Operational Obstetrics & Gynecology

Scabies

   

   

Scabies is a skin infection with small (1/2 mm) mites, Sarcoptes scabiei.

The mites burrow into the skin, laying their eggs in a trail behind them. About a month after the infection, there is a hypersensitivity skin reaction, with raised, intensely itchy skin lesions, most noticeable at night.

The burrows (tunnels) from the mites can be seen through the skin as thin, serpentine, scaly lines of up to 1 cm in length. They are most commonly found in the fingerwebs, elbows, axilla, and inner surface of the wrists. They are also seen commonly on the breast areolae of women and along the belt line and genitals of men.

The infection is spread by skin-to-skin contact with an infected person.

The diagnosis is made by visualizing a burrow and confirmed by microscopic visualization of the mite, ova or fecal pellets in scrapings of the burrow suspended in oil.

Treatment is:

  • 5% permethrin cream (Nix, Elimite) applied to the skin from the neck down and left in place for 10 to 14 hours before washing off. Itching may persist for up to one month and should not be viewed as an indicator of failed treatment.
  • If permethrin is not available, 1% lindane(Kwell lotion or shampoo) once after showering and left in place for 10 minutes before rinsing. This may be repeated in 7 days if necessary. Do not use more often or longer than this as lindane has neurotoxicity potential.
  • Diphenhydramine 25-50 mg PO every 6 hours will relieve some of the itching, but will make the patient sleepy.
  • In severe cases, Prednisone 40 mg PO QD X 2 days, then 20 mg X 2 days, then 10 mg X 2 days will provide significant relief. This regimen should be used cautiously in operational environments as it will suppress the immune system, making the patient more vulnerable to other problems.

Unlike pubic lice, Sarcoptes scabiei do not live long on clothing or bed linens.

Scabies

Note to readers from the Brookside Associates:
Although this page faithfully reproduces the original Operational Medicine 2001, there are  newer CDC Treatment Guidelines (2006) available here.


Contents -  Introduction -  Medical Support of Women in Field Environments -  The Prisoner of War Experience -  Routine Care -  Pap Smears -  Human Papilloma Virus -  Contraception -  Birth Control Pills -  Vulvar Disease -  Vaginal Discharge -  Abnormal Bleeding -  Menstrual Problems -  Abdominal Pain -  Urination Problems -  Menopause -  Breast Problems -  Sexual Assault -  Normal Pregnancy -  Abnormal Pregnancy -  Normal Labor and Delivery -  Problems During Labor and Delivery -  Care of the Newborn

Bureau of Medicine and Surgery
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Operational Obstetrics & Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000

This web version of Operational Obstetrics & Gynecology is provided by The Brookside Associates.  It contains original contents from the official US Navy NAVMEDPUB 6300-2C, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified.

This formatting C. 2006 Brookside Associates, LLC.
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