scabies

• Scabies

  • Burrow beneath the skin surface (Visual- small thread like grey lines in the webs of fingers/toes
  • Cause an allergic reaction to their coat and exudates
  • Resulting in intense itching (pruritus) worse at night
• location of scabies rash?

  • Can occur anywhere (not commonly on head) but often starts in between the fingers
  • Turns into tiny spots once spread
• Scabies 


  diagnosis ?

  
• Scabies REFER?

  • Babies and children
  • Secondary infection of skin (yellow, weeping, crusting)
  • Treatment failure/ Itching still present after 4 weeks
  • Unclear diagnosis (difficult to differentiate between acne/mosquito bites) REFER if in doubt
• scabies treatment

  Permethrin cream (Lyclear) - 2yrs+, leave cream on for 8-12hrs then wash it off (REPEAT after 7 days)

  Malathion (derbac-M)- 6 months+ leave lotion on for 24 hours then wash it off (repeat after 7 days)
• Counselling for scabies

  1. All members of the household/close contact should be treated at the same time

  2. Treatment should be applied to the whole of the body from the chin and ear downwards

  3. Clothes and bed linen should be washed at temperature above 50 degrees at time of treatment

  4. Put clothing that cannot be washed into a sealed bag for 3 days until the mites die
• Itch will continue for 2-3 weeks after treatment


  Crotamiton aka eurax cream can be used in the interim
• Avoid close contact with other people while infected as can be transmitted to other people
• Infected people may not show symptoms until up to 8 weeks after infestation