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Scabies

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 18 Aug 2025
Last updated: 28 Mar 2023

Summary

Definition

History and exam

Key diagnostic factors

  • infants, children, and older adults
  • history of overcrowding
  • history of itching in family members or close contacts over the same period
  • generalized and intense pruritus, typically worse at night
  • burrows
  • papules, vesicles, excoriations
  • positive ink burrow test
Full details

Other diagnostic factors

  • papules on face, neck, palms, and soles in children
  • immunosuppression
  • bullae
  • thick, crusted lesions occurring on elbows, knees, hands, and feet with dystrophic nails
  • nodules
Full details

Risk factors

  • overcrowded living conditions/poverty
  • living in close quarters with others who are infected
  • age under 15 or over 65 years
  • sexual contact with new or multiple partners
  • immunosuppression
  • poor hygiene
  • contact with an infected animal
  • contact with contaminated clothing, towels, and bedding
  • winter season
Full details

Diagnostic tests

1st tests to order

  • ectoparasite prep
Full details

Tests to consider

  • skin biopsy
Full details

Emerging tests

  • epiluminescence light microscopy

Treatment algorithm

ACUTE

nonpregnant/nonlactating adults or children over 5 years

infants and children 2 months to 5 years and pregnant or lactating females

infants under 2 months

Contributors

Authors

Ryan Harris, MD

Dermatologist

Treasure Valley Dermatology and Skin Cancer Center

Boise

ID

利益声明

RH declares that he has no competing interests.

鸣谢

Dr Ryan Harris would like to gratefully acknowledge Dr Pooja Khera and Dr Laura Korb Ferris, previous contributors to this topic.

利益声明

PK and LKF declare that they have no competing interests.

同行评议者

David Cassarino, MD, PhD

Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

利益声明

DC declares that he has no competing interests.

Roderick J. Hay, DM, FRCP, FRCPath, FMedSci

Chairman

International Foundation of Dermatology

London

UK

利益声明

RJH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006 Apr 20;354(16):1718-27. 摘要

Heukelbach J, Feldmeier H. Scabies. Lancet. 2006 May 27;367(9524):1767-74. 摘要

Hengge UR, Currie BJ, Jager G, et al. Scabies: a ubiquitous neglected skin disease. Lancet Infect Dis. 2006 Dec;6(12):769-79. 摘要

Strong M, Johnstone PW. Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000320.全文  摘要

Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018 Apr 2;(4):CD012994.全文  摘要

Johnstone P, Strong M. Scabies. Clin Evid. 2006 Jun;(15):2284-90. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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