Diagnostic Approach and Management of Scabies in an Adolescent: A Case Report

Abstract

Scabies is a skin infection caused by Sarcoptes scabiei var. hominis, with transmission closely associated with direct contact and environmental conditions. This case report aims to describe the diagnostic approach and management of scabies in an adolescent with a history of close contact and similar complaints among surrounding contacts. A 16-year-old male adolescent presented with a three-week history of itching affecting both hands and feet, particularly at night and in the interdigital spaces. The symptoms were accompanied by reddish bumps, some of which were reported to contain pus. The patient reported frequent direct contact and clothing exchange with friends, while similar complaints were reported in his younger sibling and close friend. Local examination revealed multiple well-defined erythematous papules and nodules in a linear distribution over the hands, feet, axillae, abdomen, and buttocks. No ancillary diagnostic examinations were performed. Based on the clinical and epidemiological findings, the diagnosis of scabies was established at the clinical level according to the 2020 criteria of the International Alliance for the Control of Scabies (IACS), with the limitation of lacking confirmatory diagnostic testing. The patient was treated with 5% permethrin cream and cetirizine 10 mg once daily, accompanied by education on medication use, personal belongings hygiene, transmission prevention, and the importance of managing close contacts. This case highlights the importance of integrating clinical findings with epidemiological history, transparently reporting diagnostic limitations, and addressing transmission control in scabies management.