A patient presents to your clinic with this rash on her arm. She reports that it began three days ago and has steadily gotten worse. Now, the rash is weeping and crusting a little bit. It hurts and itches.
She has been in jail for around 6 weeks. Her only other visits to the medical clinic in that time were for “Athlete’s Foot,” for which she was treated with anti-fungal cream, and depression for which she was prescribed citalopram. She is on no other medications.
All correctional medical people should be able to recognize scabies by sight.
Just to review, scabies is a tiny mite that burrows beneath the skin and causes intensely itchy lesions. Since the mite wanders (as little animals will do), scabies tends to spread with time, and can be passed from individual to individual. Weirdly, scabies does not cause lesions above the neck, probably because of the increased blood supply there. If you are interested, you can find more detailed information on scabies in Wikipedia.
Scabies is found commonly in correctional facilities. Both nurses and practitioners need to be able to spot scabies, hopefully before it spreads throughout a housing dorm! Continue reading →