Scabies: Difference between revisions
Mceledon83 (talk | contribs) |
Mceledon83 (talk | contribs) |
||
| Line 22: | Line 22: | ||
==Treatment== | ==Treatment== | ||
*Permethrin cream for all family members | *Permethrin 5% cream for all family members | ||
**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) | ||
**Leave on for 8-12hr before washing off | **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 | *Ivermectin 200mcg/kg may be necessary for severe infection | ||
*Wash linens/clothes in hot water | **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 | *Pruritus may continue for weeks despite successful elimination of infestation | ||
Revision as of 23:10, 2 September 2013
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
DDx
- Impetigo
- Atopic dermatitis
- Insect bites
- Drug reaction
- Dermititis Herpetiformis
Treatment
- 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
Source
Tintinalli