## Anatomical Distribution of Scabies ### Preferred Sites in Adults | Site | Frequency | Characteristics | | --- | --- | --- | | **Interdigital spaces** | Most common | Web spaces between fingers; classic location for burrows | | **Flexural wrists** | Very common | Ventral aspect; easily traumatized | | **Elbows** | Common | Extensor surfaces; pressure areas | | **Axillae** | Common | Warm, moist intertriginous area | | **Genitals** | Common in males | Penile shaft, scrotum | | **Buttocks** | Common | Pressure and friction area | | **Breasts** | Common in females | Inframammary fold | ### Why These Sites? **Key Point:** Scabies mites prefer warm, moist, occluded skin with thin stratum corneum — areas of friction, pressure, and body fold contact. **Clinical Pearl:** The **interdigital spaces** are the single most diagnostically valuable site because burrows are most visible and accessible here. Always examine the hands first when scabies is suspected. **High-Yield:** Face, neck, and scalp are **rarely** involved in immunocompetent adults (but are common in infants and elderly). Palms and soles are involved in only 10% of cases — not exclusive sites. ### Mnemonic **FOLDS & FRICTION** — Scabies favours intertriginous **F**olds, **O**ccluded areas, **L**ow-friction zones, **D**ark/moist **S**ites, and areas of **F**riction. 
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