Intense itching body and extremity …… Scabies ?

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Scabies is a skin infestation caused by a very tiny mite known as the Sarcoptes scabiei. These microscopic mites can live on your skin for up to two months. They reproduce on the surface of your skin and then burrow into your skin and lay eggs.

Scabies produces an itchy rash with small red bumps and blisters. The itch of scabies is very intense and persistent, and sometimes increases at night. It likes to affect certain areas of the body more than others. Scabies may often involve the:

  • Webs between fingers
  • Wrists and the backs of the elbows
  • Knees
  • Area of the waist and bellybutton
  • Armpits
  • Around the nipples
  • Sides and backs of the feet
  • Groin
  • Buttocks

Your doctor or your Feely’s totalhealth pharmacist can often diagnose scabies by the appearance of the rash.  If any burrows are present the ink will be applied and it will have tracked into the burrows and appear as a dark line. Scraping sample can be looked under the microscope for parasites.

The complications of scabies include secondary bacterial infection and acute streptococci glomerulonephritis as a result.

  • The whole family and close contacts must be treated regardless of symptoms which can take weeks to develop.
  • Permethrin 5% cream if > 2 months of age.
  • Apply to whole body from jawline down (include every flexure and area), leave overnight, then wash off. Wash clothing and linen after treatment and hang them in sun. Avoid hot bath before
  • Benzyl benzoate 25%, left for 24 hours before washing off. If < 10 years dialute with water
  • One treatment is usually sufficient. It can be repeated in a week if necessary.
  • Note: Persistence of the itch after treatment is common. If the itch has not abated after 7 days, re-treat. After this, reassurance is usually all that is required. Also prescribe a topical antipruritic (e.g. crotamiton cream for 3 – 5 days and an oral antihistamine for the itch). Weepy burrow compress.
  • AGN risk , Risk of 2ry bacterial , next day school , School teacher
  • Less than 2Months – Sulfer cream                                                                         Common side effects  of permethrin are eczema, rash, irritation and edema where as BB can cause  irritation and  hypersensitivity

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