SCABIES

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

Etiology

  • Causative agent: Sarcoptes scabiei var. hominis 
  • Highly contagious, typically via direct physical (skin-to-skin or sexual) contact and rarely indirect transmission (e.g., sharing textiles such as bedding, towels, or clothes)

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

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