Dermatology · UKMLA & AKT
Scabies
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Nocturnal pruritus - intense itch worse at night, often disrupting sleep; single most characteristic symptom
- Burrows - fine, grey-white, linear or curved tracks 2-10 mm long in superficial skin (the mite's tunnel)
- Erythematous papules - small, excoriated papules from scratching and immune reaction
- Genital nodules - firm, reddish-brown nodules on genitals and axillae (persistent post-inflammatory response)
- Classic sites: finger webs (look here first), wrists, elbows, axillae, nipples, umbilicus, genitals - face/scalp/back spared in adults
- Close contacts are commonly simultaneously affected - key historical clue
Nocturnal itch + linear burrows in finger webs = scabies until proven otherwise. The itch is a type IV hypersensitivity to mite proteins - NOT direct burrowing injury - hence itch lags 2-6 weeks after first infestation.
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