Description

• Scabies is a parasitic skin infestation caused by the Sarcoptes scabiei var. hominis (S. scabiei) mite, which is primarily transmitted via close personal contact but may be transmitted through clothing or towels
• The female scabies mite burrows into the stratum corneum, causing severe pruritus, particularly at night. Primary lesions commonly include erythematous papules, vesicles, or burrows

Types

• The classic symptom is intense pruritis especially at night
• The sites of predilection are the interdigital spaces, wrists, points of the elbow, antecubital fossae, anterior axillary folds, umbilicus, and the genitalia especially the gluteal cleft
• The most diagnostic or pathognomic finding is an intact S shaped or linear burrow with a papule or vesicle at its end housing the mite. The most common sites are web spaces of the hands, wrists, and lateral aspects of palms
• Generalized urticarial papules, excoriations, and eczematous changes are secondary lesions caused by sensitization to the mite
• Tiny scaly papules on the nipple and male genitalia (glans, shaft, and scrotum) are pathognomonic of scabies
• Nodular scabies: Itching nodules 5-20 mm diameter, red, pink, tan, or brown in colour persist for several months. Commonly found in the scrotum
• Scabies incognito: modifies clinical picture of classical scabies which mimic other dermatoses due to inappropriate use of topical steroids

Investigation

• Typical history and skin lesions on clinical examination 
• Detection of mites, larvae, ova, or mite faeces
• Dermoscopy: mite in burrow resembles jet with contrail
• Microscopic examination of the skin 
• Skin scraping and histology 

Treatments

Ayurvedic Treatment

Kashyas

• Patoladi kashaya ,Nimbadi kashaya, Manjistadi kashaya, Guduchyadi Kashaya, Sonitamritam Kashaya
  • Upto 1 year: for mother: 2 tsp sookshm achoorna is boiled in 2 glass water, strained and given to mother. If agni bala permits give 1 tsp thrice to the child
  • 1 year to 5 years: ½ tsp powder boiled in 1 glass water and given as divided doses mixed with sugar or jaggery
  • 5 to 10 years: 1 tsp powder boiled in 1 glass water and given as divided doses mixed with sugar or jaggery
  • 10-15 years: 1 ½ tsp powder boiled in 1 glass water and given twice daily mixed with sugar or jaggery

Arishtas

• Aragwadharishtam, Nimbamritasavam , Khadiraristam
  • Upto 2yrs- ½ tsp arishta diluted with 1 tsp water
  • 2-5 years- 2.5ml-5ml diluted with 5 ml boiled water
  • 5-10 years- 10ml
  • 10-15 years- 15ml

Choornas

• Guggulupanchapala Choorna, Haridrakhandam,Rajanyadi choorna
• Infant: 2-3 gm, Toddler- 5gm, School going- 7-10gm
• Anupana: honey or water or along with food

Externally

• Sulphur containing ointments 
• Pamantaka taila – ext application
• Gandhaka taila – ext application
• Guggulu marichadi taila – ext application
• Ayyapala taila – ext application

Department

Kaumarabhrithya