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Would Symptoms Of Scabies Occur In The Oral Cavity?
Question: I got scabies two months ago and have done 7 Permethrin treatments (all partially failed due to bad instructions I got (I am 66 and I didn't treat my head for the first 4 treatments) ) and one Ivermectin treatment after my tongue got a lesion that erupted a few days later and bled slightly for several minutes. It healed in a few days, but I now have another one in a different spot on my tongue. Was it a scabies egg burrow erupting or the effect of the Permethrin? I am terrified that I have scabies in my mouth and tongue that could get out of control if I can't keep taking Ivermectin at some point. Also I have had under-the-toenail eruptions. Help!!!
Brief Answer:
Regarding oral aphthous ulcer
Detailed Answer:
Hello. Thank you for writing to us
I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern.
Scabies would never happen in Oral cavity. The lesion in oral cavity may have been an aphthous ulcer, certainly not due to scabies mite.
For the oral mucosal lesion I suggest you to apply a chlorhexidine mouth ulcer antiseptic gel. You may also do antiseptic mouthwashes.
In addition I would suggest you to take a capsule of B complex vitamin once daily.
I would like to have a look at toe eruptions. I request you to kindly upload an Image so that I am able to guide you better. You may upload an image in "Reports Section" Or you may mail me at YYYY@YYYY with the subject line of the mail as Attention:Dr.Kakkar.
Also let me know do they itch?
Regards
Regarding oral aphthous ulcer
Detailed Answer:
Hello. Thank you for writing to us
I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern.
Scabies would never happen in Oral cavity. The lesion in oral cavity may have been an aphthous ulcer, certainly not due to scabies mite.
For the oral mucosal lesion I suggest you to apply a chlorhexidine mouth ulcer antiseptic gel. You may also do antiseptic mouthwashes.
In addition I would suggest you to take a capsule of B complex vitamin once daily.
I would like to have a look at toe eruptions. I request you to kindly upload an Image so that I am able to guide you better. You may upload an image in "Reports Section" Or you may mail me at YYYY@YYYY with the subject line of the mail as Attention:Dr.Kakkar.
Also let me know do they itch?
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Kakkar,
Thank you for your prompt reply to my question regarding scabies and
the lesions on my tongue. I would like to know why you believe a scabies
lesion is not possible in the oral cavity. I have read of such cases on
scabies internet sites, and in one case it was claimed that it was cured
by a doctor using Ivermectin. Can you please research this further and
be sure, and explain to me why it is not possible to have scabies in the
tongue, if indeed it is not? I need to know the truth about my
condition, and if it is not scabies, I need to know why it occurred. I
do appreciate the advice you have given me so far. I am so pleased to be
talking to a dermatologist at last. I have not been able in the two
months since I contracted scabies to get expert advice on this.
I regret that I do not have the computer skill to upload an image of
my toe eruptions from scabies burrows under the toes, but in any case,
they have healed and the toes look normal now. But again, I have read
cases of this from medical sites on the internet and know from my own
experience that they are real. They do not itch. There is a sudden
soreness under the toenail which lasts about ten minutes and then is
gone. The toenail appears to have something under it, but it returns to
normal appearance in about ten minutes. I can only account for it from
scabies larvae or scabies nymphs leaving a scabies egg burrow, but if I
am wrong, I would like to know what else it could be. If it is not
scabies, I certainly want to know that also, i.e. what it is.
Kindest Regards,
XXXX XXXXXXX
Thank you for your prompt reply to my question regarding scabies and
the lesions on my tongue. I would like to know why you believe a scabies
lesion is not possible in the oral cavity. I have read of such cases on
scabies internet sites, and in one case it was claimed that it was cured
by a doctor using Ivermectin. Can you please research this further and
be sure, and explain to me why it is not possible to have scabies in the
tongue, if indeed it is not? I need to know the truth about my
condition, and if it is not scabies, I need to know why it occurred. I
do appreciate the advice you have given me so far. I am so pleased to be
talking to a dermatologist at last. I have not been able in the two
months since I contracted scabies to get expert advice on this.
I regret that I do not have the computer skill to upload an image of
my toe eruptions from scabies burrows under the toes, but in any case,
they have healed and the toes look normal now. But again, I have read
cases of this from medical sites on the internet and know from my own
experience that they are real. They do not itch. There is a sudden
soreness under the toenail which lasts about ten minutes and then is
gone. The toenail appears to have something under it, but it returns to
normal appearance in about ten minutes. I can only account for it from
scabies larvae or scabies nymphs leaving a scabies egg burrow, but if I
am wrong, I would like to know what else it could be. If it is not
scabies, I certainly want to know that also, i.e. what it is.
Kindest Regards,
XXXX XXXXXXX
Brief Answer:
You certanly don't have scabies
Detailed Answer:
Hi.
Scarcoptes scabiei mite never infects oral mucosa. The infection is acquired by close skin to skin contact. It lives, feeds and reproduces only on skin. As it burrows under the skin it feeds on dead skin (keratin) whereas oral mucosa mostly lacks keratin.
Again, scabies mite would not affect the region beneath the toe nail. Toe nail is tough to penetrate for the mite. Lesions of scabies would more commonly be found on the finger and toes webs!
Moreover, ivermectin and permethrin are lethal for the mite and it is impossible for the mite to have survived after repeated treatments.
You certainly don't have scabies.
Regards
You certanly don't have scabies
Detailed Answer:
Hi.
Scarcoptes scabiei mite never infects oral mucosa. The infection is acquired by close skin to skin contact. It lives, feeds and reproduces only on skin. As it burrows under the skin it feeds on dead skin (keratin) whereas oral mucosa mostly lacks keratin.
Again, scabies mite would not affect the region beneath the toe nail. Toe nail is tough to penetrate for the mite. Lesions of scabies would more commonly be found on the finger and toes webs!
Moreover, ivermectin and permethrin are lethal for the mite and it is impossible for the mite to have survived after repeated treatments.
You certainly don't have scabies.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Regarding your advice on scabies and tongue, I bow to your advice but I am puzzled why my tongue suddenly erupted and bled for several minutes, then healed in days. Do aphthous ulcers on the tongue do that? I have had cancer sores before but they never did that. I would appreciate your advice on this.
Also regarding your advice on scabies and toenails, I have read reports of scabies burrowing under the toenail, not through the toenail, but under from the front. Also they do the same under fingernails according to my information and my experience. If it is not scabies, what would cause sudden soreness beneath the nail that would last several minutes and then go away and then this would happen again after several days? I believe I do still have scabies and they are under my toenails. Please research and advise, thank you very much. XXXX
Also regarding your advice on scabies and toenails, I have read reports of scabies burrowing under the toenail, not through the toenail, but under from the front. Also they do the same under fingernails according to my information and my experience. If it is not scabies, what would cause sudden soreness beneath the nail that would last several minutes and then go away and then this would happen again after several days? I believe I do still have scabies and they are under my toenails. Please research and advise, thank you very much. XXXX
Brief Answer:
I reiterate that you don't have scabies
Detailed Answer:
Hi.
Tongue is a very vascular organ and any kind of sore/ ulcer on tongue can bleed including canker sores. Sarcoptes scabiei certainly does'nt cause lesions on tongue. It is unheard of. I could not find any reports of that. Even immunocompromised patients (e.g those infected with HIV) never develop oral lesions of scabies!
Yes, the mite can involve the toe skin under nail gaining access from under the free distal edge of nail plate (not through nails) and therefore it is advisable to cut short nails so that the treatment with permethrin cream has access to hidden mite. Even then scabies under the nail plate does'nt usually cause pain or soreness beneath the nail unless the area is secondarily infected with bacteria e.g staph. aureus.
Regards
I reiterate that you don't have scabies
Detailed Answer:
Hi.
Tongue is a very vascular organ and any kind of sore/ ulcer on tongue can bleed including canker sores. Sarcoptes scabiei certainly does'nt cause lesions on tongue. It is unheard of. I could not find any reports of that. Even immunocompromised patients (e.g those infected with HIV) never develop oral lesions of scabies!
Yes, the mite can involve the toe skin under nail gaining access from under the free distal edge of nail plate (not through nails) and therefore it is advisable to cut short nails so that the treatment with permethrin cream has access to hidden mite. Even then scabies under the nail plate does'nt usually cause pain or soreness beneath the nail unless the area is secondarily infected with bacteria e.g staph. aureus.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Kakkar S.,
Regarding tongue and scabies: Thank you, this is good information and I am certainly very relieved concerning my tongue. It has now healed and there has been no recurrence, so it is not an issue to me now, especially with your advice.
Regarding toenails and scabies: Also good information, but I am at a loss to explain the several recent instances of sudden soreness lasting only a few minutes other than by scabies mites, either burrowing or coming out of burrow under the toenails. If you have an alternate explanation, I would be grateful to know what it is. I have certainly never had this occur before I contracted scabies. but it has occurred a number of times since I contracted scabies. This leads me to believe it is being caused by burrowing scabies mites, but I am now actively treating it with Ivermectin and hopefully that will be successful.
I have now done two treatments of Ivermectin a week apart. The last one was yesterday and it was in combination with Permethrin for 14 hours. I am wondering what the half-life of Ivermectin is in the body (I weight 150 lb. and took 18 mg. the first time and 15 mg. the second time.). I am convinced the toenail incidents were from scabies mites and I need to know if I could take one or two three-mg. Ivermectin tablets per day for a week or two weeks to keep a sufficient level of toxicity in my body to kill the mites in my toes. I want to be sure I am rid of scabies mites under my toenails but I don't want to cause other problems for myself by over use of Ivermectin. Can I safely do this daily dosage of Ivermectin? I am in generally good health and I have a good immune system.
XXXX
Regarding tongue and scabies: Thank you, this is good information and I am certainly very relieved concerning my tongue. It has now healed and there has been no recurrence, so it is not an issue to me now, especially with your advice.
Regarding toenails and scabies: Also good information, but I am at a loss to explain the several recent instances of sudden soreness lasting only a few minutes other than by scabies mites, either burrowing or coming out of burrow under the toenails. If you have an alternate explanation, I would be grateful to know what it is. I have certainly never had this occur before I contracted scabies. but it has occurred a number of times since I contracted scabies. This leads me to believe it is being caused by burrowing scabies mites, but I am now actively treating it with Ivermectin and hopefully that will be successful.
I have now done two treatments of Ivermectin a week apart. The last one was yesterday and it was in combination with Permethrin for 14 hours. I am wondering what the half-life of Ivermectin is in the body (I weight 150 lb. and took 18 mg. the first time and 15 mg. the second time.). I am convinced the toenail incidents were from scabies mites and I need to know if I could take one or two three-mg. Ivermectin tablets per day for a week or two weeks to keep a sufficient level of toxicity in my body to kill the mites in my toes. I want to be sure I am rid of scabies mites under my toenails but I don't want to cause other problems for myself by over use of Ivermectin. Can I safely do this daily dosage of Ivermectin? I am in generally good health and I have a good immune system.
XXXX
Brief Answer:
Regarding ivermectin
Detailed Answer:
Hi.
Mite burrowing into the skin does'nt usually cause pain because the burrow is limited to very superficial dead layers of skin where there is no nerve supply.
Ivermectin is to be taken in a dose of 200mcg/kg. In an adult it is generally given in 2 doses of 12mg, 1 week apart.
It should not be taken daily.
Ivermectin has a half life of 18 hrs.
Overdosing may cause nausea, vomiting, dizziness. It can also cause CNS toxicity i.e seizures.
As far as pain underneath nail is concerned it does nt seem to be due to scabies. I suggest you to consult an internal medicine specialist.
Regards
Regarding ivermectin
Detailed Answer:
Hi.
Mite burrowing into the skin does'nt usually cause pain because the burrow is limited to very superficial dead layers of skin where there is no nerve supply.
Ivermectin is to be taken in a dose of 200mcg/kg. In an adult it is generally given in 2 doses of 12mg, 1 week apart.
It should not be taken daily.
Ivermectin has a half life of 18 hrs.
Overdosing may cause nausea, vomiting, dizziness. It can also cause CNS toxicity i.e seizures.
As far as pain underneath nail is concerned it does nt seem to be due to scabies. I suggest you to consult an internal medicine specialist.
Regards
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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