Today's symptom: red, wavy rashes

NEWS/ QUIZ

2 MIN QUIZ

Red, wavy rashes

A 10-year-old girl came with her mother to the pediatrician’s office complaining about severe itch all over her body that started 2 weeks earlier. A red and wavy rash was visible on her body primarily in the areas with severe itch. According to her mother, the itchiness started between her fingers, subsequently spreading to her wrists, armpits, and back within 1 week. She also complained of itchiness on her lower extremities, mainly between her toes and on her knees. The girl reported the itch was more severe at night, to the point where she couldn’t fall asleep. This was the first time she reported these symptoms.

What is the diagnosis?

Select the correct answer

A) Prurigo

B) Atopic dermatitis

C) Scabies

D) Pediculosis corporis

CORRECT

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INCORRECT

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Answer is: C

Scabies is an itchy skin rash caused by a small burrowing mite that can affect both children and adults.¹ The rash is usually accompanied by severe itching which can get worse during the night.¹ The mite responsible for the skin condition is called Sarcoptes scabiei (var. hominis). The female mite makes tunnels under the skin to lay eggs, creating red and itchy bumps.² The itching usually happens where the mites burrow. The mites can burrow anywhere on the body but commonly are found in skin folds and warm areas such as between the fingers and toes, thighs, genitals, wrists, and knees, around the waist, under fingernails, rings, wristbands, watches, and bracelets, and around the nipples. In children, scabies can live on fingers, face, neck, scalp, palms of the hands, and soles of the feet.^1,2

Scabies is a contagious disease, and it can be transmitted by close skin-to-skin contact or by sharing clothing and bedding with an infected person. Infected people can transmit the disease even when they are not showing any symptoms.^1,3

Scabies can happen anywhere, as it is not specific to a particular area or place, however, it is more common in crowded and tropical areas of the world.²

The disease is not caused by poor hygiene, and anyone can get scabies. People living in crowded areas, infants and children, elderly people living in nursing homes, and healthcare workers caring for patients with scabies who are unaware they have the disease are more prone to contract the disease.² There are different types of scabies including classic and crusted scabies, which differ in morphology, severity, and degree of contagion. People affected with classic scabies usually harbor 10-20 mites whereas people with crusted scabies, which usually occurs in immunocompromised individuals, may harbor thousands to millions of mites.^2,3

References:

1. Mayo Clinic. Scabies. Accessed October 20, 2022. https://www.mayoclinic.org/diseases-conditions/scabies/symptoms-causes/syc-20377378

2. Cleveland Clinic. Scabies. Updated March 23, 2022. Accessed October 20, 2022. https://my.clevelandclinic.org/health/diseases/4567-scabies

3. Richards RN. Scabies: diagnostic and therapeutic update. J Cutan Med Surg. 2021;25(1):95-101. doi:10.1177/1203475420960446

Image Source: DermNet NZ

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