Let’s now discuss another skin condition that is frequently seen within our institution and that is Scabies. Here is a magnification of the scabies mite (bug). Scabies is a highly contagious skin disorder not visible to the bare eye. 1/100 in size, they burrow under the skin. Transmission is by close contact w infected humans (not casual hug or handshake). The mite does not live long off the human body, however, occasionally, is spread by clothing, towels, or bedding.
The scabies mite progresses through a life cycle. It takes 2 to 4 months to fully develop after the initial infection.
Sensitization to the mites & their products begins, resulting in a pruritic papular rash most common on skin folds wrist, elbows or knees, abdomen, penis & Groins and web spaces between fingers. Secondary bacterial infection may occur.
Here you see the tracks or burrowing of the scabies visualized under the dermascope
Infected inmate is instructed to apply Permethrin cream 5% in a thin coating over the entire body from neck down to the toes AFTER showering and to leave on at least 8 hours but no more than twelve. It is usually unnecessary to treat the face. I/M and cellie get two complete linen and clothing changes before starting treatment – one change after the initial treatment application and the second 8 hours later (after the patient showers and rinses off the skin treatment. Inmate goes into new clothes and new linens. Instruct the inmate to wash off all the medication. At both times during the changing of the linen & clothes, the entire cell and bunk including the mattresses must be sprayed with Permethrin spray. The best time to begin tx is as late in the day or evening as possible, so that the treatment can work overnight while the patient is sleeping.
Common infestation locationsCommon infestation locationsLife cycle of the scabies miteLife cycle of the scabies mite
Scabies Signs and SymptomsScabies Signs and Symptoms• Pruritus of skinPruritus of skin• Intense scratching especially at nightIntense scratching especially at night• Papular rashPapular rash
Scabies BurrowsScabies Burrows(arrows point to mites)(arrows point to mites)
Scabies TreatmentScabies Treatment• Permethrin cream 5% 1 Tube/inmate &Permethrin cream 5% 1 Tube/inmate &Permethrin SprayPermethrin Spray• Complete change of linen and clothingComplete change of linen and clothingafter 1after 1ststtx and then 8 hours later showertx and then 8 hours later showerand rinse off, change into 2and rinse off, change into 2ndndissued linenissued linenand clothingand clothing