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close this bookClinical Guidelines and Treatment Manual (Médecins Sans Frontières, 1993)
close this folderChapter 4 - Skin conditions
View the document(introductory text...)
View the documentDermatology
View the documentImpetigo and other purulent dermatoses
View the documentHerpes simplex, Herpes zoster
View the documentScabies
View the documentLeg ulcer
View the documentFungal infection
View the documentAnthrax
View the documentOther skin conditions
View the documentEndemic syphilis, Yaws & Pinta
View the documentLeprosy


Contagious skin infestation caused by a mite, Sarcoptes scabiei. Its occurrence is closely related to a lack of water and poor hygiene.

Clinical picture

- Nocturnal itching, scratch marks, burrows between the fingers
(made visible by applying ink, then washing it off), and papules.

- Secondary infection (from scratching) resembles impetigo.

- Whole family is often infested.

- Often localised to: genital region, axillae, chest, breasts, hands and thighs.

Treatment (dispensary)

- Wash the whole body with a mild soap and dry, then apply 25 % benzyl benzoate emulsion (BBE) to the whole body except head and neck. Use a broad paint brush if available. Allow to dry, then put on the same clothes.

- Repeat for 3 days.

- If a secondary bacterial infection occurs, treat as for impetigo for 4 to 5 days. Only apply benzyl benzoate emulsion once all lesions are closed (is very irritant).

- Treat the whole family. After the treatment, boil and air all clothes and bedding.

- Warn patients that itching may persist for several weeks. This represents an allergic reaction to the dead mites, not treatment failure.