Diagnosis and treatment of scabies in 2002: rapid diagnosis and proper management limit the risk of spread.

(1) Scabies is due to a parasite, Sarcoptes scabiei hominis, that colonises the human epidermis. It can affect people of all ages, regardless of their socioeconomic status. (2) Common scabies in adults causes sometimes intense pruritus and skin lesions with a characteristic aspect and distribution. The lesions are often more extensive in children. (3) Crusted (hyperkeratotic) scabies, a severe and highly contagious form, mainly occurs in immunocompromised patients. (4) Scabies lesions are often atypical in elderly patients. (5) The diagnosis of common scabies is generally based on clinical findings. Atypical forms can be diagnosed by direct examination of skin scrapings for parasites. (6) Topical treatment is based on insecticides. 5% permethrin is recommended in reference textbooks. Benzyl benzoate (possibly combined with sulfiram) is poorly evaluated. (7) Scabies can be treated more easily with ivermectin, an oral antiparasitic agent.