Mrs Adeyemi came in on behalf of her whole family — all four of them were scratching at night and none were sleeping. Three different medications had been tried. Mascot Healthcare diagnosed scabies and treated the entire family simultaneously.
Homemaker, Surulere. Presented on behalf of herself, husband, and two children — all with intensely itchy rash worst at night, affecting web spaces, wrists, and trunk. Itching had spread through the family over 6 weeks.
ScabiesThe itch started with the seven-year-old in week one. By week two, his younger sister was scratching. By week three, Mrs Adeyemi herself. By week four, her husband had begun. The family had been to three pharmacies, receiving antihistamines each time. One pharmacy had prescribed a steroid cream.
Mrs Adeyemi came to Mascot Healthcare with photographs of the rash on her wrist and her son's hand — the web space papules were clearly visible. "We're not sleeping," she said. "All four of us."
The doctor looked at the distribution photograph, asked about the nocturnal pattern, and confirmed the web space and wrist involvement. "This is scabies," the doctor said. "And to fix it, we need to treat everyone simultaneously — including anyone else who has had prolonged skin contact with your family."
Scabies spreads through close skin contact and affects entire households. The key features — nocturnal itch, web space involvement, and a family cluster — make the diagnosis straightforward once recognised.
Itch dramatically worse at night — a hallmark of scabies, caused by increased mite activity in the warmth of bed.
Papules and burrows in the finger web spaces and along the wrists — the classic scabies distribution.
Widespread papular rash on the abdomen and lower back — particularly in the adults.
Mother, father, and both children (ages 7 and 4) all itching — classic household cluster.
Chlorpheniramine had been prescribed by two different pharmacies with only temporary itch relief.
Chlorpheniramine antihistamine — prescribed three times by different pharmacies; reduced itch temporarily, did not kill mites.
Topical betamethasone steroid cream — suppressed itch and inflammation; worsened mite proliferation.
Antiseptic soap — appropriate hygiene; no acaricidal (mite-killing) effect.
Changing bedding without simultaneous treatment — reduced environmental mites temporarily; reinfestation when untreated skin touched the same bed.
A medicated cream was prescribed for all four family members at the same time. Instructions: apply from the neck down to every surface of the skin (paying special attention to web spaces, wrists, under fingernails, buttocks, and genitalia), leave on for 8–12 hours, wash off. Repeat application in 7 days.
Concurrent measures: all bedding, clothing, and towels washed in hot water and dried in the sun the same day; soft toys bagged for 72 hours; anyone else who had slept in the same bed recently was advised to be treated.
The itch may continue for up to 2 weeks after treatment — explained as a post-scabetic inflammatory response, not treatment failure. An anti-itch allergy tablet was prescribed for this period.
Scabies — household cluster (Sarcoptes scabiei; clinical diagnosis: nocturnal itch, web space burrows, family transmission pattern)
A medicated cream for all 4 family members at the same time; repeat at day 7; hot wash bedding and clothing; an allergy tablet for post-treatment itch; environmental management
Itch resolved completely within 14 days of the first application of the cream. No reinfestation at 6-week follow-up.
All four family members were itch-free within 14 days. First good night's sleep in 6 weeks occurred on day 3 after treatment (significant itch reduction). No recurrence.
Scabies is the diagnosis when a family cluster all develop nocturnal itch at the same time. The web space and wrist distribution is almost pathognomonic. Antihistamines alone are futile.
Simultaneous treatment of all household contacts on the same day — not one at a time — is the essential rule. Even a single untreated person re-infects the household.
If the whole family is itching at night — it's scabies until proven otherwise. Treat everyone on the same day.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.