Scabies is a contagious disorder of the skin caused by very small; wingless insects or mites called the Human Itch mite or Scabies itch mite Sarcoptes scabiei var. hominis.
The female insect burrows into the skin where she lays 1 – 3 eggs daily. A very small, hard to see, zigzag blister usually marks the trail of the insect as she lays her eggs. Other more obvious symptoms are an intense itching (especially at night) and a red rash that can occur at the area that has been scratched. The most common locations for scabies are on the sides of fingers, between the fingers, on the backs of the hands, on the wrists, heels, elbows, armpits, inner thighs and around the waist (belt line). One of the great problems with scabies always has been misdiagnosis. Scabies is spread by personal contact, e.g., by shaking hands or sleeping together or by close contact with infected articles such as clothing, bedding or towels. It is usually found where people are crowded together or have frequent contact, and is most common among school children, families, roommates, and sexual partners.

People with a scabies infestation have an average of about 12 mites living under their skin. The presence of the mites, their eggs and their faeces cause an allergic reaction resulting in an intense itch and a rash. It is now accepted that mites can spread when a non-infected person stands too close to an infected person. Mites are 0.1mm in diameter.

Scabies can occur at any age, but it’s most common among children.

Other names for the condition include Mite, Itch Mite, Mange, Crusted Scabies, Norwegian Scabies, Sarcoptes scabiei, or The Seven-Year Itch.

CAUSE

• Sarcoptes scabiei var. hominis.

CLINICAL FEATURES

Symptoms

• Violent itching.
• Compelled to scratch.
• Itching is worse during night.

Signs

Burrows-
• Narrow, tortuous, greyish black line.
• Length- 1-20 mm.
• Point at which parasite enters appears as black dot.
• If roof is lifted with needle, mite or eggs can be seen.
• Excoriations.
• Scratch marks.

DIAGNOSIS

• Finding mites & eggs in burrows.

DIFFERENTIAL DIAGNOSIS

• Papular urticaria.
• Atopic skin lesions in children with maximal lesions on extremeties.
• Generalised pruritus.
• Parasitophobia.
• Dermatitis herpetiformis.

COMPLICATIONS

• Eczematous dermatitis.
• Impetigo.
• Secondary lymphadenitis.
• Urticaria.

GENERAL MANAGEMENT of SCABIES

• Maintain personal hygiene.
• Change clothes, bed linens daily.
• Regular daily bath.
• Clothes & bed linens to be boiled in hot water, dried in sun & ironed.
• Thorough scrubbing with soap & water.
• Through drying of skin after bathing.
• Treat all close contacts.

HOMOEOPATHIC TREATMENT

REPERTORY

KENT- SKIN- ERUPTIONS- SCABIES.
BOENNIG HAUSEN- SKIN & EXTREMETIES- ITCH- SCABIES.
BOERICKE- SKIN- SCABIES.
KNERR- SKIN- ERUPTIONS- SCABIES.

ARSENIC ALB

The eruption appears on the bends of knees. The eruptions could be dry as well as full of small pustules. There is presence of burning and itching which is worse at night, application of cold water > by local application of warmth. The scabies has tendency to alternate with bronchial asthma.
Great Prostration, with rapid sinking of the vital forces; fainting. The disposition is:
a. Depression, melancholy, despairing, indifferent.
b. Anxious, fearful, restless, full of anguish.
c. Irritable, sensitive, peevish, easily vexed.
The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move. Indicated by its periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its intense restlessness, mental and physical: its anxiety and prostration.

CARBO-VEG

The eruptions are dry almost over the whole body, especially worse on extremities. There is presence of itching which is worse after undressing at night. Scabies can occur after abuse of mercurial salts. Concomitant symptoms like dyspepsia, belching, passing flatus should help the physician to select drug. Once infection takes place, there is presence of acrid, bloody, foul discharge. The pus smells like asafoetida. There is presence of excessive burning in lesion which is worse by local application of heat as well as cold.
Cachectic persons whose vitality has become weakened or exhausted. Persons who
have never fully recovered from the exhausting effects of some previous illness. Weakness of memory and slowness of thought.

CAUSTICUM

It is an extremely important drug when scabies are suppressed by local application of mercury and sulphur. There is excessive itching of whole body at night, also when secondarily infected there is presence of humid vesicles oozing corroding pus. The other concomitant symptoms are yellowish looking skin, warts, involuntary urination when coughing, sneezing or walking. The patient on the whole is extremely sensitive to cold air.
Adapted to persons with dark hair and rigid fibre; weakly, psoric, with excessively yellow, sallow complexion; subject to affections of respiratory and urinary tracts.

HEPER SULPH

The eruptions that resemble scabies are present on folds of skin, hands and feet. The eruptions are pustular and crusty, oozing a foul, old cheese like discharge. The skin is extremely sensitive to cold air. The itching is worse at night and better by warm application. Presence of scabies in an individual where eruptions are suppressed by mercury.
For torpid lymphatic constitutions; persons with light hair and complexion, slow to act, muscles soft and flabby. The slightest injury causes suppuration. Diseases where the system has been injured by the abuse of Mercury. In diseases where suppuration seems inevitable, Hepar may open the abscess and hasten the cure. Oversensitive, physically and mentally; the slightest cause irritates him; quick, hasty speech and hasty drinking. Patient is peevish, angry at the least trifle; hypochondriacal; unreasonably anxious. Extremely sensitive to cold air, imagines he can feel the air if a door is opened in the next room; must be wrapped up to the face even in hot weather; cannot bear to be uncovered; takes cold from slightest exposure to fresh air.

LYCOPODIUM

Eruptions on the scalp, extremities, genitals and abdomen. The eruptions are yellowish brown, moist, purulent. Itching and burning sensation is worse by warmth and better by cold application, especially itching while burning is better by local application of heat. GIT concomitants like weak digestion, craving for sweets, flatulence should help one to prescribe the drug.
For persons intellectually keen, but physically weak; upper part of body emaciated, lower part semi-dropsical; predisposed to lung and hepatic affections; especially the extremes of life, children and old people. Deep-seated, progressive, chronic diseases. Pains: aching-pressure, drawing; chiefly right-sided, <. four to eight p.m. affects right side, or pain goes from right to left.

PSORINUM

This nosode should be used in those cases of scabies where one has a repeated history of scabies in the past or scabies are suppressed with the help of conventional medicine resulting into internal affection e.g. asthma, migraine, heart trouble, etc. the eruptions are present on bends of elbow. The scabies appear in every winter and disappear in summer. There is presence of violent itching, worse by warmth of bed or by scratching.
Especially adapted to the psoric constitution. In chronic cases when well selected remedies fail to relieve or permanently improve; when Sulphur seems indicated but fails to act. Lack of reaction after severe acute diseases. Appetite will not return.


SEPIA

The eruptions is predisposed to crack and ulcerate as soon as it appears. There is presence of itching & burning sensation which is worse in the evening, open air. Better in warm room. Scabies comes periodically every spring. It is also useful in those cases of scabies after previous used of sulphur.
Adapted to persons of dark hair, rigid fibre, but mild and easy decomposition.

SULPHUR

It is one of the supreme remedy for recurrent maltreated, obstinate, suppressed cases of scabies. There is presence of voluptuous tingling & itching in the bends of joint in between fingers, as soon as he gets warm in bed, also it is worse when undressing. Itching is accompanied by burning & soreness, especially after scratching. The skin appears rough & scaly with formation of little vesicles & pustules.
Adapted to persons of a scrofulous diathesis, subject to venous congestion; especially of portal system. Persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes. For lean, stoop-shouldered persons who walk and sit stooping like old men. Standing is the worst position for sulphur patients; they cannot stand; every standing position is uncomfortable. Dirty, filthy people, prone to skin affections. Aversion to being washed; always <. after a bath.