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Scabies Medication

  • Author: Megan Barry, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jun 30, 2016
 

Medication Summary

The mainstay of scabies treatment is the application of topical scabicidal agents, with repeat application in 7 days. The treatment of choice is permethrin 5% lotion. A 2007 Cochrane Review found that topical permethrin appeared to be the most effective treatment for scabies.[50]  Alternative drug therapy includes precipitated sulfur 6% in petrolatum, lindane, benzyl benzoate, crotamiton, and ivermectin; a possible new option is albendazole.[51, 52, 53, 54]  Regarding ivermectin,  a second course of treatment is often recommended 7-10 days later because of some developing larvae that may survive the initial treatment.[55]

Pruritus can be treated with an oral antihistamine, such as hydroxyzine hydrochloride (Atarax), diphenhydramine hydrochloride (Benadryl), or cyproheptadine hydrochloride (Periactin). More severe symptoms may require a short course of topical or oral steroids.

Secondary infections may require antibiotics, which should be prescribed based on culture and sensitivity data.

Scabies outbreaks in nursing homes and cases of crusted scabies may require combination therapy consisting of topical application of permethrin and 2 oral doses of ivermectin at 200 mcg/kg (administered 1 wk apart).[56] Bullous scabies may respond to ivermectin therapy.[57]

Observations, however, have noted emerging drug resistance to oral ivermectin and 5% permethrin.[58] Drug resistance is emerging as a concern with repeated administration. Clinical resistance has not been documented for permethrin use, but it has been documented in 2 people with crusted scabies who had repeated regimens of multiple doses of ivermectin.7 Thus, the need to define molecular mechanisms of drug resistance in scabies mites is urgent, as is the development and assessment of alternative therapeutic options.[59]

Benzyl benzoate,an ester of benzoic acid and benzyl alcohol, is neurotoxic to mites and has been used. It is not available in the United States[8] and is not FDA approved as a scabicide, although it is used in Europe.[46]

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Antiparasitic Agents

Class Summary

Treatment options include either topical or oral medication. Topical options include permethrin cream (drug of choice), lindane, benzyl benzoate, crotamiton lotion and cream, sulfur, topical ivermectin, tea tree oil, or oil of the leaves of Lippia multiflora Moldenke, a shrub found growing in West African savanna. Oral options include ivermectin, although it has not been approved by US Food and Drug Administration (FDA) for the treatment of scabies. A second course of treatment is often recommended 7-10 days later because of some developing larvae that may survive the initial treatment.

The Centers for Disease Control and Prevention (CDC) recommends treatment with either permethrin lindane or ivermectin. Permethrin is the drug of choice in the United States and the United Kingdom, but it is not available in France. In some studies, it has been shown to be more effective than a single dose of oral ivermectin, although it has equivalent efficacy when 2 doses of ivermectin are used at time zero and 2 weeks later. In severe cases, a topical medication may be used with oral medication (ivermectin).

A 2007 Cochrane Review found that topical permethrin appeared to be the most effective treatment for scabies.

Drug resistance is emerging as a concern with repeated administration. Clinical resistance has not been documented for permethrin use, but it has been documented in 2 people with crusted scabies who had repeated regimens of multiple doses of ivermectin.

Permethrin (Acticin, Elimite)

 

A neurotoxin that causes paralysis and death in ectoparasites, permethrin 5% cream is the drug of choice for scabies treatment, especially in infants over age 2 months and small children. It is more effective than crotamiton in treating symptoms and reducing chances of secondary bacterial infection.

The lotion should be applied over the entire body, including the face and scalp in infants. It should be left on for 8-12 hours and then rinsed. Reapplication 1 week later is advised; however, no controlled studies have demonstrated that 2 applications are more effective than 1.

Lindane

 

This is available in 1% lotion or cream. Lindane stimulates the nervous system of parasites, causing seizures and death. It was previously the standard treatment for scabies but is now considered a second-line drug, to be used if other agents fail or are not tolerated. Lindane is not safe in children or neonates, because of increased transcutaneous absorption leading to possible neurotoxicity. The systemic absorption rate of lindane is 10 times greater than that of permethrin, and its serum levels are more than 40 times higher. Overall, permethrin is a safer choice.

Sulfur topical (Sulpho-Lac, Sulfo-Lo)

 

This is the oldest scabicide, although it has not received FDA approval for scabies treatment. Topical sulfur is one of only a few scabicidal agents that can be used safely in very small children (< 2 mo) and in pregnant women. Sulfur is messy, malodorous, stains clothes, and requires repeat applications, thus reducing compliance. Sulfur should be used only when a patient cannot tolerate permethrin, lindane, or ivermectin. It is inexpensive and can be used for mass therapy in resource-poor economies. Creams or ointments ranging from 2-10% (6% preferred) are available.

Crotamiton (Eurax)

 

Crotamiton is a 10% cream or lotion for the treatment of scabies. Its mechanism of action is unknown, and the drug is associated with frequent treatment failures.

Ivermectin (Stromectol)

 

Ivermectin binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death. It is available in 3- and 6-mg tablets. The drug is currently approved for the treatment of human onchocerciasis and strongyloidiasis. Although it is not approved by the FDA for the treatment of scabies, it is widely administered for this purpose, with the literature supporting its use.

Ivermectin is a synthetic macrocyclic lactone belonging to the avermectin group of antibiotics. It has no antibiotic activity but is active against a number of endoparasites and ectoparasites of humans and animals. Ivermectin is an ideal agent in cases in which topical therapy is difficult or impractical, such as in widespread institutional infestations and bedridden patients. Patients with crusted scabies may require 3 or more doses, given at 1- to 2-week intervals.

Ivermectin is contraindicated in patients with allergic sensitization or nervous system disorders and in women who are pregnant or breastfeeding. Children younger than 5 years or weighing less than 15 kg should not be treated with ivermectin.

One study compared the efficacy of ivermectin with benzyl benzoate lotion in the treatment of scabies and found that ivermectin was at least as effective as the other drug and led to more rapid improvement. The efficacy of benzyl benzoate lotion and permethrin were also evaluated in a retrospective, matched cohort study of pregnant women. No adverse effects on pregnancy outcome were reported in patients using either drug.

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Topical Antibiotics

Class Summary

These agents are used to treat secondarily infected lesions.

Mupirocin (Bactroban, Centany)

 

This agent is used to treat infection with Staphylococcus species, beta-hemolytic streptococci, or Streptococcus pyogenes. It inhibits protein and ribonucleic acid (RNA) synthesis by inactivating transfer-RNA synthetase.

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Corticosteroids, Topical

Class Summary

These agents may be applied to help control intense pruritus caused by scabies.

Hydrocortisone, topical (Westcort, U-Cort, Ala Cort, Rederm)

 

This is an adrenocorticosteroid derivative that is suitable for application to skin or external mucous membranes. It has mineralocorticoid and glucocorticoid effects that result in anti-inflammatory activity. Hydrocortisone is considered the lowest-potency topical steroid.

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Contributor Information and Disclosures
Author

Megan Barry, MD Resident Physician, Department of Dermatology, University of Virginia School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Catharine Lisa Kauffman, MD, FACP Georgetown Dermatology and Georgetown Dermpath

Catharine Lisa Kauffman, MD, FACP is a member of the following medical societies: American Academy of Dermatology, Royal Society of Medicine, Women's Dermatologic Society, American Medical Association, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Barbara B Wilson, MD Edward P Cawley Associate Professor, Department of Dermatology, University of Virginia School of Medicine

Barbara B Wilson, MD is a member of the following medical societies: Alpha Omega Alpha, Medical Society of Virginia, Sigma Xi, American Academy of Dermatology

Disclosure: Nothing to disclose.

Adam J Rosh, MD Assistant Professor, Program Director, Emergency Medicine Residency, Department of Emergency Medicine, Detroit Receiving Hospital, Wayne State University School of Medicine

Adam J Rosh, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Eugene Rozen, MD Resident Physician, Department of Emergency Medicine, Detroit Receiving Hospital

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

William D Binder, MD Clinical Instructor in Emergency Medicine, Brown University Medical School; Consulting Staff, Instructor, Department of Emergency Medicine, Massachusetts General Hospital

Disclosure: Nothing to disclose.

Jennifer R Casatelli, MD Consulting Staff, Department of Pediatrics, Watson Clinic of Lakeland, Lakeland Regional Medical Center

Disclosure: Nothing to disclose.

Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Kelly M Cordoro, MD Assistant Professor of Clinical Dermatology and Pediatrics, Department of Dermatology, University of California, San Francisco School of Medicine

Kelly M Cordoro, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Association of Professors of Dermatology, Dermatology Foundation, Medical Society of Virginia, National Psoriasis Foundation, Society for Pediatric Dermatology, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Kenneth E Greer, MD Former Professor, Department of Dermatology, University of Virginia School of Medicine; Former Chairman, Department of Dermatology, University of Virginia Medical Center

Disclosure: Nothing to disclose.

Ulrich Hengge, MD, MBA Professor, Department of Dermatology, Heinrich-Heine-University Düsseldorf, Germany

Disclosure: Nothing to disclose.

Daniel J Hogan, MD Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, and Canadian Dermatology Association

Disclosure: Nothing to disclose.

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Mudra Kumar, MD, MBBS, MRCP Associate Professor, Department of Pediatrics, University of South Florida College of Medicine

Mudra Kumar, MD, MBBS, MRCP is a member of the following medical societies: American Academy of Pediatrics and American Society of Hematology

Disclosure: Nothing to disclose.

Audra Malerba, MD Staff Physician, Department of Family Medicine, Long Beach Medical Center, New York

Disclosure: Nothing to disclose.

Amy L McCroskey, MD Resident Physician, Department of Emergency Medicine, Wayne State University Detroit Medical Center, Detroit Receiving Hospital

Amy L McCroskey, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Student Association/Foundation, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Giuseppe Micali, MD Head, Professor, Department of Dermatology, University of Catania School of Medicine, Italy

Giuseppe Micali, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Robert E O'Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Adam J Rosh, MD Assistant Professor, Department of Emergency Medicine, Detroit Receiving Hospital, Wayne State University School of Medicine

Adam J Rosh, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Joseph A Salomone III, MD Associate Professor and Attending Staff, Truman Medical Centers, University of Missouri-Kansas City School of Medicine; EMS Medical Director, Kansas City, Missouri

Joseph A Salomone III, MD is a member of the following medical societies: American Academy of Emergency Medicine, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Joseph Sciammarella, MD, FACP, FACEP, FAAMA Major, MC, USAR Attending Physician, Department of Emergency Medicine, Mercy Medical Center, Rockville Centre, New York

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jeter (Jay) Pritchard Taylor III, MD Compliance Officer, Attending Physician, Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, University of South Carolina School of Medicine; Medical Director, Department of Emergency Medicine, Palmetto Health Baptist

Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Mehta V, Balachandran C, Monga P, Rao R, Rao L. Images in clinical practice. Norwegian scabies presenting as erythroderma. Indian J Dermatol Venereol Leprol. 2009 Nov-Dec. 75(6):609-10. [Medline].

  2. Hay RJ. Scabies and pyodermas--diagnosis and treatment. Dermatol Ther. 2009 Nov-Dec. 22(6):466-74. [Medline].

  3. Kapadia N. Dermatology. Tschudy MM, Arcara KM, eds. The Johns Hopkins Hospital: The Harriet Lane Handbook. 19th ed. Philadelphia, Pa: Mosby Elsevier; 2012. 201-25.

  4. Bezold G, Lange M, Schiener R, Palmedo G, Sander CA, Kerscher M, et al. Hidden scabies: diagnosis by polymerase chain reaction. Br J Dermatol. 2001 Mar. 144(3):614-8. [Medline].

  5. Hicks MI, Elston DM. Scabies. Dermatol Ther. 2009 Jul-Aug. 22(4):279-92. [Medline].

  6. Centers for Disease Control and Prevention. Parasites - Scabies. Available at http://www.cdc.gov/parasites/scabies/index.html. Accessed: July 25, 2013.

  7. Currie BJ, McCarthy JS. Permethrin and ivermectin for scabies. N Engl J Med. 2010 Feb 25. 362(8):717-25. [Medline].

  8. Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006 Apr 20. 354(16):1718-27. [Medline].

  9. Galadari I, Sheriff MO. Cell typing of the scabetic lesion and its clinical correlation. Eur Ann Allergy Clin Immunol. 2006 Feb. 38(2):55-8. [Medline].

  10. Bongiorno MR, Ferro G, Aricò M. Norwegian (crusted) scabies of glans penis in an immunocompetent patient. Br J Dermatol. 2009 Jul. 161(1):195-7. [Medline].

  11. Gladstone HB, Darmstadt GL. Crusted scabies in an immunocompetent child: treatment with ivermectin. Pediatr Dermatol. 2000 Mar-Apr. 17(2):144-8. [Medline].

  12. Feldmeier H, Jackson A, Ariza L, Calheiros CM, Soares Vde L, Oliveira FA, et al. The epidemiology of scabies in an impoverished community in rural Brazil: presence and severity of disease are associated with poor living conditions and illiteracy. J Am Acad Dermatol. 2009 Mar. 60(3):436-43. [Medline].

  13. Accorsi S, Barnabas GA, Farese P, Padovese V, Terranova M, Racalbuto V, et al. Skin disorders and disease profile of poverty: analysis of medical records in Tigray, northern Ethiopia, 2005-2007. Trans R Soc Trop Med Hyg. 2009 May. 103(5):469-75. [Medline].

  14. Amro A, Hamarsheh O. Epidemiology of scabies in the West Bank, Palestinian Territories (Occupied). Int J Infect Dis. 2012 Feb. 16(2):e117-20. [Medline].

  15. Makigami K, Ohtaki N, Ishii N, Yasumura S. Risk factors of scabies in psychiatric and long-term care hospitals: a nationwide mail-in survey in Japan. J Dermatol. 2009 Sep. 36(9):491-8. [Medline].

  16. Jack AR, Spence AA, Nichols BJ, Chong S, Williams DT, Swadron SP, et al. Cutaneous conditions leading to dermatology consultations in the emergency department. West J Emerg Med. 2011 Nov. 12(4):551-5. [Medline]. [Full Text].

  17. Makigami K, Ohtaki N, Yasumura S. A 35-month prospective study on onset of scabies in a psychiatric hospital: discussion on patient transfer and incubation period. J Dermatol. 2012 Feb. 39(2):160-3. [Medline].

  18. Muhammad Zayyid M, Saidatul Saadah R, Adil AR, Rohela M, Jamaiah I. Prevalence of scabies and head lice among children in a welfare home in Pulau Pinang, Malaysia. Trop Biomed. 2010 Dec. 27(3):442-6. [Medline].

  19. Gilmore SJ. Control strategies for endemic childhood scabies. PLoS One. 2011 Jan 25. 6(1):e15990. [Medline]. [Full Text].

  20. Feldmeier H, Heukelbach J. Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues. Bull World Health Organ. 2009 Feb. 87(2):152-9. [Medline]. [Full Text].

  21. Heukelbach J, Wilcke T, Winter B, Feldmeier H. Epidemiology and morbidity of scabies and pediculosis capitis in resource-poor communities in Brazil. Br J Dermatol. 2005 Jul. 153(1):150-6. [Medline].

  22. Lokuge B, Kopczynski A, Woltmann A, et al. Crusted scabies in remote Australia, a new way forward: lessons and outcomes from the East Arnhem Scabies Control Program. Med J Aust. 2014 Jun 16. 200(11):644-8. [Medline].

  23. Sardana K, Mahajan S, Sarkar R, Mendiratta V, Bhushan P, Koranne RV, et al. The spectrum of skin disease among Indian children. Pediatr Dermatol. 2009 Jan-Feb. 26(1):6-13. [Medline].

  24. Cydulka RK, Garber B. Dermatologic Presentations. Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Elsevier's Health Sciences; 2010. Vol 2: 1545-6.

  25. Swe PM, Zakrzewski M, Kelly A, Krause L, Fischer K. Scabies mites alter the skin microbiome and promote growth of opportunistic pathogens in a porcine model. PLoS Negl Trop Dis. 2014 May. 8(5):e2897. [Medline]. [Full Text].

  26. Edison L, Beaudoin A, Goh L, Introcaso CE, Martin D, Dubray C, et al. Scabies and Bacterial Superinfection among American Samoan Children, 2011-2012. PLoS One. 2015. 10 (10):e0139336. [Medline].

  27. Brook I. Microbiology of secondary bacterial infection in scabies lesions. J Clin Microbiol. 1995 Aug. 33(8):2139-40. [Medline]. [Full Text].

  28. Chung SD, Wang KH, Huang CC, Lin HC. Scabies increased the risk of chronic kidney disease: a 5-year follow-up study. J Eur Acad Dermatol Venereol. 2013 Feb 1. [Medline].

  29. Chung SD, Lin HC, Wang KH. Increased risk of pemphigoid following scabies: a population-based matched-cohort study. J Eur Acad Dermatol Venereol. 2013 Mar 18. [Medline].

  30. Hewitt KA, Nalabanda A, Cassell JA. Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England. Epidemiol Infect. 2014 Sep 8. 1-10. [Medline].

  31. Arya V, Molinaro MJ, Majewski SS, Schwartz RA. Pediatric scabies. Cutis. 2003 Mar. 71(3):193-6. [Medline].

  32. Cestari TF, Martignago BF. Scabies, pediculosis, bedbugs, and stinkbugs: uncommon presentations. Clin Dermatol. 2005 Nov-Dec. 23(6):545-54. [Medline].

  33. Lewin J, Liang C, Pomeranz M. A critical oversight: an irksome ailment became life-threatening after misdiagnosis. Am J Obstet Gynecol. 2010 Aug. 203(2):188.e1-2. [Medline].

  34. Scheinfeld N. Controlling scabies in institutional settings: a review of medications, treatment models, and implementation. Am J Clin Dermatol. 2004. 5(1):31-7. [Medline].

  35. Hong MY, Lee CC, Chuang MC, Chao SC, Tsai MC, Chi CH. Factors related to missed diagnosis of incidental scabies infestations in patients admitted through the emergency department to inpatient services. Acad Emerg Med. 2010 Sep. 17(9):958-64. [Medline].

  36. Svecova D, Chmurova N, Pallova A, Babal P. Norwegian scabies in immunosuppressed patient misdiagnosed as an adverse drug reaction. Epidemiol Mikrobiol Imunol. 2009 Aug. 58(3):121-3. [Medline].

  37. Bakker CV, Terra JB, Pas HH, Jonkman MF. Bullous pemphigoid as pruritus in the elderly: a common presentation. JAMA Dermatol. 2013 Aug 1. 149(8):950-3. [Medline].

  38. Phan A, Dalle S, Balme B, Thomas L. Scabies with clinical features and positive darier sign mimicking mastocytosis. Pediatr Dermatol. 2009 May-Jun. 26(3):363-4. [Medline].

  39. Walton SF, Currie BJ. Problems in diagnosing scabies, a global disease in human and animal populations. Clin Microbiol Rev. 2007 Apr. 20(2):268-79. [Medline]. [Full Text].

  40. Clyti E, Deligny C, Versapuech J, Couppie P, Gessain A, Pradinaud R. [Acral crusted scabies in two HTLV1-infected patients]. Ann Dermatol Venereol. 2010 Mar. 137(3):232-3. [Medline].

  41. Neynaber S, Muehlstaedt M, Flaig MJ, Herzinger T. Use of Superficial Cyanoacrylate Biopsy (SCAB) as an alternative for mite identification in scabies. Arch Dermatol. 2008 Jan. 144(1):114-5. [Medline].

  42. Albrecht J, Bigby M. Testing a test: critical appraisal of tests for diagnosing scabies. Arch Dermatol. 2011 Apr. 147(4):494-7. [Medline].

  43. Walter B, Heukelbach J, Fengler G, Worth C, Hengge U, Feldmeier H. Comparison of dermoscopy, skin scraping, and the adhesive tape test for the diagnosis of scabies in a resource-poor setting. Arch Dermatol. 2011 Apr. 147(4):468-73. [Medline].

  44. Lawrence G, Leafasia J, Sheridan J, Hills S, Wate J, Wate C, et al. Control of scabies, skin sores and haematuria in children in the Solomon Islands: another role for ivermectin. Bull World Health Organ. 2005 Jan. 83(1):34-42. [Medline]. [Full Text].

  45. Kearns TM, Speare R, Cheng AC, McCarthy J, Carapetis JR, Holt DC, et al. Impact of an Ivermectin Mass Drug Administration on Scabies Prevalence in a Remote Australian Aboriginal Community. PLoS Negl Trop Dis. 2015 Oct. 9 (10):e0004151. [Medline].

  46. Karthikeyan K. Treatment of scabies: newer perspectives. Postgrad Med J. 2005 Jan. 81(951):7-11. [Medline]. [Full Text].

  47. Centers for Disease Control and Prevention. Parasites - Scabies - Workplace Frequently Asked Questions (FAQs). Available at http://www.cdc.gov/parasites/scabies/gen_info/faq_workplace.html. Accessed: September 16, 2013.

  48. Micali G, Lacarrubba F, Lo Guzzo G. Scraping versus videodermatoscopy for the diagnosis of scabies: a comparative study. Acta Derm Venereol. 1999 Sep. 79(5):396. [Medline].

  49. [Guideline] Centers for Disease Control and Prevention. Parasites - Scabies. Suggested General Guidelines. Available at http://www.cdc.gov/parasites/scabies/treatment.html. September 3, 2015; Accessed: April 30, 2016.

  50. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18. CD000320. [Medline].

  51. Ayoub N, Merhy M, Tomb R. Treatment of scabies with albendazole. Dermatology. 2009. 218(2):175. [Medline].

  52. Aubin F, Humbert P. Ivermectin for crusted (Norwegian) scabies. N Engl J Med. 1995 Mar 2. 332(9):612. [Medline].

  53. Huffam SE, Currie BJ. Ivermectin for Sarcoptes scabiei hyperinfestation. Int J Infect Dis. 1998 Jan-Mar. 2(3):152-4. [Medline].

  54. Worth C, Heukelbach J, Fengler G, Walter B, Liesenfeld O, Hengge U, et al. Acute morbidity associated with scabies and other ectoparasitoses rapidly improves after treatment with ivermectin. Pediatr Dermatol. 2012 Jul-Aug. 29(4):430-6. [Medline].

  55. Flinders DC, De Schweinitz P. Pediculosis and scabies. Am Fam Physician. 2004 Jan 15. 69(2):341-8. [Medline].

  56. Tjioe M, Vissers WH. Scabies outbreaks in nursing homes for the elderly: recognition, treatment options and control of reinfestation. Drugs Aging. 2008. 25(4):299-306. [Medline].

  57. Galvany Rossell L, Salleras Redonnet M, Umbert Millet P. [Bullous scabies responding to ivermectin therapy]. Actas Dermosifiliogr. 2010 Jan-Feb. 101(1):81-4. [Medline].

  58. Mounsey KE, Holt DC, McCarthy J, Currie BJ, Walton SF. Scabies: molecular perspectives and therapeutic implications in the face of emerging drug resistance. Future Microbiol. 2008 Feb. 3(1):57-66. [Medline].

  59. Castillo AL, Osi MO, Ramos JD, De Francia JL, Dujunco MU, Quilala PF. Efficacy and safety of Tinospora cordifolia lotion in Sarcoptes scabiei var hominis-infected pediatric patients: A single blind, randomized controlled trial. J Pharmacol Pharmacother. 2013 Jan. 4(1):39-46. [Medline]. [Full Text].

 
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Scabies mite scraped from a burrow (original magnification, 400X).
A typical linear burrow on the flexor forearm. Courtesy of Kenneth E. Greer, MD.
A subtle linear burrow accompanied by erythematous papules on the sole of the foot in a child with scabies. Courtesy of Kenneth E. Greer, MD.
Erythematous papules and papulovesicles on the flexor wrist. Courtesy of Kenneth E. Greer, MD.
Scabies on the penile shaft and glans. Courtesy of William D. James, MD.
Scabietic papules on the penile shaft and scrotum. Courtesy of Kenneth E. Greer, MD.
Widespread eruption on the back of an infant with scabies. Courtesy of Kenneth E. Greer, MD.
Nodular scabies in an infant. Courtesy of Kenneth E. Greer, MD.
Nodular scabies. Courtesy of Kenneth E. Greer, MD.
Crusted scabies. Courtesy of William D. James, MD.
Crusted scabies. Courtesy of Kenneth E. Greer, MD.
Scabies preparation demonstrating a mite and ova. Courtesy of William D. James, MD.
Scabies. Erythematous vesicles and papules are present on torso extremities, some with adjacent linear excoriations.
In routine scabies, a single mite is seen. Eosinophilic spongiosis may be present (hematoxylin and eosin; original magnification, 400X).
Scabies mite in the stratum corneum. Courtesy of William D. James, MD.
In crusted scabies, sections show multiple mites (arrows) within the hyperkeratotic stratum corneum. The epidermis is spongiotic (hematoxylin and eosin; original magnification, 100X).
Scabies. Courtesy of William D. James, MD.
Scabies in the interdigital web spaces. Courtesy of William D. James, MD.
Papulovesicles and nodules on the palm in a patient with scabies. Courtesy of Kenneth E. Greer, MD.
Scabies on buttocks. Courtesy of William D. James, MD.
Scabies on penis. Courtesy of Hon Pak, MD.
 
 
 
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