infestation has
been treated. These nodules are a
result of the body’s inflammatory
response to the presence of the
mites and can take time to resolve
fully.

13.  Bullous Scabies: Bullous scabies can
be mistaken for a condition called
bullous pemphigoid, which involves
skin blisters. It is more commonly
seen in adults. In this type of
scabies, the infestation leads to the
development of large fluid-filled
blisters on the skin, causing
discomfort and confusion with other
blistering skin disorders
 Scalp Scabies: As the name suggests,
scalp scabies occurs on the scalp and
is characterized by the presence of
scales that may resemble psoriasis.
Unlike typical scabies, scalp
infestations may not present the
hallmark signs of itching and
burrows.

15. Symptoms:
Commonest symptom is itching
that is especially worse at night .
Usually involves more than one
family member
Sign:
Itchy red papules (or
occasionally vesicles and
pustules) which can occur
anywhere on the skin but rarely
on the face except in neonates.

17. Long standing scabies often results
in:
Furunculosis
Impetigo
Paronychia
Pyodermia especially in children
Septicaemia (a bloodstream
infection)
 Heart disease
 Kidney problems

18. Scabies can be confirmed by:
 Taking skin scrapings of lesion
 Demonstrating the parasite under
the microscope
Burrow ink test
Adhesive tape test
Polymerase chain reaction (PCR)

19. Topical scabicides available are 5% Permethrin,
Malathion, Benzyl Benzoate lotion, Sulpher
ointment ( use 3% ointment in infants and small
children and 5% in older children and adults). Use
any of the above with following points in mind for
a successful management:
 All the skin below the neck should be treated.
 All close contacts should be treated at the same
time even if asymptomatic.
 A bath is advisable before and after completion of
treatment.
 Reapply scabicide to the hands if they are
washed.
 Clothes and bedding should be washed.

20.  Health education about proper cleanliness.
 Body care coupled with frequent change of
underclothing and bedding.
 Children who are infested should be
excluded from school until disinfected.

22.  Educate patient about personal
hygiene, including hand washing.
 Instruct patient to bath
thoroughly, scrubbing the
involved areas with a brush.
 Increase awareness and
surveillance for scabies.
 Change the diet which causes
food allergy such as egg and milk
 Avoid exposure to hard soap and
detergents.
 Provide lubricate jelly or lotions
for eczema.
 Family education