Ancillary measures
Scabies mites may survive for a few days after leaving human skin. Thus, frequent bed linen changes minimize transmission via bedding. Hot-water laundry in temperatures of 120°F (49°s mites in 10 minutes and is sufficient to disinfect all bedding, clothing, and washable items.3
Other methods of disinfection include placing items in a dryer on the hot cycle for 10 to 30 minutes, pressing them with a warm iron, dry-cleaning, or placing in a sealed plastic bag for 7 to 14 days. Carpets or upholstery should be vacuumed through the heavy traffic areas. Fumigation of living areas and furniture with insecticide is unnecessary.6-8 Pets do not need to be treated.6 Children may return to school and childcare immediately following initial treatment.6
Follow-up of scabies patient
The boy’s mother is allowed to view the mites through the microscope, fostering her accepting the diagnosis and enhancing the chance for compliance with treatment, which involves treating the entire family.
Patients should be informed that the rash and pruritus of scabies may persist for 4 weeks after treatment because scabietic antigenic material remains until natural epidermal sloughing and turnover occurs.3 When symptoms or signs persist, evaluation should ensue for faulty application of topical scabicides and for treatment failure.7
Acknowledgments
The author (GNF) wishes to acknowledge the assistance of Peggy Elston and Heather Martinez, without whose assistance photographs like these would never happen; and Lisa Nichols, without whose acquisitive skills it never would have occurred to me to mite-hunt with a dermatoscope.
CORRESPONDENCE
Gary N. Fox, MD, Defiance Clinic, 1400 East Second Street, Defiance, OH 43512. E-mail: foxgary@yahoo.com