Scabies (scabiosis)

What is it about ?

Scabiosis is the medical term for scabies. It is an itchy skin condition that is easily transmitted from person to person. A brief contact is enough to transmit it. Scabies are troublesome, but benign.

Cause of scabies

• Scabies is caused by a parasite, the sarcopte. It is a very small mite that digs micro-furrows of about 1 cm in the skin. The mite lays its eggs there, which hatch after three days. These new mites leave their compartment to lay new eggs elsewhere in the skin after two weeks.
• The transmission of the mite occurs through direct contact with the skin (for example, during treatment, physiotherapy, sexual contact) or through contaminated clothing and bed linen.
  • Scabies occurs in conditions where the people live close to each other (retirement homes, institutions, housing for refugees).
  • It can also be contracted for a stay abroad in unhygienic conditions.

What is its frequency?

We do not have exact and recent figures. Scabies outbreaks have been frequently reported in recent years. In general, these are very localized outbreaks (clusters) which have sometimes been mentioned in newsletters.

Until January 2019, scabies was one of the infectious diseases that had to be declared to the “public health control” department. From now on, it should no longer be done for isolated cases, but only if the disease affects a community (school, healthcare establishment).

How to recognize it?

• Scabies itch, especially in the evening and at night. It is at the level of the buttocks, the wrists and in the folds between the fingers that the itch is the worst. Scratching causes lesions that are sometimes difficult to distinguish from other skin conditions such as eczema.
• Scabies is contagious : If other members of your family or roommates have the same symptoms, it’s a safe bet that it is also scabies.

How is the diagnosis made?

The diagnosis of scabies is not easy for the doctor to make because he must distinguish it from other skin conditions that cause itching. The diagnosis of scabies is very likely when at least 3 of the following 4 characteristics are met:

• a scabious groove in the skin : between the fingers, at the level of the wrists, the folds of the elbows, the front fold of the armpits, around the nipples and navel, at the level of the penis and scrotum;
• from scabies lesions like red pimples or small bumps (nodules) in characteristic places like the penis, scrotum, around the navel and on the fingers;
• from itching nocturnal ;
• a (recent) contact with someone with scabies.

Your doctor will most likely make a diagnosis of scabies if you have itching generalized symptoms that get worse especially at night, and if other people around you have the same itchy symptoms.

What can you do ?

People with scabies are often ashamed of themselves, yet anyone can get it. If you have scabies, be honest with those around you so that they can seek treatment if they are infected.

For effective treatment of scabies, it is very important to follow the advice following:

• Follow the doctor’s advice exactly.
• Even though the itching do not decrease immediately, you must take the treatment correctly and completely. Only this way will you prevent further infection.
• Apply the cream prescribed by the doctor all over the body, starting from the edge of the lower jaw to the toes and sole of the foot.
• In children under 2 years old and in seniors, it should also be put on the face.
• Don’t forget to put cream between the toes, between the fingers and between the buttocks!
• The cream works for about 8 to 12 hours. It is therefore recommended to apply it before going to bed and to wash well in the morning. Then put on clean clothes.
• Wash all bed linen at 60 ° C, along with clothing and anything that has been in contact with the person with scabies in the past 72 hours.
• If this is not possible right away, leave everything in a tightly closed plastic bag for 3 days, then wash everything.
• Ventilate the mattress, pillows and blankets well for 2 to 3 days.

What can your doctor do?

• When the doctor makes the diagnosis of scabies, he will insist on treating the whole family (and other people you have had close physical contact with) the same time. This is very important, even if these people do not (yet) have symptoms.
• The doctor will prescribe a cream Permethrin based.
• In more or less 9 out of 10 people, a single treatment with permethrin cream is sufficient.
• In the event of a relapse or if the person is not cured after a single treatment, other applications must be made in addition.
• The most common side effects of treatment with permethrin cream are tingling, burning sensations and irritation.
• Unfortunately, the itching may persist for several days to several weeks, even after recovery. Your doctor may prescribe a moisturizere, a cortisone cream or one medicine to reduce itching (antihistamine).
• THE’ivermectin is a product which can be taken in tablet form, and which is more convenient to use. It is a good alternative for people who, for example, cannot use cream because of a skin disease. At the moment, it is only used in large hospitals and is not available in pharmacies.

Want to know more?

• Gale – AVIQ – Agency for Quality Life
• Scabies – Furrows (image) – DermIS – Dermatology Information System
• Scabies – Papules and Blisters (image) – DermIS – Dermatology Information System

• Permethrin – CBIP – Belgian Center for Pharmacotherapeutic Information
• Corticosteroids for the skin (low potency preparations) – CBIP – Belgian Center for Pharmacotherapeutic Information
• Antihistamines – CBIP – Belgian Center for Pharmacotherapeutic Information
• Ivermectin – CBIP – Belgian Center for Pharmacotherapeutic Information

Source

www.ebpnet.be