Scabies: Clinical manifestations and diagnosis
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Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Submission date: 2014-11-12
Acceptance date: 2015-04-01
Online publication date: 2015-04-22
Publication date: 2020-03-24
Corresponding author
Joanna Korycińska   

Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn Żołnierska 14C/ 14, 10-561 Olsztyn, Poland. Tel.: +48 89 524 61 16; fax: +48 89 524 61 16.
Pol. Ann. Med. 2015;22(1):63-66
Scabies is an infectious disease caused by an obligate parasite of human skin – Sarcoptes scabiei var. hominis. The disease affects people regardless of their age, sex or socioeconomic status. The transmission occurs mainly through direct contact with an infected person as well as personal items including clothes, bedclothes, etc.

The aim of the paper is to present a variety of clinical manifestations of scabies as well as diagnostic methods used.

The diagnosis of scabies can often times be difficult, especially if there are concurrent diseases, with pruritus being a symptom. The skin lesions may vary in appearance, depending on the local and general immune response. The diagnosis rests on finding characteristic signs of the disease accompanied by the pruritus becoming particularly intense at night. The use of various diagnostic tools allows for confirmation of the diagnosis, with varied sensitivity and specificity, which is based on confirmation of the presence of the parasite.

Scabies still remains a major public health problem worldwide. Research is hindered mainly due to difficulty in obtaining the material from infested people as well as a lack of an in vitro system. To date, there is no diagnostic method for detecting scabies infection, which would give a 100% reliable result. Each of the methods mentioned above has some limitations in use. It seems that the sensitivity of those methods will vary, depending on a patient's clinical features.

None declared.
Ramos-e-Silva M. Giovan Cosimo Bonomo (1663–1696): discoverer of the etiology of scabies. Int J Dermatol. 1998;37(8):625–630.
Currier RW, Walton SF, Currie BJ. Scabies in animals and humans: history, evolutionary perspectives, and modern clinical management. Ann N Y Acad Sci. 2011;1230:E50–E60.
Strausbaugh LJ, Sukumar SR, Joseph CL. Infectious disease outbreaks in nursing homes: an unappreciated hazard for frail elderly persons. Clin Infect Dis. 2003;36(7):870–876.
Savin JA. Scabies in Edinburgh from 1815 to 2000. J R Soc Med. 2005;98(3):124–129.
Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world-its prevalence, complications, and management. Clin Microbiol Infect. 2012;18(4):313–323.
Orkin M. Resurgence of scabies. JAMA. 1971;217(5):593–597.
Heukelbach J, Walton SF, Feldmeier H. Ectoparasitic infestations. Curr Infect Dis Rep. 2005;7(5):373–380.
Johnson CG, Mellanby K. The parasitology of human scabies. Parasitology. 1942;34(3/4):285–290.
Heukelbach J, Wilcke T, Winter B, Feldmeier H. Epidemiology and morbidity of scabies and pediculosis capitis in resource-poor communities in Brazil. Br J Dermatol. 2005;153(1):150–156.
Chosidow O. Scabies. N Engl J Med. 2006;354:1718–1727.
Bartley WC, Mellanby K. The parasitology of human scabies (women and children). Parasitology. 1944;35(4):207–208.
Mancini AJ, Frieden IJ, Paller AS. Scabies and infantile acropustulosis are difficult to differentiate from one another. Pediatr Dermatol. 1998;15(5):337–341.
Meyers LN. Clinical presentation of scabies in a nursing home population. J Am Acad Dermatol. 1988;18(2 Pt 1):396–397.
Hicks MI, Elston DM. Scabies. Dermatol Ther. 2009;22(4):279–292.
Fernandez N, Torres A, Ackerman AB. Pathologic findings in human scabies. Arch Dermatol. 1977;113(3):320–324.
Czeschik JC, Huptas L, Schadendorf D, Hillen U. Nodular scabies: hypersensitivity reaction or infection? J Dtsch Dermatol Ges. 2011;9(10):840–841.
Liu HN, Sheu WJ, Chu TL. Scabietic nodules: a dermatopathologic and immunofluorescent study. J Cutan Pathol. 1992;19(2):124–127.
Alexander JO. Scabies. In: Arthropods and human skin. Berlin: Springer; 1984:227–292.
Bornhovd E, Partscht K, Flaig MJ, Messer G. [Bullous scabies triggered bullous pemphigoid]. Hautarzt. 2001;52(1):56–61 [in German].
Galvany Rossell L, Salleras Redonnet M, Umbert Millet P. [Bullous scabies responding to ivermectin therapy]. Actas Dermosifiliogr. 2010;101(1):81–84 [in Spanish].
Balighi K, Robati RM, Hejazi N. A dilemma: bullous pemphigoid like eruption in scabies or scabies-induced bullous pemphigoid. Dermatol Online J. 2006;12(4):13.
Chosidow O. Scabies and pediculosis. Lancet. 2000;355(9206):819–826.
Mehta V, Balachandran C, Monga P, Rao R, Rao L. Norwegian scabies presenting as erythroderma. Indian J Dermatol Venereol Leprol. 2009;75(6):609–610.
Roberts LJ, Huffam SE, Walton SF, Currie BJ. Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature. J Infect. 2005;50(5):375–381.
Huffam SE, Currie BJ. Ivermectin for Sarcoptes scabiei hyperinfestation. Int J Infect Dis. 1998;2(3):152–154.
Currie BJ, Carapetis JR. Skin infections and infestations in Aboriginal communities in northern Australia. Australas J Dermatol. 2000;41(3):139–143.
Morsy TA, Romia SA, al-Ganayni GA, Abu-Zakham AA, al-Shazly AM, Rezk RA. Histocompatibility (HLA) antigens in Egyptians with two parasitic skin diseases (scabies and leishmaniasis). J Egypt Soc Parasitol. 1990;20(2):565–572.
Woodley D, Saurat JH. The burrow ink test and the scabies mite. J Am Acad Dermatol. 1981;4(6):715–722.
Walter B, Heukelbach J, Fengler G, Worth C, Hengge U, Feldmeier H. Comparison of dermoscopy, skin scraping, and the adhesive tape test for the diagnosis of scabies in a resource-poor setting. Arch Dermatol. 2011;147(4):468–473.
Carbonaro PA, Schwartz RA. Arthropods in dermatology. J Am Acad Dermatol. 2004;50(6):819–842.
Katsumata K, Katsumata K. Simple method of detecting Sarcoptes scabiei var hominis mites among bedridden elderly patients suffering from severe scabies infestation using an adhesive tape. Intern Med. 2006;45(14):857–859.
Falk ES, Eide TJ. Histologic and clinical findings in human scabies. Int J Dermatol. 1981;20(9):600–605.
Micali G, Lacarrubba F, Massimino D, Schwartz RA. Dermatoscopy: alternative uses in daily clinical practice. J Am Acad Dermatol. 2011;64(6):1135–1146.
Lacarrubba F, Musumeci ML, Caltabiano R, Impallomeni R, West DP, Micali G. High-magnification videodermatoscopy: a new noninvasive diagnostic tool for scabies in children. Pediatr Dermatol. 2001;18(5):439–441.
Micali G, Lacarrubba F. Possible applications of videodermatoscopy beyond pigmented lesions. Int J Dermatol. 2003;42(6):430–433.
Jacobson M, Bornstein S, Wallgren P. The efficacy of simplified eradication strategies against sarcoptic mange infections in swine herds monitored by an ELISA. Vet Parasitol. 1999;81(3):249–258.
Lower K, Medleau L, Hnilica KBB. Evaluation or an enzyme linked immunosorbant assay (ELISA) for the serological diagnosis of sarcoptic mange in dogs. Vet Dermatol. 2001;12(6):315–320.
Jayaraj R, Hales B, Viberg L, et al. A diagnostic test for scabies: IgE specificity for a recombinant allergen of Sarcoptes scabiei. Diagn Microbiol Infect Dis. 2011;71(4):403–407.
Arlian LG, Morgan MS. Serum antibody to Sarcoptes scabiei and house dust mite prior to and during infestation with S. scabiei. Vet Parasitol. 2000;90(4):315–326.
Bezold G, Lange M, Schiener R, et al. Hidden scabies: diagnosis by polymerase chain reaction. Br J Dermatol. 2000;144(3):614–618.
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