Potential Risk 

Complications from Scabies

• Post scabies dermatitis with pruritus

• Treatment: topical or oral corticosteroid

• It is a superficial inflammation of the skin. Initially there is mild to moderate erythema and local edema, followed by vesicle formation with oozing and then crusting and scaling. If the dermatitis persists, there will be evidence of excoriation from scratching and thickening of the skin, and the color becomes more brownish. Secondary infection may result. Crusts and scales are not removed but are allowed to drop off naturally as the skin heals. Topical corticosteroids are applied to dry lesions. Systemic corticosteroids may be given in acute extensive exacerbations.

• Secondary infections:

• Treatment: Systemic antibiotics

It occurs as a result of ulceration or excoriations from excessive scratching of the affected area. Pathogenic mites penetrate and burrows into the affected area causing infection. Systemic antibiotics are prescribed when infection is present.

• Post scabies papules or nodules:

  Treatment: Coal tar gels.  It is the result of repeated cycle of scabies infection or failure to comply with the complete medication and treatment regimen.

Diagnosis:

• Appearance of the lesion, and the intense itching and finding of the causative mite

• Scraping from its burrow with a hypodermic needle or curette, and then examined under low power of the microscope or by hard lens.

Management:

Treatment and care have two focuses. The first is to help in the treatment. Second, good hygiene and daily linen changes should be encouraged to minimize spread of scabies and assist in control. Health teachings should include family members and persons in close contact to minimize spread of scabies and promote disease control. Pediculicides are best recommended for patients with scabies. Complete course of treatment must be followed accordingly. Sensitivity to pediculicides must be assessed prior to usage of the product to prevent further complications.

Guidelines for Applying Pediculicides

1. Apply pediculicide shampoo to dry hair until hair is thoroughly and work shampoo into a lather.

2. Allow product to remain on hair for stated period (varies with product).

3. Rinse hair and allow to dry

4. Use a fine-toothed comb to remove dead lice and nits; rinse comb in vinegar after treatment; comb should not be shared by other family members.

5. Repeat treatment in 8 to 10 days to remove any hatched nits.

Body

1. Apply pediculicide lotion or cream to affected areas.

2. Bathe after 12 hours and put on clean clothes.

Guidelines for Teaching the Person with Pediculosis/Scabies

1. Use only the prescribed amount of pediculicide, to prevent toxicity.

2. If pediculicide accidentally contacts the eyes, flush eyes immediately with water.

3. Wash brushes and combs with pediculicide.

4. Wash or dry-clean clothing and linens (garments can be stored for 1 month and will no longer be infested).

5. Vacuum carpets, mattresses, and upholstery.

6. All persons in household should use lotion or shampoo and use separate combs or brushes to decrease spread of infection.

7. Itching may continue for 4 to 6 weeks; use menthol or phenol lotion for comfort.