Penis & scrotum



Topic Completed: 1 February 2010

Minor changes: 21 June 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Scabies penis

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
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Cite this page: Chaux A, Cubilla AL. Scabies. website. Accessed October 25th, 2021.
Definition / general
  • Most common parasitic infection of penis, usually part of generalized infection
  • Red papules or nodules on glans, shaft and scrotum are typical
  • Caused by infestation with mite Sarcoptes scabiei var. hominis, which burrows into the skin and causes intense itching
  • Spread by prolonged (15 - 20 minutes) skin to skin contact with an infected individual, often as a sexually transmitted disease or between members of a household
  • Animals can get scabies but do not spread human scabies
Clinical features
  • First human disease recognized as caused by a specific pathogen (eMedicine: Scabies [Accessed 30 March 2018])
  • Highly contagious and difficult to diagnose early
  • Symptoms may not occur for up to 6 weeks after infection (Clin Microbiol Rev 2007;20:268)
  • Diagnosis requires examining the skin for burrows, then confirming the presence of mites, ova or scybala by microscopy (Dermatol Ther 2009;22:279)
  • Main symptom is intense pruritus, which is worse at night or after hot baths
  • Small crooked lines 4 - 6 mm long (scabetic burrows) and erythematous papules and nodules are often present on glans, shaft and scrotum
  • Excessive scratching may lead to sores, bacterial infections and even glomerulonephritis (Postgrad Med J 2004;80:382)
  • Patients with immunocompromise are at risk for developing "crusted scabies," also called "Norwegian scabies," characterized by scaly rashes, a thickening of the skin and an overwhelming number of mites (J Am Podiatr Med Assoc 2004;94:583)
  • Clinically, scabies can mimic eczema, mycosis fungoides, syphilis and bullous pemphigoid (Dermatol Online J 2006;12:19)
  • Scratch marks often obscure signs of burrows
Case reports
  • Topical permethrin (drug of choice), crotamiton (CDC: Scabies [Accessed 30 March 2018]); possibly topical lindane or oral ivermectin (Am J Clin Dermatol 2002;3:9)
  • Topical treatments must coat the body to be effective
  • Household members and close personal contacts should be treated at the same time
  • Nodules may persist for weeks after mites are killed
  • Bedding or clothing of infected individuals should be machine washed and dried with hot water or sealed in a plastic bag for at least 3 days (CDC: Scabies [Accessed 30 March 2018])
Clinical images

Images hosted on other servers:



Penile lesions:

Various images

Various images

Arm / hands:

Norwegian scabies in AIDS patient

Multiple vesicles and tense bullae

Small erythematous papules

With secondary infection

With leprosy



Arm of infant

Legs / feet:

Crusted scabies



Other sites:



Erythematous vesicles and papules are present on torso extremities, some with adjacent linear excoriations

Crusted scabies

Microscopic (histologic) description
  • Mite and scybala (hardened masses of feces) in epidermis
  • Scabetic burrows are observed in the stratum corneum of the epithelium
Microscopic (histologic) images

Contributed by Daniel Ostler, D.O. (Case #160)

Lesion on leg (fig 1 and 2: mites in the epidermis; fig 3: mite and scybala, hardened masses of feces)

Images hosted on other servers:


Crusted scabies: show
multiple mites (arrows)
in hyperkeratotic
stratum corneum

Intact bulla on forearm

Neutrophils, eosinophils and fibrin

Hyperkeratosis, inflammatory response

Serial section of mite


Routine scabies:
single mite;
eosinophilic spongiosis
may be present

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Image 01 Image 02