Complications
Occurs as an immunological reaction to mites, their eggs, or faeces. Manifests as continued pruritus despite adequate treatment of scabies. May last for up to 1 month after treatment. May be treated with topical mid-potency steroid application 1 to 2 times per day for 2 to 4 weeks. Oral antihistamines may also be given.[6]
Due to disruption of skin barrier from inflammation and scratching, skin may be secondarily infected with streptococcal or staphylococcal bacteria. Treatment with antibiotics (dicloxacillin, flucloxacillin, or a first-generation cephalosporin) is usually sufficient. In developing countries, untreated secondary infection can lead to post-streptococcal glomerulonephritis and subsequent renal failure or rheumatic heart disease.[5]
Prolonged immune response to scabies can result in persistent nodules that show a mixed inflammatory infiltrate. Treatment usually consists of high-potency topical steroids, intralesional steroids or an oral steroid taper.[43]
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