A patient states he is having intense itching between the fingers with brown linear lines presenting. Based on your nursing knowledge this best describes what condition?

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Question

This question was previously asked in

SGPGI Staff Nurse Official Paper (Held On: 28 Feb, 2024 Shift 1)

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Answer 1

Correct Answer: Scabies

Rationale:

Scabies is a skin infestation caused by the mite *Sarcoptes scabiei*. These microscopic mites burrow into the upper layer of the skin to lay their eggs, triggering an allergic reaction that causes intense itching.
The hallmark symptom of scabies is intense itching, particularly at night. This itching is often localized between the fingers, around the wrists, elbows, armpits, waist, and other warm areas of the body.
The presence of brown linear lines, also known as burrows, is a classic sign of scabies. These burrows are created by the mites as they tunnel into the skin, and they appear as thin, irregular lines on the surface of the skin.
Scabies is highly contagious and can spread through prolonged skin-to-skin contact or sharing of personal items such as clothing, bedding, or towels.

Additional Information:

Treatment for scabies typically involves topical medications like permethrin cream or oral medications such as ivermectin. It’s also important to treat close contacts and clean personal items to prevent reinfestation.
Patients with scabies should be educated on the importance of completing the full course of treatment and taking measures to prevent spreading the infestation to others.

Explanation of Other Options:

Ringworm

Rationale: Ringworm, or tinea, is a fungal infection that causes circular, red, scaly patches on the skin. Unlike scabies, it does not present with burrows or intense itching localized between the fingers. It typically affects areas like the scalp, groin, or feet.
Ringworm is not caused by mites but by dermatophytes, a type of fungus, and is treated with antifungal medications such as topical creams or oral antifungal agents.

Psoriasis

Rationale: Psoriasis is an autoimmune condition that leads to the rapid buildup of skin cells, forming thick, scaly patches. It commonly affects areas like the knees, elbows, and scalp, and does not involve burrows or mite infestations.
Psoriasis can cause itching, but the pattern of symptoms is distinct and does not typically include intense itching between the fingers or burrow-like lines.

Eczema

Rationale: Eczema, or atopic dermatitis, is a chronic inflammatory skin condition that causes red, itchy, and dry patches on the skin. While it can affect the hands, it does not produce burrows or the linear brown lines characteristic of scabies.
Eczema is often triggered by allergens, irritants, or environmental factors and is managed with moisturizers, topical steroids, and antihistamines.

Conclusion:

The presence of intense itching and brown linear lines between the fingers is most consistent with scabies. While the other options describe skin conditions with itching as a symptom, none of them involve the burrows or specific localization seen in scabies.