Scabies: assessment and management

Scabies is a highly contagious skin infestation caused by the microscopic mite Sarcoptes scabiei. This parasitic condition affects millions of people worldwide and can occur in any climate or socioeconomic group, though it is more prevalent in crowded living conditions and areas with poor sanitation.There are two major types of scabies:

1. Classical scabies: The most common form, characterized by a limited number of mites (10-15) on the body.
2. Crusted (Norwegian) scabies: A severe form found primarily in immunocompromised individuals, characterized by thousands of mites and extensive skin crusting.
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Pathophysiological Basis of Symptoms

The primary symptoms of scabies - intense itching and skin rash - are rooted in the mite's life cycle and the body's immune response:

1. Burrowing: Female mites burrow into the superficial layers of the epidermis, creating tunnels where they lay eggs. This mechanical disruption of the skin contributes to irritation and rash formation.
2. Allergic reaction: The presence of mites, their eggs, and feces triggers a hypersensitivity reaction in the host. This allergic response is responsible for the intense pruritus (itching) associated with scabies.
3. Delayed onset: Symptoms typically appear 2-5 weeks after initial infestation in individuals never previously exposed to scabies. This delay represents the time required for...