Scabies is caused by a mite. This disease has been recognized for 100s of years. The mite was identified under the microscope in the early 1800s. Sulfur in petrolatum was used successfully to treat patients over 200 years ago. Scabies has been called the seven-year itch. The mite is acquired from direct contact with another person. It may be possible to acquire them might from infested bed sheets or clothing. There are little or no signs of the disease for 2-8 weeks. Mites copulate, increase in numbers and cause a localized to generalized itchy intolerable eruption. The disease is often misdiagnosed as eczema. Inappropriate treatment with topical steroids makes the disease worse. Many residents in a nursing home may be infested. Topical treatment with permethrin is effective. Resistant cases are treated with permethrin and oral ivermectin.