Scabies

43

Clinical practice guideline for scabies

(scabies)


Sarcoptes scabiei var hominis ectoparasite
3-6 5-15 1 ,

endemic , ,

300

-
(generalized and intense itching)
-

- burrows


- , eczema, scabiatic nodules

-
, , , ,

44

- ,

(crusted Norwegian scabies)

-
burrow , , (eggshell
fragments) (fecal pellets scybala)

- mineral oil potassium hydroxide pellets

rule out
therapeutic diagnosis

- Eczematous dermatitis contact dermatitis

- Impetigo
- (pediculosis pubis)
- papular urticaria

Streptococcus pyogenes Staphylococcus aureus acute glomerulonephritis

(standard treatments)
ectoparasite 3

1.

2.
3.
60o C
48-72
4.

45

1. 1% gamma benzene hexachloride (Lindane) 1 ( 814 ) 7

- clinical study gamma benzene hexachloride
86
- gamma benzene hexachloride neurotoxicity
2 , ,
/

- gamma benzene hexachloride second-line

treatment
2. 5% Permethrin gamma benzene hexachloride neurotoxicity
- clinical study 5% permethrin
91-98
- Centers for Disease Control and Prevention (CDC) permethrin first-line
topical therapy
- .. 2552

1. Benzyl benzoate
gamma benzene hexachloride permethrin
benzyl benzoate full strength 25%
10 12.5 %
1-3 7
2. 5-10% Sulfur ointment


7 3 3
crotamiton, pyrethrin, tea tree oil, malathion, topical ivermectin

Ivermectin
- ()
- HIV
-
- crusted scabies eczematization
neurotoxicity
- contraindication

46


- 150-200 cure rate 70
permethrin
2 cure rate 95
- ivermectin encephalopathy

1.
2.
Crusted scabies scabies
lindane neurotoxicity
ivermectin keratolytics
1 Level of evidence Strength of Recommendation

Gamma
benzene
hexachloride
Permethrin
Benzyl benzoate
Sulfur ointment
Ivermectin

Level of evidence
1

Strength of recommendation
A

1
1
1
1

A
A
A
A

- 4
hypersensitivity scabiatic nodules

-

1. Chosidow O. Clinical practices. Scabies. N Eng J Med 2006; 354(16): 1718-27.

2. Scheinfeld N. Controlling scabies in institutional settings: a review of medications, treatment models, and
implementation. Am J Clin Dermatol 2004; 5(1): 31-7.
3. Karthikeyan K. Scabies in children. Arch Dis Child Educ Pract 2007; 92: 65-9.
4. Strong M, Johnstone PW. Interventions for treating scabies. Cochrane Database of Syst Rev. 2007; 3: CD000320.

47