Scabies is a contagious skin disease caused by the scabies mite (itch mite). The scabies mite burrows into the epidermis of human skin, where it lays eggs and moves around, causing characteristic papules or small vesicles in affected areas, accompanied by intense itching. This disease can occur nationwide, with no gender differences. It spreads through direct or indirect contact, is highly contagious, and spreads rapidly, often causing outbreaks in families and communities where multiple people become infected simultaneously or successively. If not treated properly, the condition can worsen and recur, becoming chronic.

bubble_chart Clinical Manifestations

1. The primary skin lesions are pinhead-sized papules, vesicles, chickenpox-like eruptions, and burrows created by scabies mites in the epidermis; some patients may develop soybean-sized nodules on the scrotum or penis. 2. Lesions commonly occur in finger webs, flexural aspects of the wrists, lower abdomen, upper inner thighs, and external genitalia. The face, palms, and soles are less frequently affected, though infants and young children often exhibit widespread involvement, with pustules commonly found on the palms and soles. 3. Cutaneous pruritus is intense, particularly at night. 4. Scratching may lead to secondary eczema-like changes, pustules, folliculitis, furunculosis, and other complications.

bubble_chart Diagnosis

1. History of exposure to pestilence, with multiple people around affected; 2. Rash presents as small papules, chickenpox-like lesions, tunnels, nodules, etc.; 3. Commonly occurs in finger webs, flexural side of wrists, lower abdomen, inner thighs, external genitalia, etc.; rarely seen on the head, face, palms, or soles (except in infants); 4. Intense itching, especially at night; 5. Scabies mites or eggs can be found in the rash.

Principles of Treatment
1. Isolate as a contagious pestilence, disinfect clothing and bedding, and treat surrounding patients simultaneously; 2. Pathogenic treatment, primarily with topical medications; 3. Relieve itching; 4. For secondary eczematous changes, refer to the principles of eczema treatment; 5. For secondary infections, administer antibiotic therapy; 6. Pediatric medication differs from adult medication; 7. Genital scabies nodules may be treated with intralesional injection therapy.

Principles of Medication
1. Apply medication to the entire body, including areas without rashes, requiring a larger quantity of medication; 2. If new rashes appear after two weeks, repeat the second course of treatment; 3. For secondary eczematous changes, refer to the principles and medications for eczema treatment; 4. For secondary infections, administer antibiotic therapy, referring to antibiotic treatment for coccal skin diseases; 5. Pediatric medication differs from adult medication, with lower-concentration sulfur preparations being preferable; 6. Genital scabies nodules may be treated with intralesional injection therapy; 7. For itching relief, select 1–2 types of antihistamines.

bubble_chart Cure Criteria

1. Cure: Symptoms and signs disappear with no recurrence; 2. Improvement: Symptoms and signs improve, skin lesions decrease; 3. No cure: Symptoms and signs show no improvement, or symptoms and signs disappear but recur after 2 weeks.