00:00Human scabies is an extremely pruritic skin infestation caused by the scabies mite,
00:06scientifically known as Sarcoptes scabaei hominis.
00:09It is a common condition worldwide that affects individuals of all age groups.
00:14However, the disease is more prevalent among children and sexually active individuals.
00:19In this video, our primary goal is to explore the various treatment methods available for scabies infestation.
00:25Let's quickly recall the two main types of human scabies.
00:29In classic scabies, which is the most common type, only about 10 to 15 mites live in the host.
00:36During the first month of the infection, only a little evidence of infection exists.
00:41However, in the subsequent weeks, a delayed type of hypersensitivity reaction occurs against the mites, eggs, and their fecal matter,
00:49which gives rise to intense itching associated with scabies.
00:53In the other type, crusted scabies, also known as Norwegian scabies,
00:58Millions of scabies mites live in the host.
01:01It is highly contagious and associated with significant morbidity.
01:05The treatment of scabies is with topical or systemic scabicidal agents.
01:10Antimicrobial therapy may also be required as patients with scabies tend to develop secondary bacterial infections.
01:17Commonly used agents include permethrin cream, oral ivermectin, or lindane cream.
01:22These agents are very effective in the treatment of scabies.
01:26For secondary bacterial infections, oral or topical antibiotic preparations can be administered.
01:32Severe itching associated with scabies is treated with antihistamines, such as hydroxyzine hydrochloride,
01:39diphenhydramine hydrochloride, or cyproheptadine hydrochloride.
01:43In rare occasions, the extensive inflammatory response may be suppressed with oral prednisolone or dexamethasone.
01:51Patients with crusted scabies should be instructed to remove excess scales to allow better penetration of the scabicidal agent.
01:59This process can be facilitated by applying warm water soaks,
02:03followed by application of a keratolytic agent, such as 5% salicylic acid.
02:08Unlike in classic scabies, patients with crusted scabies may require repeated applications of topical scabicides for a long time due to heavy mite burden.
02:18In addition, simultaneous use of topical agents with oral ivermectin yields relatively better results.
02:25Finally, it is important to advise the patient and family members regarding preventive methods to reduce the risk of reinfestation of scabies.
02:33All household members and close personal contacts older than 2 months and not pregnant should be treated for scabies,
02:40even if they have no symptoms or signs of infestation.
02:44Patients should be advised to wash clothing, bed linens, and towels in hot water, and dry them in bright sunlight.
02:50Other non-washable equipments should also be disinfected appropriately.
02:54All carpets and upholstered furniture should be vacuumed and the vacuum bags immediately discarded.
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