patient 25 yrs comes with itching over shoulder, forearm, arm and back. itching increased at night. above lesions seen. complaints present since past 1 month. was given lindane in view of scabies. pt says it didn't work after 2 uses of lindane.

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Thank you for tagging Dr. Rajkiran, Multiple itching papular lesions on shoulder, fore arm and back means, it could be CONTACT from other objects, like plants, sprays or from cloth. In scabies, lesions mainly on interdigital areas, shoulder back, genitals and thighs.So see these these lesions on that area. If not there treat it as a Contact dermatitis. TREATMENT: 1) Tab Levocetrizine daily night. 2) Betamethasone and gentamicin cream on lesions. 3) ivermectin 6 mg and ALBENDAZOLE 400 mg Combination tablet weekly once for 3 weeks. 4) permethrin cream on night times. 5) The remaining treatment as scabies.
topical steroids to be avoided & treat whole family simultaneously it as a case of scabies
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Such cases are common in ALLERGY practice. It could be Inhaled, Ingested, Injected (insect bites and thorn pricks ) or Contact. Often it is not easy to identify the culprit. What is generally advised is, an Antihistaminic, avoidance of going near plants or animals, avoiding outside food. If troublesome, I resort to Allergy Test and identify the Offending agents. Desensitization follows.
SCABIES 1.To confirm the diagnosis do skin scrapping to look for scabies mites or eggs. 2.Treat all family members SIMULTANEOUSLY. 3.Rule out DM n HIV. 4.Treatment is as advised by Dr.P.Kishore kumar.
Treat family members USE Permite 5% below neck at night for 3 days and repeat at 7 days Wash all clothes at home with warm water and dry it sun
Probably it is not scabies, it is allergic eruptions may be due to talcum powder, deodorant, bedbugs ,so treat it as allergy.
It's Scabies.. Treatment. Permite 5%locally. Tab levocetrizine, treatment of family contacts. Personal hygiene.
It may be infective dermatitis .antibiotic , antiallergic emollient with Calamin
Allergic erruptions, bedbugs bite should be ruled out
SUGGESTIVE. OF A. C. D ICD
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