Thread by @skinandall_

#dermatologyteaching
This particular thread is a reminder. My colleague @flakydancindoc and I were talking yesterday and we agreed to both talk about this as it's like there's an outbreak. It's also one of the neglected tropical diseases. SCABIES again.!

This condition is caused by a mite (like an insect) called sarcoptes scaibei. It is presently being misdiagnosed out there a lot. AMD the diagnosis is often missed causing distress to the patients. There are some reasons why the diagnosis is often missed.

1) Some health workers think that it affects people in the lower class only which is completely false. Infact....I'm seeing it more in my Lekki and Ikoyi people now😁. All you need is close contact to someone that has it. And the infection can be propagated far and wide

2) Use of these triple action creams which contain high dose steroids. The steroids calm the inflammation associated with the condition for some time but does NOT treat the infection. So all you're doing is just sitting on a keg of gunpowder...which would definitely explode.

3) Failure to treat asymptomatic close contacts of the patient (people living in the house that have not manifested anything still have to be treated). This is because the incubation period (time of exposure to time of symptoms manifestation) of scabies can be up to 6 weeks.

And if you do not treat them, there will be a continuous and recurring cycle of infection. Have you heard of the 7 year itch? That's a name given to scabies...If it is not treated properly..it can go on for a long time.
How does scabies present?

Intensely itchy komobustop kind of rashes that look like tiny mosquito bites especially in the folds like the groin, between the webs of the fingers and toes, the inner side of the belt area, the upper thighs. May even affect the elbows and other areas depending on how long.

There may be a history of communal living like camps, hostel amongst others. It is a very common infection in prisons.
There are certain medications and creams used for treating and it looks like magic after treatment. All my patients treated for scabies love me😁

As part of the treatment, its necessary to wash the clothes, beddings, underwear in hot water and either dry in the hot sun or iron them. I mentioned the last time that it may not be compulsory IF those materials are not used for some time (over 72hrs).

This is because the mites cannot survive for long outside the human body. They die off. I guess it was misunderstood by someone that it meant that washing as stated above was not necessary. If you have any questions on my thread, please ask me. That's the whole point of this😊.

As simple as scabies sounds...it causes a lot of distress to those affected. It doesn't need to get to a dermatologist before it is diagnosed. It is very easy to treat. If you need clarifications on treatment as a doctor, please send a DM.

A note of caution to my colleagues. If you have anything at all on the skin and you don't know what it is, you're better off moisturising judiciously. Don't be so quick to prescribe steroids. And please NEVER triple action creams. Give some relief for the itching.

Scabies can also be imported. One of my patients imported it to the 'abroad' for his family member there. I can imagine how the person is feeling right now. It's not commonly seen there so diagnosis might be delayed.

Appearance of scabies. Imagine such rashes in the areas mentioned. Very itchy especially at night. Can become secondarily infected by bacteria. The rashes can look bigger than this. Picture from medicalxpress via Google images.

@threadreaderapp please unroll

I use the word infection loosely. Scabies is actually an infestation from the mite I mentioned earlier.