It is important that all people who have been in close contact with a person who has scabies are treated at the same time. Who should be treated if scabies is suspected? The dermatologist may take a skin scraping to confirm the diagnosis. Scrapings from a number of burrows will reveal the mite, eggs or faeces when examined under magnification. A microscope or dermatoscope may be used to identify the mite and confirm the diagnosis. Burrows are most commonly found on the hands (particularly between the fingers), wrists and feet. These burrows are characteristic and diagnostic of scabies. The mite however leaves squiggly lines (burrows) in the skin which are usually less than a centimetre long. The scabies mite cannot be seen with the naked eye or without magnification. Image of a scraping of a burrow showing multiple eggs and pregnant mite – image reproduced with permission of permission Department of Dermatology St Vincent’s Hospital Melbourne People who are very sensitive (hypersensitive) to the mite may develop hives or blisters. Pustules (blisters or pimples containing pus) on the hands and feet can occur in infants who have scabies. Itchy lumps or nodules can occur on the penis and are characteristic of scabies. The skin appears red and swollen and sometimes can be scaly or with crusted scabs. Itching in the genital region, buttocks and nipples is common. It can be experienced all over the body but usually doesn’t affect the face or scalp in adults. The person may have a history of contact with someone who has scabies or has an itchy rash. Scabies should be suspected in anyone with an unexplained and severe itch of recent (weeks to months) onset.
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