Scabies

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Template:Scabies Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

• Sarcoptes scabiei treatment

• 1. Adult

• Preferred regimen (1): Permethrin 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
• Preferred regimen (2): Ivermectin 200 ug/kg PO qd and repeated in 2 weeks
• Alternative regimen: Lindane (1%) 1 oz of lotion or 30 g of cream applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours

• 2. Infants and young children

• Preferred regimen: Permethrin 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
• Note: Infants and young children aged< 10 years should not be treated with lindane.

• 3. Crusted Scabies

• Crusted scabies (i.e., Norwegian scabies) is an aggressive infestation that usually occurs in immunodeficient, debilitated, or malnourished persons, including persons receiving systemic or potent topical glucocorticoids, organ transplant recipients, persons with HIV infection or human T-lymphotrophic virus-1-infection, and persons with hematologic malignancies.

• Preferred regimen: (Topical scabicide 5% topical Benzyl benzoate 5% OR topical Permethrin 5% cream (full-body application to be repeated daily for 7 days then twice weekly until discharge or cure) AND treatment with Ivermectin 200 ug/kg PO on days 1,2,8,9, and 15. Additional Ivermectin treatment on days 22 and 29 might be required for severe cases

• 4.Pregnant or Lactating Women

• Preferred regimen: Permethrin 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours

Case Studies

Case #1

External Links

• Center for Disease Control
• The Merck Manual of Diagnosis and Therapy, 17th edition, 1999
• Clinician's Pocket Reference, 9th edition, 2002
• United States Centers for Disease Control and Protection
• American Social Health Association
• Chosidow O. "Scabies". New Engl J Med. 354 (16): 1718&ndash, 1727.
• MedlinePlus Drug Information: Lindane
• Scabies Pictures & Symptoms

References