Scabies should be suspected in any patient, regardless of age or socioeconomic status, who presents with severe, persistent pruritus. It is more common in the fall and winter months. The signs and symptoms tend to crescendo progressively over 2-3 weeks before compelling the patient to seek medical attention. Undiagnosed scabies can last for years, which is the basis for the common term, the seven-year itch. The involvement of multiple family members should suggest the diagnosis.
Nocturnal pruritus is a highly characteristic complaint associated with scabies infestation.
Scabies is unusual in the neonate but it has been reported. Occasionally, the mite is visible to the naked eye as a small white dot. A small vesicle or papule may appear at the end of the burrow or occur independently. Bullous lesions may be seen in immunocompromised patients. Canine scabies does not exhibit the classic burrow.