Scabies

© Scabies is caused by the itch mite Sarcoptes scabiei hominis, which affects both humans and animals. Infection usually affects the interdigital and popliteal folds, axillary folds, the umbilicus, and the scrotum. The infection causes severe itching and excoriations in the interdigital web spaces, buttocks, groin, and scalp.89,90 Diagnosis is made by identifying the mite from skin scrapings on a wet mount.

Treatment

© The agent of choice for scabies is permerthrin 5% (Elimite) cream. Alternative agents in subjects who cannot use permethrin are crotamiton 10% (Eurax) and oral ivermectin (Stromectal) 200 mcg/kg as a single dose. To initiate the treatment with permethrin, the skin should be scrubbed in a warm soapy bath to remove the scabs. The permethrin lotion should then be applied to the whole body, avoiding the face, mucous membranes, and eyes, and left on for 8 to 14 hours. A single application eradicates 97% of scabies. All close contacts should be treated appropriately. The pruritus associated with scabies may persist for 2 to 4 weeks because of the remnants of mite parts in the skin.

Self-assessment questions and answers are available at ht-tp://www. mhpharmacotherapy. com/pp.html.

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