Is there a role for empiric scabies treatment in itchy patients without clear clinical signs of scabies?
I have seen many astute clinicians miss scabies or consider it after months of treating for AD with biologics and other systemics (including myself). Though this is very rare my personal rule of thumb is to treat with oral ivermectin if at any point patient is not responding the way I expect to trea...
So we see scabies more often.
So I will treat a patient and family empirically if either they or I have a concern - with topicals.
- Case of girl at University of Michigan who has been seen by derm and heme onc - and halfway through her chemo for leukemia cutis her rash was getting worse and unbearab...
In Southern Delaware, we find scabies commonly.
Our worst problems were on two occasions when patients were treated by primary care and dermatology physicians for 1 year with steroids, with a diagnosis of atopic dermatitis. In both cases, those patients were eventually hospitalized at my institutio...
Rarely, if ever unless a patient has exposure to a partner/family member with documented scabies or resides in a nursing home with an outbreak. Way too many "scabies" are diagnosed/treated by FPs, PAs, and NPs as part of a shotgun regimen.