To avoid an unnecessary call or office visit, remind patients that itching from a scabies infection may persist for as long as one to two weeks after eradication.There is usually no need for retreatment if the patient has followed the medication instructions and washed all bedding and clothing in hot water.
—Stacy Ramsey, MSN, RNC, ANP, WHNP, Warwick, R.I. (100-26)
Patients with scabies infestation have pruritus. Itching is caused by hypersensitivity to the debris, eggs, and/ or feces rather than the direct effects of the mite. Immunologically, the cellular infiltrate demonstrates T4 lymphocyte dominance in lesions of patients with persistent itching. Following antiscabetic therapy, the hypersensitivity reaction may outlast the prescence of live parasites, and symptomatic treatment (antihistamines and topical corticosteroids) can be used to control the pruritus. Re-infection or persistent infection should be suspected if lesions are present at follow-up one month after treatment
—Philip R. Cohen, MD (100-26)