Modern treatment of scabies

Abstract

Scabies is a common contagious skin disease caused by the mite Sarcoptes scabiei that affects all people, regardless of age or socioeconomic status. Transmission of scabies most often occurs through direct and prolonged skin contact, which usually happens between family members and sexual partners. The most common form of scabies is classic scabies, the main symptom of which is severe itching that intensifies at night. Tunnels hollowed out by female scabies are typical lesions on the patient’s skin. These changes are mainly located in the interdigital spaces, the proximal phalanges and the flexural surfaces of the wrists. The diagnosis of scabies is mainly based on the clinical picture, but in order to confirm the infestation, adult scabies, their eggs or faeces, must be found by microscopic examination. Treatment of scabies is primarily aimed at eradicating mites as well as managing subjective symptoms and minimizing the risk of transmission. In addition to the use of medicinal preparations for all household members, it is also important to wash and iron all clothes and bedding. According to the European guidelines of 2017, the treatment of scabies is based primarily on the use of topical preparations of permethrin 5% (present in Poland in the form of a cream and gel) or ivermectin used orally at a dose of 200 μg/kg body weight. Both preparations are used twice with a weekly break between doses. Both topical permethrin and ivermectin show a similar, very high cure (over 90%).