#f left untreated$ the condition can persist for many years" #n immunocom immunocompetent petent indi!iduals$ indi!iduals$ the number number of mites may decrease o!er time"
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Treatment •
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atients should be educated that e+cessi!e &ashing of the s'in &ith harsh soap &il aggra!ate their s'in irritation" ral antihistamine and emollients can be bene*cial"
Secon da dary impetiginizatio n ma y occur and poststrept poststreptococ ococcal cal glomerulon glomerulonephrit ephritis is has resulted resulted from scab scabie iesi sind nduc uced ed pyod pyoder erma mas s caus caused ed by Streptococcus pyogenes. Lymphangitis and septicemia ha!e also been reported in crusted scabies" Scabies infestation can also trigger bullous pemphigoid"
Prognosis •
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Scabies is treated by a combination of a scabicide and fomite control" %suall %sually y a &ee' &ee' after after the initia initiall treat treatmen ment$ t$ a second second appl applic icat atio ion n is re(u re(uir ired ed to redu reduce ce the the poten potenti tial al for for reinfestation from fomites as &ell as to 'ill any nymphs that may ha!e hatched after treatment" )opical )opical scabicides are applied o!ernight to the entire s'in surface &ith special attention to *nger and toe creases$ cleft cleft of the buttoc buttoc's$ 's$ belly belly button button$$ and beneath beneath the *ngernails and toenails" #n adults$ one can e+clude treating the scalp and face" ,ost treated indi!iduals e+perience relief from symptoms &ithin 3 days$ but patients must be informed that e!en after ade(uate scabicidal therapy$ the rash and pruritus may persist for up to - &ee's .postscabetic itch/"
regnant regnant females$ females$ breastfeed breastfeeding ing mothers$ mothers$ and children children under 2 years should limit their t&o applications .1 &ee' apart/ to 2 hours only &hen using permethrin" #n crusted scabies$ the combination of oral i!ermectin and a topi topica call scab scabic icid ide e are are reco recomm mmend ended ed as the the oral oral medication &ill not penetrate into the thic'ness of the 'eratinous debris under the nails"
Prevention •
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Because of the common occurence of asymptomatic mite carriers in the household$ all family members and close contacts should be treated simultaneously" simultaneously" fter fter treatment treatment$$ treated treated indi!iduals indi!iduals should &ear clean clothing$ and all clothing$ pillo& cases$ to&els and bedding used during the pre!ious &ee' should be &ashed in hot &ater and dried at high heat" 4on&ashables should be drycleaned$ ironed$ put in the clothe clothes s dryer dryer &ithou &ithoutt &ashin &ashing$ g$ or stored stored in a sealed sealed plastic bag in a &arm area for 2 &ee's" 5loors$ carpets$ upholstery .in both home and car/ play areas$ and furniture shoul be carefully !acuumed" 5umigation of li!ing spaces is not recommended"
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ets also do not need to be treated becuse they do not harbor the human scabies mite"
Reference: Fitzpatrick’s Dermatology in General Medicine, 8t !dition
