What are the guideline sources, guidelines and references for Scabies ?
Guideline sources The following summarized guidelines for the evaluation and management of scabies are prepared by our editorial team based on guidelines from the American Association of Family Physicians (AAFP 2019) and the International Union Against Sexually Transmitted Infections (IUSTI 2017). 1 2 Guidelines 1. Screening and diagnosis Diagnosis: consider the diagnosis of scabies when evaluating a patient with a papular, pruritic rash. C 2. Diagnostic investigations Screening for sexually transmitted infections: screen for sexually-transmitted infections (including human immunodeficiency virus) in patients with scabies who are sexually active. B https://web.pathway.md/diseases/rec1XfAR4rBTaQXme 1/3 6/24/23, 3:06 PM Scabies Pathway 3. Medical management First-line therapy: Offer one of the following medications as first-line therapy: permethrin 5% cream applied head to toe and washed off after 8-12 h, repeat after 7-14 days B ivermectin PO 200 g/kg taken with food, repeat after 7 days B benzyl benzoate 10-25% lotion applied once daily at night on 2 consecutive days, repeat after 7 days B Alternative treatment options: As per AAFP 2019 guidelines, reserve ivermectin for patients with classic scabies not improving with topical permethrin. B As per IUSTI 2017 guidelines: Consider the following medications as alternative treatment options: malathion 0.5% aqueous lotion C ivermectin 1% lotion B sulfur 6-33% cream, ointment or lotion applied on 3 successive days B synergized pyrethrins foam C Avoid agricultural grade malathion for treating human infestations as it can induce acute toxicity. D Management of crusted scabies: Use the combination of the following agents in patients with crusted scabies: topical permethrin (5% cream) or benzyl benzoate (25% lotion), repeated daily for 7 days then twice weekly until cure oral ivermectin PO 200 g/kg on days 1, 2, and 8. B Offer additional ivermectin treatment on days 9 and 15 or on days 9, 15, 22, and 29 in patients with severe disease, based on persistent live mites on skin scrapings at the follow-up visit. B Management of sexual partners: assess and treat individuals who have been sexual partners of an infected patient within the past 2 months. B 4. Nonpharmacologic interventions Decontamination measures: Decontaminate clothing, bedding, towels and other items with one of the following methods: laundering with a washing machine ( 50 C or 122 F) dry-cleaning storing in a sealed plastic bag for 1 week. B 5. Specific circumstances https://web.pathway.md/diseases/rec1XfAR4rBTaQXme 2/3 6/24/23, 3:06 PM Scabies Pathway Pregnant patients: consider using benzyl benzoate and sulfur in pregnant patients, given their evidence for safety in this population. C 6. Patient education General counseling: provide patients with a detailed explanation of their infestation together with clear written information. B Close contact precautions: advise avoidance of close contact until both patient and sexual partners have completed treatment. B 7. Follow-up and surveillance Follow-up: arrange a follow-up visit 2 weeks after completion of treatment for a test of cure by microscopy examination. B References 1. C M Salavastru, O Chosidow, M J Boffa et al. European guideline for the management of scabies. J Eur Acad Dermatol Venereol. 2017 Aug;31 8 1248 1253. Open 2. Karen Gunning, Bernadette Kiraly, Karly Pippitt. Pediculosis and Scabies: A Treatment Update. Am Fam Physician. 2019 May 15;99 10 635 642. Open 3. Alexander K C Leung, Joseph M Lam, Kin F Leong. Scabies: A Neglected Global Disease. Curr Pediatr Rev. 2020;16 1 33 42. Open 4. Cristina Thomas, Sarah J Coates, Daniel Engelman et al. Ectoparasites: Scabies. J Am Acad Dermatol. 2020 Mar;82 3 533 548. Open 5. Daniel Engelman, L Claire Fuller, Andrew C Steer et al. Consensus criteria for the diagnosis of scabies: A Delphi study of international experts. PLoS Negl Trop Dis. 2018 May 24;12 5):e0006549. Open https://web.pathway.md/diseases/rec1XfAR4rBTaQXme 3/3