Review of Scabies in the Elderly

Scabies, an ectoparasitic infestation of the skin by the mite Sarcoptes scabiei, is a clinical problem of particular significance in the elderly population because of unique vulnerability factors. Such factors include reduced mobility, residency in grouped living facilities, and difficulty with implementation of certain treatments. There is also risk of transmission to nearby caretakers and cohabitants. Furthermore, the diagnosis of scabies can be difficult, as this condition can closely resemble other dermatologic diseases. Complicating the diagnosis in this group is the variety of medical settings in which these patients are evaluated, some of which may not be equipped to follow diagnostic guidelines. The diagnosis itself can be complex because of varying clinical presentation and mite burden. Finally, the transmissibility of scabies, especially in grouped living arrangements, makes prompt and proper treatment of this condition paramount. All of these factors present a unique challenge for the clinician treating elderly patients. This article aims to describe the susceptibility factors, clinical presentation, diagnosis, and management considerations specific to elderly adults with scabies.