Parasitic Infections - Scabies
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Scabies is an intensely pruritic and highly contagious infestation of the skin caused by mite Sarcoptes scabies.
Clinical presentation
- Itchy vesicles and papules. Itching worse at night.
- Papules in between finger spaces, wrists, penis and scrotum.
- Someone else in the family is itching.
Non-pharmacological Treatment
- Treat all members of the household at the same time to prevent reinfection, regardless of presence or absence of itching.
- Advise patients to bath and dress regularly and changing bed linen at the same time of treatment.
Pharmacological Treatment
A: benzyl benzoate emulsion, BBE (25% for adults, 12.5% for children)
Adults and children over 2 years: Apply with fingers, from neck down to cover the whole-body surface, while paying attention to all skin folds. Leave emulsion in place for 6-8 hours overnight.
Repeat the application after 7 days.
OR
C: lindane lotion (1%) to be applied as BBE above (do not use in children less than 1 year)
AND
C: betamethasone valerate cream (topical) 12hourly for the itch
AND
A: cetirizine (PO) 10mg 12hourly for 3- 4weeks
OR (if extensive, Norwegian scabies)
A: ivermectin (PO) 200microgram/kg stat then repeat after 1 week
Should be in combination with the topical above