Scabies
exp date isn't null, but text field is
- Is a contagious skin disease associated with severe itching
Cause
- Sarcoptes scabies.
Signs and symptoms
- Itchy vesicles and papules
- Short elevated serpiginous (S-shaped tracks in the superficial epidermis (burrow)
- “Norwegian” scabies presents with extensive crusting (psoriasis-like lesions) of the skin with thick, hyperkeratotic scales overlying the elbows, knees, palms, and soles
Differential diagnosis
- Papular urticaria
- Atopic or seborrheic dermatitis
- Drug eruptions
- Onchocerciasis
Investigations
- Microscopic identification of mites, their eggs or faeces obtained from the vesicles or mite burrows
Treatment objectives
- Relieve symptoms
- Prevent the spread and recurrence of the infection.
Non-pharmacological treatment
- Good personal hygiene
- Avoid sharing personal items and toiletries
Pharmacological treatment
|
After normal bathing apply Gamma benzyl benzoate 1% lotion Apply from neck downwards twice a day and wash off after 24 hours. Caution - In pre-pubertal children, the lotion should be washed off after 12 hours. - Hot baths and scrubbing should be avoided to prevent systemic absorption.
Alternative in pregnancy, lactating mothers or children < 6 months Benzyl benzoate 25% emulsion - Apply from the neck downward once at night for 3 nights. - Wash off the next morning. - Repeat if necessary, within 10 days. Note: Child: Dilute with one part water (1:1) Infant: Dilute with three parts water (1:3) OR Sulphur ointment 10% Apply twice a day for 1 – 2 weeks To relieve itching Calamine lotion apply as needed PLUS Chlorpheniramine oral Adult 4mg three times a day for 5 days Child 0.1mg/kg If the above treatment is ineffective or unsuitable give Ivermectin oral Two doses of oral ivermectin (200µg/kg/dose) should be taken with food, each approximately one week apart Note: Avoid in pregnancy, and in children <15 kg |