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Scabies

History

Scabies has been a recognized disease for 25 centuries, when its treatment with topical sulfur originally was reported. The etiologic agent, Sarcoptes scabiei, was identified in 1687, making it the first disease of humans whose cause was specifically ascertained. During times of war, famine, overcrowding, and poor sanitation, scabies becomes more common. In these situations, it can be considered epidemic and endemic. Outbreaks have been described during several of Napoleon's military campaigns, and it has been half-seriously suggested that the reason he always posed with his hand inside his coat was because of the chronicity of his scabies. The term "scabies" probably is derived from the Latin term "scabere," to scratch, and from the "scabs" of secondary infection.

Because this infestation is not a reportable disease in the US, efforts to confirm "epidemics" rely mainly on case reports and may not reflect the true epidemiology of the disease. Significant increases in cases of scabies have been reported in developed countries during modern times. During the Second World War, Mellanby did substantial work on this problem. Among his more interesting experiments was the use of a dissecting microscope to determine the number of active mites on infected individuals. Even though most adult patients who had scabies had hundreds of lesions, the number of active mites usually was less than 15, and most of these were on the hands, according to Mellanby.

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