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Scabies - Management
What should I do if someone presents with crusted scabies?
- Seek specialist advice for the management of crusted scabies (e.g. from a consultant dermatologist).
- Where appropriate, investigate for an underlying immunodeficiency (e.g. suspected HIV).
Basis for recommendation
- These recommendations are based on expert opinion from the medical literature [McCarthy et al, 2004; HPA, 2005; Johnston and Sladden, 2005].
- People with crusted scabies may not respond to treatment with topical insecticides alone and may require oral ivermectin in combination with a topical insecticide.
- Oral ivermectin is available on a named-person basis only.
- There is evidence that doses of ivermectin 200 micrograms/kg given 2 weeks apart are effective for treating crusted scabies, however relapses may occur in severe cases and require additional doses [McCarthy et al, 2004].
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