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GENERAL DERMATOLOGY

Scabies

Scabies

Scabies is a highly contagious, parasitic skin disease with itchy rashes, especially seen in public areas and in winter. Scabies is parasitosis caused by Sarcoptes scabiei hominis and can affect everyone regardless of gender, age and race. This disease which is felt more intensely at night than during the day, causes rashes and serious wounds. Scabies, which is contagious, does not pass from animals to humans. Transmission from person to person can occur through sexual intercourse, communal living areas, close contact, and direct or indirect contact with the personal belongings of patients with scabies.

 

What are the symptoms of scabies?

Itching which increases especially at night and exacerbates with heat, is the most important symptoms. Between the fingers, the inside of the wrist, armpits, buttocks, nipples in women and genital area in men are the body areas where itchy rash can often be seen. The back, midline, face, and scalp are usually unaffected in adult patients. In infants, it can also be seen in these regions. The most obvious typical skin lesion is the gray-white, 1-10 mm long tunnel formations in which the parasite lives, seen as lines between the fingers. Apart from this, small bumps, hardness, water-filled bubbles and scaly crusted lesions can be seen on the skin.

 

Treatment in Scabies

The most important point in the effective treatment of scabies is treatment compliance. Usually, antiparasitic cream treatment is applied. (permethrin, phenotrin, sulfur, benzyl benzoate, crotamiton, ivermectin, malation; oral ivermectin in systemic agents). Although the treatment efficacy of scabies patients is close to each other in line with clinical studies, the main treatment success is determined by the patient's compliance with the treatment. While creating a treatment plan for scabies patients, it is imperative that other people with whom the patient shares his/her living space are treated at the same time, even if they do not have any complaints, to prevent re-infection.

 

 

Things to Consider in the Treatment of Scabies

 1. Before the treatment, a shower should be taken and cream should be applied all over the body from the neck down, including the neck and behind the ears. While applying the creams, between the fingers, belly and groin should not be forgotten.

2. Especially in infants, adults with immunodeficiency or scalp lesions, the eye and mouth area should be protected and the head area should be included in the treatment area.

3. Family members who are in close contact should definitely be treated even if they do not have complaints.

4. During the breastfeeding period, it is recommended to interrupt breastfeeding for up to 5 days after the treatment.

5. The clothes, towels and bedding used after the treatment should be clean. Previously used items should be free of parasite by appropriate methods. (Washing at 50 degrees for at least 10 minutes, ironing, keeping non-washable items in a plastic bag for 7 days, or keeping them in the freezer between -10 and -18 degrees for 5 hours).

6. Repeated treatment protocols are recommended in crusty scabies, diffuse scabies with multiple tunnel-nodule lesions, immunosuppressed patients, epidemic situations, and in cases where the patient's compliance with treatment is not enough.

7. It should be known that itching may continue after treatment due to the allergic response to scabies mites and their secretions.

8. The patient does not need to be isolated, except for crusty scabies.

9. In cases where new lesions develop despite repeated treatment, drug resistance may be suspected, but it generally develops due to the inability to apply the correct medicine or the continuation of contact with people with new scabies.

 

It will be very beneficial for you to consult with specialists in order to avoid such negative situations and for your treatment to be successful