Background: Scabies is a widespread, contagious skin disease caused by the burrowing mite Sarcoptes scabiei, affecting humans and over 150 mammal species. Transmission primarily occurs through direct, prolonged, human-to-human contact, though zoonotic scabies can result from infested animal exposure. This study aimed to determine the frequency of scabies infestation among suspected patients in Mashhad, Iran, and to evaluate its association with age, gender, season, occupation, residence, and animal contact. Methods: A cross-sectional study was conducted from March 2019 to March 2020. A total of 201 patients (104 females, 97 males) with pruritus and clinically suspected scabies were referred by dermatologists to selected medical laboratories, including those of the Islamic Azad University of Medical Sciences. A structured questionnaire recorded demographic information, residence (urban/rural), occupation,direct animal contact and time of symptom onset. Skin scrapings were collected from four sites—interdigital spaces of the hands, chest, abdomen, and feet—digested in 10% potassium hydroxide (KOH), and examined under light microscopy for S. scabiei mites or eggs. Negative specimens were re-examined to confirm results. Results: Of 201 patients, 75 (37.31%) were positive: 39 males (52%) and 36 females (48%). The highest frequency occurred in spring and among patients under one year old (range: 6 months–61 years). The family infestation was identified in four families, three in rural and one in urban areas. Rural cases accounted for 78.7% of positives, with higher frequencies in both rural women and men compared to urban residents. Twenty-three positive cases reported animal contact via livestock farming or pet ownership. The interdigital spaces were the most frequent site of detection, followed by the abdomen, chest, and feet. Conclusion: Although human-to-human transmission is dominant, the observed proportion of patients with animal contact suggests the need for further epidemiological and molecular studies to investigate potential cross-species transmission pathways.

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