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Dermatology (Expert Forum)
Scabies?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
Scabies?
by JRD, Feb 16, 2004 12:00AM
Help:
Background- On 1/18,1/24 and 1/25, I was out at my sister's land cutting scrub trees, which she warned me had poison ivy on it.
On 1/21, I noticed two itchy spots around my waistline, near the underwear band. Within a few days, the minor itching disappeared and these spots began to heal. On 1/24, I noticed an itchy "pimple" on my trunk, located about the 4th rib from the bottom on the right side. Then, the next day, I noticed a couple more itchy pimples on my back near the bottom of my latisimus doris muscle. On 1/25 went out to land site & cut trees, wearing only jeans, t-shirt & gloves. Sat on one of the trees for rest On 1/26 - itchy rash appeared, about the size of a half-dollar, near my collar line, just above my left collarbone. Although itchy, neither the rash or the bumps/pimple (3 of them) kept me up at night. The only time they really itched was when something "rubbed" up against them, like clothing, or turning over in bed, etc. However, when rubbed, it was quite itchy. I refrained completely from scratching any of them. I went to the doctor on 1/30. She looked at the rash & the bumps and said they looked like scabies to her, however they were not in any of the classic scabies sites, like hands, groin, armpits, etc. She did not scrapings, etc. I did the medicine that night (permethrin 5%), washed all clothes, bedsheets, etc. However we didn't apply to the whole family, because she said "they have no symptoms", (mistake?). She also gave me a steroid cream to apply twice a day. Within a couple days, the rash on my neck subsided considerably, and the itchy bumps on my side began to disappear within a few more days. However, on 2/2, I noticed a few itchy bumps on my forearms develop. I called my doctor (a GP) and she said just to keep applying the steroid cream. The bumps continued to spread on my forearms all week, and then to the back of my right thigh. I went to a dermatologist on 2/6, who diagnosed contact dermatitis vs. scabies, likely from poison ivy. Her diagnosis was primarily because (a) none of the bumps appeared in the classic scabies area, i.e. webs of fingers, underarms, genital area, feet, etc. (b) no one else in my family was suffering the same symptoms (c) scabies is usually a rash causing uncontrollable itching/scratching, (d) scraping a couple papules on my arms revealed nothing. She recommended I simply wait a while & not worry about it. By 2/15, the itching on my arms & back of right thigh all but ceased, with the bumps healing, without any use of steroid creams or scabicides. Since 2/6, there had been no additional bumps anywhere on my body. Ceased using steroid cream 2/6. Now, however, on the morning of 2/16, I noticed one small itchy "welt" or "bump" on my right trunkside, just above the first rib from the bottom. The anxiety is getting bad. I have two small children at home (5 & 2) and my wife. No one has any symptoms yet, but I want to protect them.
Advice?
Background- On 1/18,1/24 and 1/25, I was out at my sister's land cutting scrub trees, which she warned me had poison ivy on it.
On 1/21, I noticed two itchy spots around my waistline, near the underwear band. Within a few days, the minor itching disappeared and these spots began to heal. On 1/24, I noticed an itchy "pimple" on my trunk, located about the 4th rib from the bottom on the right side. Then, the next day, I noticed a couple more itchy pimples on my back near the bottom of my latisimus doris muscle. On 1/25 went out to land site & cut trees, wearing only jeans, t-shirt & gloves. Sat on one of the trees for rest On 1/26 - itchy rash appeared, about the size of a half-dollar, near my collar line, just above my left collarbone. Although itchy, neither the rash or the bumps/pimple (3 of them) kept me up at night. The only time they really itched was when something "rubbed" up against them, like clothing, or turning over in bed, etc. However, when rubbed, it was quite itchy. I refrained completely from scratching any of them. I went to the doctor on 1/30. She looked at the rash & the bumps and said they looked like scabies to her, however they were not in any of the classic scabies sites, like hands, groin, armpits, etc. She did not scrapings, etc. I did the medicine that night (permethrin 5%), washed all clothes, bedsheets, etc. However we didn't apply to the whole family, because she said "they have no symptoms", (mistake?). She also gave me a steroid cream to apply twice a day. Within a couple days, the rash on my neck subsided considerably, and the itchy bumps on my side began to disappear within a few more days. However, on 2/2, I noticed a few itchy bumps on my forearms develop. I called my doctor (a GP) and she said just to keep applying the steroid cream. The bumps continued to spread on my forearms all week, and then to the back of my right thigh. I went to a dermatologist on 2/6, who diagnosed contact dermatitis vs. scabies, likely from poison ivy. Her diagnosis was primarily because (a) none of the bumps appeared in the classic scabies area, i.e. webs of fingers, underarms, genital area, feet, etc. (b) no one else in my family was suffering the same symptoms (c) scabies is usually a rash causing uncontrollable itching/scratching, (d) scraping a couple papules on my arms revealed nothing. She recommended I simply wait a while & not worry about it. By 2/15, the itching on my arms & back of right thigh all but ceased, with the bumps healing, without any use of steroid creams or scabicides. Since 2/6, there had been no additional bumps anywhere on my body. Ceased using steroid cream 2/6. Now, however, on the morning of 2/16, I noticed one small itchy "welt" or "bump" on my right trunkside, just above the first rib from the bottom. The anxiety is getting bad. I have two small children at home (5 & 2) and my wife. No one has any symptoms yet, but I want to protect them.
Advice?
Doctor's Answer
by Alan Rockoff, MD, Feb 16, 2004 12:00AM
, Feb 16, 2004 12:00AM
Yes. Ignore the few remaining bumps and forget the whole thing. Your rash sounds nothing at all like scabies. Unfortunately, non-dermatologists have a tendency to over-diagnose scabies, and the implications of that diagnosis (like contagiousness) make people more concerned than they need to be. Your rash doesn't sound much like contact dermatitis either. I doubt that the dermatologist meant to imply you had "contact dermatitis vs. scabies, likely from poison ivy." Certainly, her advice was not consistent with any concern at all about scabies. I believe she thought that you had a mild dermatitis, which basically would go away on its own. I think she was correct. I'd stay in touch with the dermatologist in the (unlikely) event that symptoms persist.
Best.
Dr. Rockoff
Best.
Dr. Rockoff
Member Comments (2)
by sasssass, Apr 06, 2004 12:00AM
I have a question I had a scabe on my back which is gone now but now I have like 4 or 5 scabs on my lower back they don't really itch that much but 1
