Rapid Review: Scabies

November 16, 2017

Reviewed February 2024


  • Sx: severe pruritus that is worse at night
  • PE: small papules, vesicles, and burrows in the webbed spaces of the fingers and toes
  • Diagnosis is made by microscopic visualization
  • Most commonly caused by Sarcoptes scabiei var. hominis
  • Treatment is permethrin 5% (infants > 2 months old) or oral ivermectin (ivermectin not first-line in pregnancy or children < 15 kg)

Sample question:

An 8-year old girl presents to the clinic because of intense pruritus of the interdigital folds and abdominal area. She feels the pruritus more at night and her younger siblings have the same symptoms. On physical examination, threadlike burrows and papular eruptions with excoriations are noted on the interdigital folds of the hands, wrist flexors and umbilical area. What is the most likely etiologic factor?

By Yehuda Wolf, MPA, PA-C

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