Scabies

Scabies is a contagious and intensely itchy skin infestation caused by the microscopic mite Sarcoptes scabiei var. hominis. This disease affects millions of people worldwide each year, spreads rapidly in crowded environments, and leads to significant public health challenges. Its inclusion in the World Health Organization’s list of “neglected tropical diseases” in 2017 is an indication of its importance.

The causative agent is Sarcoptes scabiei, a microscopic, oval-shaped, eight-legged mite invisible to the naked eye. Female mites burrow into the stratum corneum, the outermost layer of the skin, where they lay eggs. Transmission typically occurs through prolonged and direct skin-to-skin contact. Activities such as sharing a bed or living in close quarters facilitate transmission, while brief contacts carry a lower risk. In special forms such as crusted scabies, transmission occurs much more easily.

Scabies can occur in all age groups. Children, the elderly, and immunocompromised individuals are more susceptible. Communities with low socioeconomic status, refugee camps, and crowded living conditions are at higher risk. Epidemiological studies conducted in Türkiye have shown a marked increase in scabies cases, particularly since 2018.

The most common form is classic scabies. In this form, reddish, itchy rashes appear in areas such as the finger webs, wrists, waistline, armpits, and genital region. Itching typically worsens at night.

Crusted scabies develops in immunosuppressed individuals and is characterized by thick, scaly crusts on the skin. In this form, the number of mites can reach millions and is associated with high infectivity.

Nodular scabies presents as firm, itchy nodules, often persisting after treatment, resulting from an exaggerated immune response. These nodules are commonly found in the genital and axillary regions.

The primary diagnostic method is clinical evaluation. Confirmation is achieved through microscopic examination of skin scrapings, dermatoscopy, or the ink test to detect mites or eggs. Molecular techniques such as PCR offer more sensitive diagnosis.

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