Serpiginous burrows on the wrist and the genitalia characteristic. Caused by the mite sarcoptes scabiei which usually penetrates skin below the neck. Permethrin 5% - Lyclear dermal cream - should be used (Permethrin 1% rinse cream ineffective in scabies cf head lice). An alternative treatment is Malathion (safe in pregnancy). All household members should be treated simultaneously. Pruritus is felt at most times but worse at night. After treatment the itching from scabies can take weeks to settle. Treatment should be extended to the scalp, neck, face and ears in children up to the age of 2 years. All skin surfaces should have the agent applied for 24 hours for malathion and for 8-12 hours for Permethrin 5% and have treatment repeated at 7 days.