Scabies is an itchy contagious skin disease caused by scabies mites. In the severe form of scabies, called crusted scabies, the number of mites living on the skin is much higher and the infectivity increases. The following are the memoirs of a scabies patient living in Japan and the comments of his doctor, edited by the JAGntd office. The memoir was written in November 2021.

"Sarcoptes scabiei - Scabies" by Michael Wunderli is licensed under CC BY 2.0

My (patient's) wife was the first to show symptoms. I had eczema all over my body and used ointment prescribed by my internal medicine doctor, but the symptoms continued for more than half a year. My wife started scratching all over her body, and one day, the person at the day care service she was taking care of suspected me of scabies. A nearby dermatologist introduced me to a doctor who was more knowledgeable about scabies, and my husband and I visited him. I was diagnosed with normal scabies and my wife with crusted scabies.

I didn't know about this disease, so I took it lightly that it would be cured with ointment. But when I heard that ticks were the cause, I became very scared. I was itchy and itchy for about 30 minutes to an hour when I went to bed at night, and it was painful. My doctor told me, ``Don't worry, this sickness will definitely heal,'' and ``Ticks don't live longer than 2-3 days if they leave people,'' and this gave me emotional support.

Treatment began immediately after diagnosis. I took a drug called ivermectin once a week. At that time, it seems that it was difficult to obtain ivermectin due to the influence of the new coronavirus, but the teacher arranged for it. I also had a treatment where I put ointment all over my body. After about eight weeks of treatment, my wife and I were free of ticks. My itch was relieved, but my wife was still scratching for over a month after the mites were gone. My wife, who has dementia, used her fingernails to scratch until they bled, and the wounds became crusted and itchy.

I stopped working during the treatment. I couldn't leave my wife alone at home because she couldn't use the day service because of scabies. Washing clothes every day was very difficult. Put the laundry in a plastic bag, spray it with a chemical that kills mites, close the bag, and wait for an hour. Then wash with hot air sterilization at 60 degrees. When cleaning, I also rolled the flooring and tatami mats, vacuumed them, and then wiped them with a rag.

Even when shopping, I was careful not to transmit ticks. I bought only the minimum necessary items such as food, did not touch items that I did not buy, and tried to shorten my stay as much as possible. I called the hospital I went to every month to say that I was infected with scabies, waited in front of the hospital to get a prescription, and paid for it there. I did the same at the pharmacy, got the medicine in front of the pharmacy, and paid the bill.

I was still worried when the doctor told me that there were no more ticks, so I continued like this until I had two more visits and was told that I was cured.

 

Comment from the attending physician

The basic treatment for scabies is to “deworm” and “prevent the spread of infection”, and in the case of crusted scabies, isolation is necessary. In this case, the patient (“wife”) who was diagnosed with the keratinized type was isolated from the day service staff, but not from her husband, the caregiver. After about two weeks of treatment, deworming progressed, and when it changed from crusted scabies to normal scabies, measures such as thorough washing and cleaning and avoiding contact with others were lifted. However, at that point, the itching was still strong, and the patient was worried and could not decide to cancel the treatment for the keratinized type. Scabies is a skin disease that is difficult to distinguish from other skin diseases, so it is important to start treatment before it develops into crusted scabies. If you notice that "this itching is not normal" or "somehow everyone is getting itchy", please consult a dermatologist as soon as possible.