Which finding is noted on assessing a child with scabies?

Appeared in: JIPMER Nursing Officer - 2020

Explanation

Scabies is a contagious skin infestation caused by the mite Sarcoptes scabiei.
The hallmark sign of scabies is the presence of burrows, which are created by the female mite tunneling into the skin to lay eggs.
These burrows appear as fine, wavy, grayish, or skin-colored threadlike lines on the skin's surface.
Common locations for burrows include the webs of fingers, wrists, elbows, axillae, and groin.

Option A: These describe striae, or stretch marks, which result from the tearing of the dermis during rapid growth or weight changes, not a parasitic infestation.
Option B: While scabies can cause red papules (raised bumps), flat pink-red macules are more characteristic of viral exanthems like measles or rubella, or allergic drug reactions.
Option D: This is a duplicate of the correct answer. In a standard multiple-choice question, there should only be one correct option. This indicates an error in the question's construction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment findings of scabies in children as background academic context rather than a clinical decision trigger.
Recognizing scabies burrows is crucial for early diagnosis and treatment, preventing outbreaks in families, schools, and daycare centers due to its high contagion.
Patient and family education is a key nursing role, emphasizing the need to treat all close contacts simultaneously and perform environmental decontamination (washing linens in hot water) to prevent reinfestation.
Nurses must manage the intense itching (pruritus), which can persist for weeks after treatment, to prevent secondary bacterial infections from scratching.

How to Approach the Question

Identify the core subject of the question: the clinical signs of scabies.
Recall the pathophysiology of scabies: a mite burrowing under the skin.
Visualize what a mite's tunnel would look like on the skin. This directly leads to the concept of a 'burrow'.
Evaluate the options based on this knowledge. 'Gray threadlike lines' is the most accurate description of a scabies burrow.
Differentiate the other options: 'Purple lines' are striae, and 'pink-red macules' suggest viral rashes, not a parasitic burrow.
Note the duplicate option, but confirm that 'Gray threadlike lines' is the definitive correct description.

Concept Tested & Keywords

Concept Tested: Clinical assessment findings of scabies in children.
Stem keywords: scabies, child, assessing, finding
Lead-in keywords: Which finding
Clinical cues: The question asks for a specific assessment finding, implying a pathognomonic sign.

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

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1982-1984

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

Practise the full JIPMER Nursing Officer - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.