Skin Issues: Concerns About Scabies and Infection Risks

Skin issues

Hello, doctor.
Today, while I was buying breakfast, I suddenly noticed a young boy, about elementary school age, standing next to me (I’m not sure if I touched him).
Upon closer inspection, I saw that he was scratching his hands, and both of his palms were bleeding, with blood also visible on the inner sides of his elbows.
I felt a bit startled and quietly stepped back, noticing a mother with her child standing at a distance.
The boy continued to scratch at the counter, and skin flakes were flying around (since it was close to the breakfast shop closing time, the staff were mostly busy tidying up and didn’t notice; when they did, they seemed a bit taken aback).

1.
I closely observed the boy, and aside from scratching his hands, it seemed he wasn’t scratching other areas.
However, there were a few red spots on his neck and legs.
Could this possibly be scabies?
2.
Since I was standing next to the boy, I was a bit worried about touching him or coming into contact with the skin flakes, so when I got home, I changed my clothes and washed my body.
Is there still a possibility of infection?
3.
Given that scabies has an incubation period, is it true that symptoms cannot be confirmed before they appear? Thank you.

123, 20~29 year old female. Ask Date: 2018/07/15

Dr. Wu Yuxin reply Dermatology

1.
Uncertain
2.
The probability is very low
3.
Of course, it is possible, but the probability is very low

Reply Date: 2018/07/15

More Info

When it comes to skin issues, particularly concerning potential infections like scabies, it’s essential to understand the nature of the condition, its transmission, and the symptoms associated with it. Based on your observations of the young boy and your subsequent concerns, let’s address your questions one by one.

1. Could the boy have scabies?
Scabies is caused by a mite called Sarcoptes scabiei, which burrows into the skin, leading to intense itching and a rash. The symptoms typically include red, itchy bumps or blisters, often found in areas like the wrists, between the fingers, and around the elbows and knees. If the boy was scratching to the point of bleeding and had visible red spots, it is possible that he could be experiencing scabies, especially if he had been scratching in those areas. However, other skin conditions could also cause similar symptoms, such as eczema, contact dermatitis, or even a bacterial infection. A definitive diagnosis would require a medical professional to examine the boy.

2. Am I at risk of infection?
Scabies is highly contagious and can spread through direct skin-to-skin contact with an infected person. However, it is less commonly spread through surfaces or clothing. Since you mentioned that you were standing close to the boy and observed his skin condition, your concern about potential transmission is understandable. Changing your clothes and washing your body after the encounter was a prudent step. If you did not have direct contact with the boy’s skin or any contaminated surfaces, the risk of contracting scabies is relatively low. However, if you start to notice any symptoms such as itching, especially at night, or a rash developing, it would be wise to consult a healthcare provider.

3. Understanding the incubation period of scabies:
Scabies has an incubation period of about 2 to 6 weeks for someone who has never been exposed to the mites before. This means that if you were to contract scabies, you might not show symptoms immediately. If you have been previously exposed, the symptoms can appear much sooner, within a few days. This can make it challenging to determine the source of the infection. If you notice any symptoms, it is crucial to seek medical advice promptly.

In summary, while the boy's symptoms could suggest scabies, it is essential to remember that only a healthcare professional can provide a proper diagnosis. Your proactive measures of changing clothes and washing up were appropriate given the circumstances. If you develop any symptoms, do not hesitate to reach out to a healthcare provider for evaluation. Keeping an eye on your skin health and being aware of any changes is always a good practice, especially after potential exposure to contagious conditions.

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