Scabies

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Background

  • Infestation with the Sarcoptes scabiei mite
  • 4-6wk incubatio nperiod after exposure
  • Not a reflection of poor hygiene

Diagnosis

  • Older children / adults
    • Generalized eruption w/ linear burrows, papules, pustules
    • Hand, feet, groin predominance
  • Infants
    • Hyperpigmented nodules may be found in axilla and diaper areas
    • May be widespread

DDx

  • Impetigo
  • Atopic dermatitis
  • Insect bites
  • Drug reaction

Treatment

  • Permethrin 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
  • Ivermectin 200mcg/kg may be necessary for severe infection
  • Wash linens/clothes in hot water
  • Pruritus may continue for weeks despite successful elimination of infestation

Source

Tintinalli

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