Feature Article

Could it be scabies?

Nina Wines, Stephen Shumack



Scabies can present in atypical ways, making the diagnosis challenging. This article describes the various forms of presentation and discusses treatment options.

Key Points

  • The scabies mite is an obligate human parasite transmitted by skin to skin contact or by contact with contaminated objects.
  • Consider the diagnosis in any patient who has generalised pruritus with nocturnal exacerbations.
  • The presentation is variable and is influenced by age, immune status, hygiene and previous treatment.
  • Permethrin, applied topically, is the first line therapy.
  • The itch can persist for two to three weeks after treatment.
  • Oral ivermectin is currently approved to treat special forms of scabies only.