title: Dermatologic infestations.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Shmidt
authors.forename: Jacob
authors.initials: J
authors.lastname: Levitt
mesh_terms: D000818:Animals; D001511:Bedbugs; D003937:Diagnosis, Differential; D004478:Ectoparasitic Infestations / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007299:Insect Bites and Stings / Q000175:diagnosis / Q000628:therapy; D010373:Lice Infestations / Q000175:diagnosis / Q000628:therapy; D055535:Morgellons Disease / Q000175:diagnosis / Q000628:therapy; D010374:Pediculus; D012532:Scabies / Q000175:diagnosis / Q000628:therapy; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000628:therapy; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis / Q000628:therapy; D014581:Urticaria / Q000175:diagnosis / Q000628:therapy