Dermatologic infestations

Eugenia Shmidt, Jacob Levitt

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Head lice are transmitted by head to head contact. Optimal therapy includes malathion lotion 0.5% repeated in one week left on for 30minutes to 8hours. Spinosad topical suspension 0.9% repeated in one week left on for 10minutes 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 200mcg/kg is another option, repeated in four days. For scabies more than lice, fomites should be placed in a drier at 60°C for 10minutes 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.

Original languageEnglish (US)
Pages (from-to)131-141
Number of pages11
JournalInternational Journal of Dermatology
Issue number2
StatePublished - Feb 2012


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