Treatment of Today's Scabies and Pediculosis

Abstract

RECENTLY we noted 1 the increase of scabies in the United States following an eight-year pandemic in most of the world. 2,3 The cyclic nature of scabies epidemics is not understood, but immunologic factors, especially delayed hypersensitivity, probably play a significant role. 4 Based on extrapolation from experience in previous cycles in this century, the current epidemic may abate by approximately 1980. SCABIES Principles of Management The diagnosis should be made with certainty, preferably by identifying the mite (principally in direct skin scrapings, at times by cutaneous biopsy) prior to instituting therapy. If the mite cannot be detected, there should be a review of suggestive features, and the more such features, the more positive is the diagnosis. A decision as to risk-to-benefit ratio must take into account the efficacy of the scabicide. Unfortunately, there has been limited interest in comparative, controlled efficacy trials of scabicides since World War II. The