Dermatology · UKMLA & AKT
Scabies
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise scabies — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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