title: Treatment for crusted scabies: limitations and side effects of treatment with ivermectin.
abstract: Skin eruption with mild itching of the hands and feet developed in a man in his 90s 1 month after he was hospitalized following a traffic accident. Scabies was diagnosed in an attending nurse 3 months after the patient's hospitalization, and infection from the patient was suspected. Cornification of the patient's soles and marked hypertrophy of the nails of both feet were observed. After a large number of scabies mites were detected on microscopic examination, crusted scabies was diagnosed. The patient was given oral ivermectin, 6 mg, once per week for 3 weeks, and crotamiton topical ointment containing 30% benzyl benzoate was applied on the body from the neck down. However, because a large number of scabies mites were detected again on microscopic examination, the dose of ivermectin was increased to 12 mg and administered 3 times. One week after the sixth dose of ivermectin was administered, hemorrhagic scabs around the mouth and erosion of the tongue developed. Mucosal drug eruption was suspected, and eruptions around the mouth and on the tongue resolved within 1 week after ivermectin being discontinued. 1% gamma-benzene hexachloride ointment was applied topically on the body from the neck down once a week, crotamiton ointment containing benzyl benzoate was applied daily, and the hypertrophic parts of the nails were removed. The patient subsequently achieved a full recovery.
authors.affiliation: Department of Dermatology, Nippon Medical School.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Yushi
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Kensuke
authors.initials: K
authors.lastname: Morimoto
authors.forename: Izumi
authors.initials: I
authors.lastname: Kikuchi
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawana
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D000818:Animals; D000977:Antiparasitic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology; D001556:Hexachlorocyclohexane / Q000627:therapeutic use; D006790:Host-Parasite Interactions / Q000187:drug effects; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012520:Sarcoptes scabiei / Q000187:drug effects / Q000502:physiology; D012532:Scabies / Q000175:diagnosis / Q000188:drug therapy* / Q000469:parasitology; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D014052:Toluidines / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000977:Antiparasitic Agents; D001565:Benzoates; D014052:Toluidines; D001556:Hexachlorocyclohexane; D007559:Ivermectin; C005553:crotamiton; C006723:benzyl benzoate