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caused by mite - sarcoptes scabei
spread by prolonged skin contact esp in young adults and kids
mite burrows into stratum corneum and lays eggs - intense pruritis is delayed type 4 hypersensitivity reaction 30 days later

''features''
intense pruritis
burrows - sides of fingers, interdigital webs, flexor aspect wrist
infants - face and scalp
secondary features from scratching and infection

''Mx''
Permethrin 5% 1st line
Malathion 0.5% 2nd line
pruritis persists for 4-6/52 post Rx

advise ..
Rx all close contacts even if aSx at same time and avoid close contact with others
wash iron or tumble dry bedding at time of Rx
apply lotion to all areas of body esp fingers and webs, wash off after 12(permeth) or 24 (malath) hrs (reapply if wash in that time) and repeat after 7/7

''Norwegian (crusted) Scabies''
immunocompromised esp HIV
Ivermectin and isolate