Sarcoptes scabiei (Scabies)


Sarcoptes scabiei (Scabies)


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USMLE® Step 1 questions

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Sarcoptes scabiei (Scabies)

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USMLE® Step 1 style questions USMLE

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A 37-year-old man presents to an outpatient clinic for evaluation of pruritus and skin lesions. The symptoms developed five weeks ago and have progressively worsened. The symptoms are diffuse but most prominent in the upper extremities. The patient frequently wakes up at night due to itching and has difficulty falling asleep again. Past medical history is notable for inflammatory bowel disease and hypertension. The patient worked as a fisherman but lost his job a year ago. Since then, he has been residing in a homeless shelter. His temperature is 37.2˚C (99.0˚F), pulse is 92/min, and blood pressure is 147/85 mmHg. The heart and lungs are clear to auscultation. Abdominal examination is unremarkable. Examination of the patient’s hands is shown below. Which of the following best describes the pathophysiology of this patient’s condition?

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First Aid



Scabies p. 161, 200


Scabies is a highly contagious skin infection caused by the mite Sarcoptes scabiei. Scabies is spread through close physical contact with an infected person or by sharing clothing or bedding. Symptoms of scabies include severe itchiness and a pimple-like rash. Occasionally tiny burrows may be seen in the skin. These symptoms can be present across most of the body or just in certain areas such as the wrists, between fingers, or along the waistline. The itch is often worse at night. Treatment includes topical permethrin and oral ivermectin. Benzyl benzoate application is an alternative. It's also important to treat all close contacts, and to wash all clothing, bedding, and towels used by the infected person in hot water.


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