Scabies

January 16, 2013

This teen sought care because of extremely pruritic nodules on the penis and scrotum. He also had mild itching on the wrists and between several finger webs. This distribution of a pruritic dermatosis is classic for scabies.

A 16-year-old boy sought medical attention because of extremely pruritic nodules on the penis and scrotum. He also had mild itching on the wrists and between several finger webs.

Key point: This distribution of a pruritic dermatosis is classic for scabies. This disorder is acquired primarily via close, personal contact. The patient admitted to sexual relationships with several older women. A mineral oil prep of a scraping from the crusted center of a scrotal nodule revealed the characteristic mite.

Treatment: The eruption cleared following 2 oral doses of ivermectin, 200 µg/kg.  

Note: While topical permethrin therapy may be effective, the CDC now also recommends ivermectin as first-line therapy.