Now that you are done scratching your head after the past three weeks, it is time to get the rest of you scratching!
Caused by the mite: Sarcoptes scabei .
Mostly affects the folds of the skin behind the knee and others, bellybutton and scrotum. Spread by direct, prolonged, skin-to-skin contact with a person who has scabies. Transmitted through direct contact, and frequently sexual contact. Can survive off a human host 24-36 hours under normal conditions of heat and humidity. Increased humidity prolongs survival off the host. Can be transmitted through towels, bed linens and sleeping bags. Is a problem for the military servicemen.
- Severe itching and an inability to sleep.
- Lesions between webs of fingers, wrists, buttocks, elbows, groin & scalp.
- Look for burrows made by the mite, and skin scrapings. Short irregular mark, 2-3 cm long and the width of a hair.
- The diagnosis of scabies is confirmed by detecting scabies mites, eggs, or feces with a microscope.
Elimite cream 5%: treatment of scabies – DRUG of CHOICE available in 60 gm tubes
Warnings/Precautions /Adverse Effects
- Not recommended if nursing.
- Can be used in children over age 2 months.
- Caution with asthmatics.
- Thoroughly massage cream from the head to the soles of the feet. Rarely do scabies affect the heads of adults. They may infest the infants or geriatrics around the hairline.
- Remove cream by washing off in bathtub or shower after 8 to 14 hours.
- One application is generally curative. (half a tube is sufficient for 1 adult)
- Patients may experience itching after treatment, rarely a sign of treatment failure. Living mites after 14 days would indicate that re-treatment is necessary
Ivermectin (Stromectol®) oral tablets. May be a safe and effective treatment for scabies, although not FDA-approved for scabies. Consider for patients who have failed treatment with or who cannot tolerate FDA-approved topical medications for the treatment of scabies. Might be a good option for nursing homes or large families, where head to toe treatment of each patient is impractical.
After successful treatment, patients may continue to itch for several weeks.
- A steroidal cream will help resolve the dermatitis.
- Short course of corticosteroids, like prednisone will also decrease itching.
- Oral antihistamines like diphenhydramine (Benadryl) might be of some benefit to relieve itching.
- If no relief of itching, recheck for reinfestation.
Worst of the worst: Crusted scabies or “Norwegian scabies” — occurs only in people with a weakened immune system (such as HIV infection, lymphoma, or other conditions). This condition may also affect older adults or those with Down syndrome. Ivermectin or permethrin 5% are used to treat this condition. Lesions appear as large, crusty red patches or bumps on the skin