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Scabies
Sreenu Thalla
Associate Professor
Department of Pharmacology
Skin Scraping
• Scraping the skin area across the burrow to examine under a
microscope, which can help determine the presence of mites or
their eggs.
Burrow Ink Test
• Gently rubbing the burrow with the underside of a fountain pen,
covering it with ink.
• The excess ink is wiped off with alcohol. If a burrow is present, the
ink will track it down and outline the limit of the burrow.
Dermoscopy
• It is a diagnostic technique which involves the magnified
observation of skin
• Permethrin is the drug of choice for the treatment of scabies.
• Topical permethrin should be administered every 2-3 days for 1-2 weeks
to treat crusted scabies.
• Benzyl benzoate 25% (with or without tea tree oil) Benzyl benzoate may
be used as an alternative topical agent to permethrin
Permethrin
• It is a topical cream that is used for scabies treatment.
• Five per cent of permethrin cream should be applied on the skin from
the neck to toe and leave it on overnight and then wash it off.
• For infants, the cream is applied to the whole body including the face
and head.
• Permethrin cream should be reapplied one week later to kill recently
hatched mite's eggs.
• Permethrin is safe for use in pregnancy and lactation.
Ivermectin
• Oral ivermectin is used for the treatment of scabies, particularly for
crusted scabies and used in managing institutional or community
outbreaks, although Food and Drug Administration has not
approved its use for scabies treatment.
• Some studies have stated that ivermectin administered orally as a
single dose is for people who are 10 years and older. Additional
doses are given two weeks later if the symptoms still continue.
• Two doses of ivermectin are scabistatic, the second dose kills mites
that have hatched. Ivermectin isn't recommended for children
weighing less than 15 kg and women who are pregnant or
breastfeeding.
• Ivermectin's use depends on the convenience, ease of
administration, side effects and safety.
This binding causes an increase in the permeability of the cell membrane to
chloride ions and results in hyperpolarization of the cell, leading to paralysis
and death of the parasite.
Ivermectin binds selectively and with high affinity to glutamate-gated chloride
ion channels in invertebrate muscle and nerve cells of the microfilaria.
Ivermectin also is believed to act as an agonist of the neurotransmitter gamma-
aminobutyric acid (GABA), thereby disrupting GABA-mediated central
nervous system (CNS) neurosynaptic transmission.
Ivermectin may also impair normal intrauterine development of O.
volvulus microfilariae and may inhibit their release from the uteri of gravid
female worms.
Benzyl benzoate
• It is another effective and the most widely used medication in
developed countries.
• The recommended use of benzyl benzoate is 28 per cent for adults
and 10 to 12.5 per cent for children.
• Apply the benzyl benzoate cream on the skin and leave it on for 24
hours.
• Pregnant women shouldn't use this medication.
• Antihistamine medications can be used to relieve itching, and
topical or oral antibiotics can be used for treating bacterial
infections.
Clinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies Disease

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Clinical Pharmacotherapy of Scabies Disease

  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. Skin Scraping • Scraping the skin area across the burrow to examine under a microscope, which can help determine the presence of mites or their eggs. Burrow Ink Test • Gently rubbing the burrow with the underside of a fountain pen, covering it with ink. • The excess ink is wiped off with alcohol. If a burrow is present, the ink will track it down and outline the limit of the burrow. Dermoscopy • It is a diagnostic technique which involves the magnified observation of skin
  • 10. • Permethrin is the drug of choice for the treatment of scabies. • Topical permethrin should be administered every 2-3 days for 1-2 weeks to treat crusted scabies. • Benzyl benzoate 25% (with or without tea tree oil) Benzyl benzoate may be used as an alternative topical agent to permethrin
  • 11. Permethrin • It is a topical cream that is used for scabies treatment. • Five per cent of permethrin cream should be applied on the skin from the neck to toe and leave it on overnight and then wash it off. • For infants, the cream is applied to the whole body including the face and head. • Permethrin cream should be reapplied one week later to kill recently hatched mite's eggs. • Permethrin is safe for use in pregnancy and lactation.
  • 12. Ivermectin • Oral ivermectin is used for the treatment of scabies, particularly for crusted scabies and used in managing institutional or community outbreaks, although Food and Drug Administration has not approved its use for scabies treatment. • Some studies have stated that ivermectin administered orally as a single dose is for people who are 10 years and older. Additional doses are given two weeks later if the symptoms still continue. • Two doses of ivermectin are scabistatic, the second dose kills mites that have hatched. Ivermectin isn't recommended for children weighing less than 15 kg and women who are pregnant or breastfeeding. • Ivermectin's use depends on the convenience, ease of administration, side effects and safety.
  • 13. This binding causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell, leading to paralysis and death of the parasite. Ivermectin binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate muscle and nerve cells of the microfilaria. Ivermectin also is believed to act as an agonist of the neurotransmitter gamma- aminobutyric acid (GABA), thereby disrupting GABA-mediated central nervous system (CNS) neurosynaptic transmission. Ivermectin may also impair normal intrauterine development of O. volvulus microfilariae and may inhibit their release from the uteri of gravid female worms.
  • 14. Benzyl benzoate • It is another effective and the most widely used medication in developed countries. • The recommended use of benzyl benzoate is 28 per cent for adults and 10 to 12.5 per cent for children. • Apply the benzyl benzoate cream on the skin and leave it on for 24 hours. • Pregnant women shouldn't use this medication. • Antihistamine medications can be used to relieve itching, and topical or oral antibiotics can be used for treating bacterial infections.