Symptoms

An itchy rash that worsens at night and that involves multiple members of the same household is a common presentation.

Diagnosis

Because the disease is often missed and occasionally overdiagnosed, scrapings from suspect lesions are examined microscopically to confirm the presence of the mite, its eggs, or its excretions.

Patient care

For children 2 months and older and nonpregnant adults, permethrin 5% cream is applied to the entire body surface. The eyes and mouth are avoided when the cream is being applied. The cream is thoroughly washed off after about 8 to 14 hr. Retreatment is sometimes required if the itch persists for more than a few weeks. Alternatively, nonpregnant patients may be treated with ivermectin given orally. Pregnant women and infants under 2 months of age should be treated with 6% precipitated sulfur in petrolatum daily for 3 days. Infection control in the home includes the washing of all linens, towels, and clothing with hot water and drying them thoroughly.