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Scabies - Management
When should I refer or seek specialist advice?
- Consider referral to a dermatologist if the diagnosis is in doubt, or after continued treatment failure (e.g. if two courses of an insecticide have failed).
- Seek specialist advice from a consultant dermatologist for the management of anyone presenting with crusted scabies. Admission may be required.
- Consider referral to a genito-urinary medicine clinic for specialist advice, diagnostic services, partner notification, and contact tracing if there is a history of risk behaviour for sexually transmitted infections:
- Contact tracing of partners from the previous 2 months should be undertaken.
- Refer institutionalised outbreaks of scabies (e.g. schools, long-stay nursing homes, and prisons) to the Health Protection Agency, as control measures are necessary to deal with all residents, staff and healthcare workers.
- Scabies is rare in children under 2 months of age. Seek specialist advice (e.g. from a paediatric dermatologist) if treatment is required for this age group.
Basis for recommendation
- These recommendation are based on expert opinion from the medical literature and pragmatic advice [HPA, 2005].
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