Rx Note

Introduction Scabies is an intensely itchy skin condition, especially at night, caused by the mite Sarcoptes scabiei . The diagnostic burrows are small (0.5-1.5 cm grey irregular tracks) and scratching often makes them difficult to see. The mite is transmitted by direct physical contact (e.g. holding hands, hugging or sexual contact), although transmission through casual contact like shaking hands is unlikely. Occasionally, scabies is acquired via bedding or furnishings. Scabies typically affects the finger webs, sides of the fingers and wrists . In adults, it rarely affects the scalp and face, but in children aged 2 years or under and the elderly, the head is more common affected, especially the area behind the ear. Management All household members and close contacts of the affected individual should be treated simultaneously , even in the absence of symptoms. Because the incubation period of the scabies mites is 3 weeks and the itch of scabies may take up to 8 weeks to develop,...

Introduction Gamma Benzene Hexachloride, in short GBH, is an organochlorine insecticide. It has been used topically in a concentration of 1% for scabies and head lice . However, it is no longer favoured due to The rare neurologic adverse effects Reported resistance It has been classified as carcinogenic to humans in 2015. In fact, Lindane use is banned in California, United Kingdom, Australia and many Western countries. Dosing The recommended duration of GBH 1% lotion application differs, depending on the indication: Scabies : Apply a thin layer of lotion and massage it on skin from the neck to the toes; after 8-12 hours, bathe and remove the drug; most patients will require 30 ml; larger adults may require up to 60 ml. Do not re-treat. Do not leave on for more than 12 hours. CDC STD guidelines recommend an 8 hour application. Head lice , crab lice: Apply shampoo to dry hair and massage into hair for 4 minutes; add small quantities of water to hair until lather forms, then rinse h...

Introduction Benzyl benzoate 10-25% is an effective yet inexpensive medication in scabies management . It is listed on the World Health Organization's List of Essential Medicines . But, permethrin 5% is the drug of choice for the treatment of scabies, especially in pregnant and breastfeeding women. Roles in Scabies In uncontrolled trials, benzyl benzoate has been shown to provide cure rates of approximately 50%. It may cause skin irritation, and a transient burning sensation in approximately 45% of patients. This is usually mild, but in the event of severe skin reaction, the preparation should be washed off using soap and warm water. More importantly, compliance is an issue. Treatment Regimen In adult, a 25% emulsion is applied to the whole body, usually from the chin down, wash off 24 hours later and then reapply. A third application may sometimes be necessary. In other words, the application is to be kept on the skin surface continuously for 24 hours for 2-3 days (with baths...