Article first published online: 17 JAN 2012
© 2012 The International Society of Dermatology
International Journal of Dermatology
Volume 51, Issue 2, pages 131–141, February 2012
How to Cite
Shmidt, E. and Levitt, J. (2012), Dermatologic infestations. International Journal of Dermatology, 51: 131–141. doi: 10.1111/j.1365-4632.2011.05191.x
Conflicts of interest: None.
- Issue published online: 17 JAN 2012
- Article first published online: 17 JAN 2012
Head lice are transmitted by head to head contact. Optimal therapy includes malathion lotion 0.5% repeated in one week left on for 30 minutes to 8 hours. Spinosad topical suspension 0.9% repeated in one week left on for 10 minutes is another option. Scabies is transmitted mainly by direct contact but also via heavily infested fomites due to crusted scabies. Permethrin 5% cream to the body repeated in four days is often sufficient; however, scalp treatment with malathion lotion 0.5% is helpful in crusted scabies and in infested children. Oral ivermectin 200 mcg/kg is another option, repeated in four days. For scabies more than lice, fomites should be placed in a drier at 60 °C for 10 minutes to kill the arthropods. Treatment of close contacts in both cases will control outbreaks and repeated infestations. Both have been associated with methicillin-resistant Staphylococcus aureus infection. Bed bugs are a common cause for papular urticaria. Identification of the insect in the mattress or bedding confirms the diagnosis. Prevention involves encasing the mattress in a sealed plastic cover and extermination. Delusions of parasitosis is a diagnosis of exclusion that is best treated with an antipsychotic.