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icon Re: latest about scabies

quote:
abidrana wrote:
dear consultant dermatologist.can you refresh me about latest trend in management os scabies ,a very comon skin disorder in our area


Scabies is a very common skin infection which leads to itch and finally leads to eczema. Fairly close physical contact between people is required for transmission. There is often a history of a close personal contact having had an itchy rash as well. The condition affects both children and adults. The spaces between the fingers are commonly affected. The genital area in males is a common site and around the nipples in females is another common site. However, most patients have a widespread itchy rash and detecting individual sites of involvement amongst the rash can be extremely difficult. There are various available treatments for scabies. It is important for the treatment to be applied to all of the skin from the neck downwards (not just picking out the itchy sites). It is also important for close contacts to be treated on the same day. The treatment should be left on the skin for twenty-four hours and all bedding and clothing should be washed and changed. I advise my own patients to repeat this treatment again after one week (even though one good treatment is often completely successful). The second treatment is a precaution. It is very important to understand that even after successful treatment (where the infection has been killed off) the resulting eczema does not fade away for at least six weeks. It is important that repeated scabies' treatments are not given during this time because they can make the eczema worse. Moisturizers and weak steroids should help the eczema to fade away but these should not be used until at least 24 hours after the scabies treatment applications

Two main treatments we use are Malathion and permethrin (In Uk it is sold as Lyclear Dermal cream). I prefer premethrin as there is resistance against malathion.

So in summary you should get 100% results if you followi simple rules.

All family members should be treated same day. Whole body should be treated (below neck in adults)

If any one washes their hands - treatment should be reapplied imediately.

Remember - only reason of treatment failure is either not treated properly or whole family is not treated.

If for financial reason - premethrin is not possible than use old fashioned Benzylbenzoate. Three applications (every consecutive days) should be fine.

I hope this helps

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