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CONTINUING PROFESSIONAL DEVELOPMENT
6. Strong M, Johnstone P. Interventions for treating
scabies. Cochrane Database of Systematic Reviews
[Internet]. 2007;(3). At: http://onlinelibrary.wiley.com/
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9. Chosidow O. Scabies and pediculosis. Lancet.
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of scabies. Current Opinion in Infectious Diseases.
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Diagnosis can be difficult but
treatment is simple and effective.
However, correct application of topical
medication is essential, as is treating all
people who have had close personal
contact with the patient. The patient’s
clinical presentation can range from
asymptomatic to an intense itch and
secondary infection. Some patients
will require treatment with ivermectin
as well as topical permethrin if crusted
scabies is evident.
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dermatology, venereology and leprology. 2009;75(4):340–7.
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C-H . Factors related to missed diagnosis of incidental
scabies infestations in patients admitted through the
emergency department to inpatient services. Academic
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5. Green M. Epidemiology of scabies. Epidemiologic Reviews.
Amy’s mother should be advised to treat
the entire family and anyone that has
had direct and prolonged contact with
the family with a 5% topical permethrin
cream. Irritation may persist for a few
weeks after treatment. However, this
does not mean the treatment has failed.
Topical steroids or oral antihistamines
can provide symptomatic relief of the
itch. It is also important to wash all
recently‐worn clothing, bed linen and
towelling to ensure any mites have
been destroyed. It is also necessary to
retreat the whole family in seven days
to ensure the lifecycle of the mite has
Scabies is an infestation that can be
spread through extended skin‐to‐
skin contact or exposure to fomites.
1. Which statement is CORRECT with
regard to treating the symptoms of
a) Advise the patient to have a hot shower
to elevate the itch.
b) Patient should be advised to reapply
the scabies treatment if the itch is still
present after two days.
c) The patient should be advised that the
itch might last for several weeks after
treatment and to apply a topical steroid
or take an oral antihistamine to reduce
d) There is no need to treat if there are
no symptoms even though they have
had close and direct contact with an
2. Which statement is CORRECT with
regard to the spread of scabies?
a) Scabies can be spread as easily as
b) Scabies can be spread by direct and
prolonged contact with the skin.
c) The scabies mite can live off the skin or
on a fomite for up to one week.
d) Frequent washing with soapy water can
prevent scabies infestations.
3. Which statement is CORRECT with
regard to identifying scabies in a
community pharmacy setting?
a) Scabies can only be proven by visually
identifying burrow sites.
b) All suspected scabies infections should
be referred to the GP for a skin scaping
and microscopy test.
c) History and symptomology is the best
guide to determine if scabies is likely.
d) Accurate diagnosis is always possible.
4. Which statement is INCORRECT with
regards to application of a 5% topical
a) In an adult, the cream needs to be
applied from the neck down and over
the whole of the body.
b) The cream needs to be reapplied seven
days after initial treatment to ensure the
lifecycle of the mite is broken.
c) One whole tube of cream is required to
treat one adult person.
d) The cream should only be applied to
areas of mite infestation that have a red
rash and are itchy.
5. Which statement is CORRECT with
regard to the treatment of crusted
a) Crusted scabies can be treated with a
combination of a topical scabicidal and
oral steroids to reduce the irritation.
b) Crusted scabies is a common
presentation and can be treated in a
c) Ivermectin can be used in conjunction
with permethrin cream to treat crusted
d) Norwegian scabies is a form of scabies
that is self-limiting and is asymptomatic.
COUNSELLING IN PRACTICE
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