SCABIES

• Scabies


  A highly transmissible skin infection characterized by burrows, pruritus, and excoriations with secondary bacterial infection
• Etiologic Agent


  Sarcoptes scabei var. homonis
• Source of Infection


  Human skin
• Mode of Transmission


  1. Skin to skin contact

  2. Direct contact with fomites
• Incubation Period


  The itch mite may burrow under the skin and lay ova within 24 hours of an original contact
• Period of Communicability


  The disease is communicable for the entire period that the host is infected
• Clinical Manifestations


  • Intense itching that becomes more severe at night
  • Burrows (lesions) seen in webs of the fingers, wrists and elbows
  • Burrows in immunocompromised, infants, young children and elderly appears in face, neck, scalp and ears
• Diagnostic Procedure


  Superficial scraping and examination under a low-power microscope of material from a burrow
• Treatment


  • Aqueous Malathion lotion
  • Permethrin derma cream left on the skin for 8-12 hours
  • Benzyl Benzoate
  • Sulfur in petrolatum
  • Ivermectin - Anti-helminthic drug is effective in resistant cases
  • Antipruritic emollient or topical steroid for itching
• Nursing Intervention


  1. Have the patient's fingernails cut short to minimize skin breaks from scratching

  2. Instruct patient on proper application of the drugs

  3. Contaminated clothing or beddings should be dry-cleaned or boiled

  4. Advise patient to report any skin irritation

  5. Advise family member and other people who had close contact with the patient be checked for possible symptoms and be treated if necessary

  6. Practice contact precaution

  7. Terminal disinfection should be carried out

  8. Encourage the patient to verbalize his/her feelings
• Prevention and Control


  • Good personal hygiene
  • Avoid contact with infected persons
  • All members of the household, including close contact should be treated