Scabies

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

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

Permethrin 5% cream for all family members
- 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

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