Scabies is an infestation of the skin caused by the mite Sarcoptes scabiei. Scabies is usually transmitted by close person-to-person contact, but can occasionally be transmitted by fomites such as clothing and linens. Scabies usually presents with severe itching, often worse at night, and erythematous papules in a characteristic distribution. The combination of a pruritic eruption with characteristic lesions and distribution, and family involvement strongly suggests the diagnosis. Skin scrapings, dermoscopic examination, and an adhesive tape test can be used for confirmation of scabies infestation, but negative tests do not rule out the diagnosis. Patients with scabies can be treated with permethrin 5% cream twice, one week apart (applied to all areas of the body from the neck down and washed off after eight to fourteen hours) or oral ivermectin (200 mcg/kg stat and repeated after two weeks). Patients with crusted scabies should be treated simultaneously with oral ivermectin and topical permethrin 5% cream. Simultaneous treatment of the patient and close contacts is recommended to reduce risk of spread and recurrence of scabies in the treated patient. Because mites usually survive for only two to three days when not on human skin, clothing and linens used within the preceding three days should be washed in hot water and dried in a hot dryer or bagged for seven days.