Scabies: Difference between revisions
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==Treatment== | ==Treatment== | ||
===Adults=== | ===Adults=== | ||
*Permethrin 5% cream for all family members | *Permethrin 5% cream for all family members<ref>Strong M. Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;(3):CD000320</ref> | ||
**Apply from neck down | **Apply from neck down | ||
**Infants may require applicatio nto scalp/face (avoid mucus membranes) | **Infants may require applicatio nto scalp/face (avoid mucus membranes) | ||
Revision as of 15:33, 10 November 2014
Background
- Infestation with the Sarcoptes scabiei mite
- 4-6wk incubation period after initial exposure
- Those previously infected, sx begin in 1-3 days (sensitization)
- Not a reflection of poor hygiene
Diagnosis
Must elicit history of symptomatic close contacts (human or animal)
- Older children / adults
- Generalized eruption w/ linear burrows, papules, pustules
- Hand, feet, groin predominance
- Infants
- Hyperpigmented nodules, vesiculopustules, papules may be found in axilla and diaper areas
- May be generalized
Differential Diagnosis
Treatment
Adults
- Permethrin 5% cream for all family members[1]
- Apply from neck down
- Infants may require applicatio nto scalp/face (avoid mucus membranes)
- Leave on for 8-12hr before washing off
- Has 95-98% success rate, may reapply in 1-2wks if incomplete effect
- Ivermectin 200mcg/kg may be necessary for severe infection
- Also viable option in adolescent or adult with insecure social situation
- Success rate 70%, increases if give repeat dose 2wks after
- Contraindicated in lactating women and children < 15kg
- Wash linens/clothes in hot water or bag bulky items and keep sealed for 2wks
- Pruritus may continue for weeks despite successful elimination of infestation
Infants
- Permethrin 5% is FDA approved for > 2 months of age although still recommended for neonatal scabies [2]
Source
- Tintinalli
- AAP