Pruritic papules and vesicles on the scrotum and penis in men and areolae in women are highly characteristic. Infants and young children may develop lesions diffusely, but unlike in adults, lesions are common on the face, scalp, neck, palms, and soles.
Patient history can reliably suggest the presence of scabies. Lesion distribution and intractable pruritus that is worse at night, as well as scabies symptoms in close contacts (including multiple family members), should immediately rank scabies at the top of the clinical differential diagnosis.
Signs and symptoms of pruritus tend to crescendo progressively over 2-3 weeks before compelling the patient to seek medical attention. However, debilitated or immunocompromised patients may not have the urge to scratch.
For more on the presentation of scabies, read here.
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Cite this: Richard H. Sinert. Fast Five Quiz: Test Yourself on Clinical Information About Insect Bites - Medscape - Jun 16, 2017.