B86
DESCRIPTION
An infestation with the parasite Sarcoptes scabei .
Commonly occurs in the skin folds.The infestation spreads easily, usually affecting more than one person in the household.
Clinical features include:
- intense itching, which is more severe at night
- small burrows between fingers, toes, elbow areas and buttocks where the parasite has burrowed under the skin
- secondary infection which may occur due to scratching with dirty nails
- in small babies, there are often vesicles and pustules on the palms and soles and sometimes on the scalp
GENERAL MEASURES
All close contacts must be treated simultaneously even if they are not itchy - see medicinal treatment below.
- Cut finger nails and keep them clean.
- Wash all linen and underclothes in hot water.
- Expose all bedding to direct sunlight.
- Put on clean, washed clothes after medicine treatment.
MEDICINE TREATMENT
Adults and children > 6 years of age
- Benzyl benzoate 25% lotion, applied undiluted to the whole body from neck to feet and rub in well.
- Allow the lotion to remain on the body for 24 hours, then wash off using soap and water.
- For severe infestation treatment may be repeated after 24 hours or once within 5 days.
- All infected persons living in the household, or likely to contract the infection, should be treated at the same time.
If benzyl benzoate is unsuccessful:
- Permethrin 5%, topical, apply lotion undiluted to the whole body from neck to feet.
- Leave on overnight (8–12 hours) and wash off the following morning.
Children < 6 years of age
- Permethrin 5%, topical, apply lotion, applied undiluted to the whole body from neck to feet.
- Leave on overnight (8– 12 hours) and wash off the following morning.
Note:
- Benzyl benzoate and permethrin are toxic if swallowed.
- Avoid contact with eyes and broken skin or sores.
- Do not continue if rash or swelling develops.
- Itching may continue for 2–3 weeks after treatment.
Treatment may need to be repeated after one week.
Treat secondary infection with antibiotics. See: Impetigo