Scabies is an infestation with the mite Sarcoptes scabei var. hominis, which is spread by close skin-to-skin contact. The female mite burrows into the human stratum cor-neum and lays her eggs. Affected individuals become sensitized to the mite and to their waste products. Individuals who are immunosuppressed may develop extensive infestation. Scabies presents as a severe generalized pruritus, affecting the trunk and limbs, which is often worse at night. The patient may have a generalized eczematous rash which may become impetiginized, and small linear streaks of scabies burrows may be seen, in particular on the flexural aspect of the wrists, on the palm, on the sides of the fingers, and on the soles of the feet. In men, papular lesions on the genitalia are common. Norwegian scabies is characterized by infestation with large numbers of mites and is most commonly seen in immunosuppressed patients, such as those with leukemia or HIV infection. Patients develop crusted water lesions on the hands and feet which contain hundreds of mites. This form of scabies is highly contagious owing to the large number of mites present.

Benzyl benzoate (25% lotion), 10% sulfur in yellow soft paraffin, lindane (1% lotion), malathion (0.5% lotion), and permethrin (5% cream), all are effective. However, lindane should be avoided during pregnancy or in nursing mothers. It is important that all members of an affected household and any person having close physical contact should be treated whether symptomatic or not. Treatment should be applied to the whole body and in infants and younger children this should include the scalp, neck, face, and ears. It is important that all areas, particularly the finger and toe web spaces, and the genital areas are adequately treated. Two "coats" should be applied (using a 2-in. paint brush for lotions if possible) to ensure all areas are treated. The treatment should be washed off after 24 h and all clothing changed. The most common causes of treatment failure are failure to treat all members of a household or failure to treat all areas of the body. It is important to warn patients that the pruritus associated with infestation may persist for several days after treatment, and topical steroids applied after successful treatment of the mites can help to settle the pruritus.

F. Insect Bites

Some individuals seem particularly sensitive to bites from flea and other insects. They develop pruritic papules and sometimes blister at the site of injury. Topical corticosteroids may be of benefit, and any potential animal source should be treated.

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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