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lots of info on scabies well written Scabies is highly contagious and is usually transmitted by direct personal contact It typically presents as an intensely pruritic eruption The symptoms may resemble numerous other disorders especially atopic dermatitis or dermatitis herpetiformis and other insect infestations Atypical presentations are common in Norwegian scabies and in childhood scabies Norwegian scabies occurs in institutionalized patients and in those with immune system deficiency The female scabies mite burrows into the skin depositing eggs and fecal pellets called scybala The classic lesion is a threadlike wavy gray-white papule several millimeters in length It typically appears on the wrists elbows belt line the aureole in women and the genitalia in men Infestation is documented by obtaining skin scrapings and visualizing the mite its eggs or scybala on low-power microscopy The treatment of choice is 5 percent permethrin cream used in a single application at bedtime and removed the next morning Because of infectivity it is recommended that bed partners and other members of the household be treated concurrently even if they do not display symptoms The rash and itching is a hypersensitivity reaction and there is a lag of 10 to 14 days or longer between infestation and development of symptoms This is important and is the reason asymptomatic intimates of a Scabies patient should be treated Low-strength non-prescription permethrin products are not effective Skin lotions containing permethrin lindane or crotamiton are available through the prescription of a physician for the treatment of scabies The lotions are applied to the whole body except the head and neck Sometimes itching may persist but should not be regarded as treatment failure or reinfestation Symptomatic individuals should be treated with a second course of lotion seven to 10 days later followed by a cleansing bath eight hours after application and a change to fresh clothing Scabies is caused by a mite Scabies mites burrow into the skin producing
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