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Scabies - Anogenital in
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Scabies - Anogenital in

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Contributors: Susan Burgin MD, Belinda Tan MD, PhD, Lowell A. Goldsmith MD, MPH, Benjamin K. Fisher MD
Other Resources UpToDate PubMed


This summary discusses adult patients. Scabies in children is addressed separately.

Scabies is an intensely pruritic eruption caused by the mite Sarcoptes scabiei var. hominis. It is transmitted most often via direct person-to-person contact and less frequently by fomites. It is extremely contagious, spreading between individuals who share close contact or living spaces.

Nocturnal itching is a classic symptom. In a typical infestation, there are 10-20 mites. Most patients mount an intense hypersensitivity reaction to the mites, which burrow into and just below the stratum corneum of the epidermis. This results in a widespread and highly pruritic eruption. The hypersensitivity reaction usually develops 2-6 weeks after initial infestation.

Nodular scabies refers to the presence of pink to red nodules that represent a localized intense hypersensitivity reaction to retained mite parts or antigen. The presence of mites within these nodules has also been reported, but nodular scabies may be seen even after the infestation has been successfully treated. Typical sites include the scrotum, lower abdomen, and buttocks.

Persons with human immunodeficiency virus (HIV) infection and others who are immunosuppressed are at increased risk for crusted scabies.


B86 – Scabies

128869009 – Infestation caused by Sarcoptes scabiei var hominis

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Differential Diagnosis & Pitfalls

Scabies presents a diagnostic challenge, as it is a great clinical imitator. Some of the conditions scabies is mistaken for include the following:
  • Pediculosis pubis
  • Psoriasis
  • Arthropod bite or sting
  • Papular urticaria
  • Folliculitis
  • Nonbullous impetigo
  • Allergic contact dermatitis
  • Lichen planus
  • Autoeczematization
  • Neurotic excoriations
  • Prurigo nodularis
  • Lichen nitidus
  • Lichen simplex chronicus
  • Genital wart
  • Molluscum contagiosum
  • Pearly penile papules
  • Bowenoid papulosis
  • Secondary syphilis

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Last Reviewed:11/28/2022
Last Updated:01/08/2017
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Patient Information for Scabies - Anogenital in
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Scabies - Anogenital in
See also in: Overview
A medical illustration showing key findings of Scabies : Axilla, Buttocks, Excoriated skin lesion, Umbilicus, Wrist, Anogenital, Pruritus
Clinical image of Scabies - imageId=177763. Click to open in gallery.  caption: 'Excoriations and a burrow at the wrist.'
Excoriations and a burrow at the wrist.
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