True about scabies is -

Ans. is 'c' i.e., All family members should be treated together o Palms, soles, scalp & face are characteristically spared in adults. These are affected only in infants and young children.o Oral antibiotics are needed only in case of secondary infectiono Patient and all other family members are to be treated together in scabieso Itching is more common in night in scabies.Scabieso Scabies is an intensly pruritic skin infestation caused by Sarcoptes scabiei, an acarus (mite). Scabies usually affects children but can occur at any age. More common in low socioeconomic strata as overcrowding and poor hygiene facilitate transmission. The most important means of transmission is via direct contact with an infected individual. Scabes is a water washed disease which occurs due to inadequate use of water or improper hygiene.Pathogenesiso After copulation, the male mite dies and the female mite burrows into the superficial skin layer (stratum cornuem) at the rate of 2 mm/day. Female mite lays eggs which hatch into larva, which moulds and mature into adult mites. The mite then burrows into stratum corneum. These burrow is visible clinically as an irregular gray- brown line. Burrow is a pathognomic sign for scabies.Incubation period of scabieso Incubation period is 4-6 weeks before itching begins. Usually there is no itching in the first four to six weeks of contracting the infection, because itching is due to the development of sensitization (Hypersensitivity) to some of the products (Saliva-scabin) of the mite. About 4-6 weeks are required for the hypersensitivity to develop.Clinical features of scabies1. Severe itching(AI03'PGI02) is the most prominent symptom, and has following characteristic features : -i) Worse at nightii) Generalizediii) Affecting several family mem herso In Scabies, severe itching typically worsen at night, most notably along the web spaces of fingers, wrists, elbows, axillae and groin area - Areas know as circle of Hebra.2. Burrow is the serpentine (S-shaped), thread like gray-brown line which represent the intraepidermal tunnel created by the moving female mite in stratum corneum. Burrow is pathognomic of scabies. Burrow are difficult to demonstrate in infants.3. Papules and papulovesicles; due to hypersensitivity to mite.4. Pustules can occur due to secondary infection.5. Excoriation and scratch marks.6. History of involvement of family memberArea of predilecton in scabieso Adults manifest lesions on following sites:-i) Web of fingers, Flexor surfaces of wrist, ulnar border of forearm, anterior axillary fold.ii) Umblicus and periumbilical regions (anterior abdomen)iii) Genitals (Scrotum and penis in males; and nipple & areola in females).iv) Upper thigh, lower part of buttocks.o Scalp, face, palm and soles are characteristically spared except in young children and infant - In Infants & young children scalp, face, palms & soles are typically involved.