Linear burrowing of a mite at finger webs, wrists, elbow, ankles and penis is seen in case of?

JODHPUR AIIMS SNO-2018

Medical & Surgical Nursing

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

Scabies is a parasitic infestation caused by the mite Sarcoptes scabiei.
The hallmark sign of scabies is the presence of linear burrows, which are created by the female mite as she tunnels under the skin to lay eggs.
The locations mentioned—finger webs, wrists, elbows, ankles, and penis—are classic sites for scabies infestations due to the mite's preference for these areas.
Intense itching (pruritus), especially at night, is another key symptom resulting from a hypersensitivity reaction to the mites, their eggs, and their feces.

Option A: Impetigo is a bacterial skin infection, not a parasitic infestation. It is characterized by vesicles that rupture to form honey-colored crusts, not linear burrows.
Option B: Psoriasis is a chronic autoimmune condition. It presents as well-demarcated, red plaques with silvery scales, typically on extensor surfaces like elbows and knees, not as burrows.
Option D: Herpes zoster (shingles) is a viral infection caused by the reactivation of the varicella-zoster virus. It causes a painful, unilateral vesicular rash along a single dermatome, not linear burrows.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of skin infestations based on clinical presentation as background academic context rather than a clinical decision trigger.
Nurses must use strict contact precautions (gloves, gown) when caring for a patient with suspected or confirmed scabies to prevent transmission to themselves and other patients.
Patient and family education is critical. All household members and close contacts must be treated simultaneously, even if asymptomatic, to prevent re-infestation.
It is important to manage patient expectations by explaining that itching can persist for 2-4 weeks after successful treatment due to the body's reaction to dead mites. This is not a sign of treatment failure.

How to Approach the Question

First, analyze the question stem and identify the key descriptors of the condition. The most specific clues here are 'linear burrowing' and 'mite'.
Consider the anatomical locations provided: 'finger webs, wrists, elbow, ankles and penis'. These are classic intertriginous and flexural areas.
Evaluate each option against these key features.
Recall or deduce the causative agent and presentation of each option. Impetigo is bacterial, Psoriasis is autoimmune, and Herpes zoster is viral.
Recognize that only Scabies is caused by a mite (Sarcoptes scabiei) and presents with the pathognomonic sign of burrowing.
Conclude that the combination of a mite causing linear burrows in the specified locations uniquely points to Scabies.

Concept Tested & Keywords

Concept Tested: Identification of skin infestations based on clinical presentation.
Stem keywords: Linear burrowing, mite, finger webs, wrists, elbow, ankles, penis
Lead-in keywords: is seen in case of
Clinical cues: The presence of 'linear burrowing' and 'mite' are the most definitive clues in the question stem.

Q_v5NtHqRgH8oxMEPAMdtZ

E6 Medicine Harrison 22e Part 2 p. 1633-1635

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 78-80