Scabies Questions & Answers

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. [QxMD MEDLINE Link].

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

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. [QxMD MEDLINE Link].

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

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. [QxMD MEDLINE Link].

8. Veraldi S, De Micheli P, Schianchi R, Pontini P. A new treatment regimen with permethrin in scabies. G Ital Dermatol Venereol. 2018 Aug. 153 (4):491-493. [QxMD MEDLINE Link].

9. Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006 Apr 20. 354(16):1718-27. [QxMD MEDLINE Link].

10. 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. [QxMD MEDLINE Link].

11. 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. [QxMD MEDLINE Link].

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

13. Liu JM, Chiu FH, Lin CY, Chang FW, Hsu RJ. Incidence of autoimmune diseases in patients with scabies: a nationwide population-based study in Taiwan. Rheumatol Int. 2017 Apr 18. [QxMD MEDLINE Link].

14. 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. [QxMD MEDLINE Link].

15. World Health Organization. Neglected tropical diseases: Scabies. Available at https://www.who.int/neglected_diseases/diseases/scabies/en/. May 20, 2019; Accessed: June 7, 2019.

16. 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. [QxMD MEDLINE Link].

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

18. 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. [QxMD MEDLINE Link].

19. 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. [QxMD MEDLINE Link]. [Full Text].

20. 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. [QxMD MEDLINE Link].

21. 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. [QxMD MEDLINE Link].

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

23. 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. [QxMD MEDLINE Link]. [Full Text].

24. 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. [QxMD MEDLINE Link].

25. 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. [QxMD MEDLINE Link].

26. 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. [QxMD MEDLINE Link].

27. 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.

28. 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. [QxMD MEDLINE Link]. [Full Text].

29. 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. [QxMD MEDLINE Link].

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

31. 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. [QxMD MEDLINE Link].

32. 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. [QxMD MEDLINE Link].

33. 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. [QxMD MEDLINE Link].

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

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

36. 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. [QxMD MEDLINE Link].

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

38. 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. [QxMD MEDLINE Link].

39. 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. [QxMD MEDLINE Link].

40. 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. [QxMD MEDLINE Link].

41. 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. [QxMD MEDLINE Link].

42. 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. [QxMD MEDLINE Link]. [Full Text].

43. 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. [QxMD MEDLINE Link].

44. 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. [QxMD MEDLINE Link].

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

46. 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. [QxMD MEDLINE Link].

47. Sanz-Navarro J, Feal C, Dauden E. Treatment of Human Scabies with Oral Ivermectin. Eczematous Eruptions as a New Non-Reported Adverse Event. Actas Dermosifiliogr. 2017 Sep. 108 (7):643-649. [QxMD MEDLINE Link].

48. Abdel-Raheem TA, Méabed EM, Nasef GA, Abdel Wahed WY, Rohaim RM. Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies. J Dermatolog Treat. 2016 Oct. 27 (5):473-9. [QxMD MEDLINE Link].

49. Thadanipon K, Anothaisintawee T, Rattanasiri S, Thakkinstian A, Attia J. Efficacy and safety of antiscabietic agents: A systematic review and network meta-analysis of randomized controlled trials. J Am Acad Dermatol. 2019 May. 80 (5):1435-1444. [QxMD MEDLINE Link].

50. Baudou E, Lespine A, Durrieu G, André F, Gandia P, Durand C, et al. Serious Ivermectin Toxicity and Human ABCB1 Nonsense Mutations. N Engl J Med. 2020 Aug 20. 383 (8):787-789. [QxMD MEDLINE Link].

51. Gilson RL, Crane JS. Scabies (Sarcoptes Scabiei). StatPearls [Internet]. 2020 Jan. [QxMD MEDLINE Link]. [Full Text].

52. Enbiale W, Baynie TB, Ayalew A, Gebrehiwot T, Getanew T, Ayal A, et al. "Stopping the itch": mass drug administration for scabies outbreak control covered for over nine million people in Ethiopia. J Infect Dev Ctries. 2020 Jun 29. 14 (6.1):28S-35S. [QxMD MEDLINE Link].

53. Matthewman J, Manego RZ, Dimessa Mbadinga LB, Šinkovec H, Völker K, Akinosho M, et al. A randomized controlled trial comparing the effectiveness of individual versus household treatment for Scabies in Lambaréné, Gabon. PLoS Negl Trop Dis. 2020 Jun. 14 (6):e0008423. [QxMD MEDLINE Link].

54. Arora P, Rudnicka L, Sar-Pomian M, Wollina U, Jafferany M, Lotti T, et al. Scabies: A comprehensive review and current perspectives. Dermatol Ther. 2020 Jun 2. e13746. [QxMD MEDLINE Link].

55. 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. [QxMD MEDLINE Link]. [Full Text].

56. 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. [QxMD MEDLINE Link].

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

58. 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.

59. Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018 Apr 2. 4:CD012994. [QxMD MEDLINE Link].

60. Thomas J, Davey R, Peterson GM, Carson C, Walton SF, Spelman T, et al. Treatment of scabies using a tea tree oil-based gel formulation in Australian Aboriginal children: protocol for a randomised controlled trial. BMJ Open. 2018 May 31. 8 (5):e018507. [QxMD MEDLINE Link].

61. Bernigaud C, Fang F, Fischer K, Lespine A, Aho LS, Mullins AJ, et al. Efficacy and Pharmacokinetics Evaluation of a Single Oral Dose of Afoxolaner against Sarcoptes scabiei in the Porcine Scabies Model for Human Infestation. Antimicrob Agents Chemother. 2018 Jun 18. [QxMD MEDLINE Link].

62. Gopinath H, Aishwarya M, Karthikeyan K. Tackling scabies: novel agents for a neglected disease. Int J Dermatol. 2018 Apr 16. [QxMD MEDLINE Link].

63. 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. [QxMD MEDLINE Link].

64. Boyer PH, Deboscker S, Hernandez C, Ramsheyi M, Schneider P, Foeglé J, et al. An Undiagnosed Index Case Leading to a Nosocomial Scabies Outbreak: How Mass Single-Dose Ivermectin Treatment Can Help Control a Nosocomial Epidemic. Infect Control Hosp Epidemiol. 2018 May. 39 (5):631-632. [QxMD MEDLINE Link].

65. [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.

66. [Guideline] Executive Committee of Guideline for the Diagnosis and Treatment of Scabies. Guideline for the diagnosis and treatment of scabies in Japan (third edition): Executive Committee of Guideline for the Diagnosis and Treatment of Scabies. J Dermatol. 2017 May 31. [QxMD MEDLINE Link].

67. [Guideline] Sunderkötter C, Feldmeier H, Fölster-Holst R, Geisel B, Klinke-Rehbein S, Nast A, et al. S1 guidelines on the diagnosis and treatment of scabies - short version. J Dtsch Dermatol Ges. 2016 Nov. 14 (11):1155-1167. [QxMD MEDLINE Link].

68. Dressler C, Rosumeck S, Sunderkötter C, Werner RN, Nast A. The Treatment of Scabies. Dtsch Arztebl Int. 2016 Nov 14. 113 (45):757-762. [QxMD MEDLINE Link].

69. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007 Jul 18. CD000320. [QxMD MEDLINE Link].

70. Ayoub N, Merhy M, Tomb R. Treatment of scabies with albendazole. Dermatology. 2009. 218(2):175. [QxMD MEDLINE Link].

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

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

73. 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. [QxMD MEDLINE Link].

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

75. 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. [QxMD MEDLINE Link].

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

77. 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. [QxMD MEDLINE Link].

78. 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. [QxMD MEDLINE Link]. [Full Text].

79. Bernigaud C, Fang F, Fischer K, et al. Efficacy and Pharmacokinetics Evaluation of a Single Oral Dose of Afoxolaner against Sarcoptes scabiei in the Porcine Scabies Model for Human Infestation. Antimicrob Agents Chemother. 2018 Sep. 62 (9):e02334-17. [QxMD MEDLINE Link]. [Full Text].

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, American Medical Association, Royal Society of Medicine, Society for Investigative Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Jonathan Eyal, LLM, LLB Medical Assistant, Georgetown Dermatology

Disclosure: Nothing to disclose.

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.

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, American Academy of Dermatology, Medical Society of Virginia, Sigma Xi, The Scientific Research Honor Society

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.

Megan E Barry, MD Dermatologist, Dermatology PLC, Sentara Medical Group

Disclosure: Nothing to disclose.

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

Disclosure: Nothing to disclose.

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.

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