Page 110 - LECTURE NOTES

Incubation period

Several days or even weeks (two to four weeks) after exposure to an infected person.,
the adult female burrows into the superficial layer of the skin and remains there for the

rest of her life laying eggs daily for up to 2 months and then dies. The eggs hatch in 3 to
4 days and progress through and form adult mites in about 10 days.

Clinical manifestation
The main symptoms of scabies is itching during the night

Classic signs of scabies are the following:-
• The patient complains of severe itching caused by immunologic reaction to the

mite or allergic reaction to the waste products produced by mite which burrows in

the epidermis.
• Because of penetration of mite, there is a visible papule or vesicle.The the

classical sites are prominent between finger webs, flexurel surface of wrist,

elbow, anterior axillary fold, belt line, inner surface of thigh, gluteal fold penis or
scrotum. In women the nipples, abdomen and lower portion of buttocks are

affected. The lesion is excoriated & crusted and bacterial super infection may
result from constant excoriation.

• The lesion is itchy as a result secondary bacterial infection can occur and there is
creuting & excoriation marks.

Management and nursing intervention

1. Instruct patient instruct to take warm, soapy baths or shower to remove the
scaling debris from the crust, and dry thoroughly and allow skin to cool applying

scabicide 1 % gamma hexachloride cream or lotion immediately after bathing
prior drying & cooling of the skin, increases per cutaneous absorption of

scabicide has the potential for CNS side effects such as seizures.

2. Benzyl benzoate lotion 25% apply for 3 consecutive days , no washing in
between

3. Sulfur ointment 5% - 10% can be used for 7 days
4. 1% gamma benzene, hexacholrde single application enough but not available

in Ethiopia.

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