Scabies

Question 1

What are 4 symptoms of scabies?

Answer 1

1. Intense itching, especially at night or after a hot shower
2. Visible burrows on the skin, typically finger webs, armpits, genitals (i.e., skin creases)
3. A bump or pimple-like rash that is difficult to see
4. Small, clear, fluid-filled spots or lesions

Question 2

Does scabies require a counselling room?

Answer 2

Yes

Question 3

What are 5 red flags for referral with scabies?

Answer 3

1. Children < 2 years.
2. Immunosuppressed patients.
3. Signs of secondary infection for example, yellow discharge, crust on skin.
4. Treatment failure.
5. Unclear diagnosis.

Question 4

Does scabies have a PSA self-care card?

Answer 4

Yes (Scabies)

Question 5

What is the preferred treatment option for scabies?

Answer 5

Permethrin 5% (Lyclear)

Question 6

What are the directions for Permethrin 5% (Lyclear) in scabies?

Answer 6

Adults and children over 2 months: Apply from the chin down particularly between fingers, toes and genitalia and wash off with warm, soapy water 8 to 14 hours later. Best applied before bedtime and washed off in the morning. Rinse thoroughly. Repeat after 7 days

Question 7

What is 1 non-preferred option for scabies and why?

Answer 7

1. Benzyl benzoate (unfavourable in pregnancy/breastfeeding and efficacy reduced by dilution in children)

Question 8

Is Permethrin 5% (Lyclear) safe in pregnancy?

Answer 8

Yes

Question 9

Is Permethrin 5% (Lyclear) safe in breastfeeding?

Answer 9

Yes (but should be washed from nipples before breastfeeding)

Question 10

What is the age range for Permethrin 5% (Lyclear)?

Answer 10

Safe in infants over 2 months

Question 11

What are 8 pieces of non-pharmacological advice for scabies?

Answer 11

1. Check other family members for scabies. Treat them regardless
2. Use gloves when handling the products or wash hands thoroughly afterwards
3. Ensure to repeat the treatment after 7 days
4. Any clothing, bedding or towels that were in contact with the person in the past 2-3 days should be washed on a hot cycle or dry-cleaned
5. Items that cannot be washed should be stored in tightly sealed plastic bags for at least 3 days
6. Avoid prolonged physical contact with others to reduce transmission
7. Exclude from others until 24hours after appropriate treatment has started
8. Avoid scratching the area, an antihistamine may be used to relieve itch.

Question 12

Does scabies cause a rash?

Answer 12

In scabies, there is usually not many rashes to be seen because the mites bury into the skin. In elderly people, the rash may appear more widespread. In children, areas such as the face, scalp, palms, and soles of the feet are often affected

Question 13

How long does it usually take for symptoms to present in scabies?

Answer 13

Symptoms usually develop two to four weeks after infection. However, people who have previously been exposed may develop symptoms within 24 to 48 hours, because the immune system takes less time to respond.

Question 14

How long does it take to see improvement of symptoms with scabies?

Answer 14

Improvement usually occurs within 1 or 2 days of treatment. The itch may persist for 2-3 weeks after treatment, even if the scabies has been effectively treated. This is because the itch is caused by the body’s immune system responding to the mites and may take time to settle down. Reinvestigate if itch last >4 weeks

Question 15

When is a person considered to no longer be infectious with scabies?

Answer 15

Generally, a person is no longer infectious 24 hours after treatment.

Question 16

Do contacts of a scabies patient require treatment?

Answer 16

Sexual partners and family members also require treatment