Scalp-to-toes application of permethrin for patients with scabies

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" Scalp-to-toes application of permethrin for patients with scabies "
Modi, Krishna; Patel, Devika; Shwayder, Tor

Document Type	:	AL
Record Number	:	924422
Doc. No	:	LA1zz05980
Language of Document	:	English
Main Entry	:	Modi, Krishna; Patel, Devika; Shwayder, Tor
Title & Author	:	Scalp-to-toes application of permethrin for patients with scabies [Article]\ Modi, Krishna; Patel, Devika; Shwayder, Tor
Title of Periodical	:	Dermatology Online Journal
Volume/ Issue Number	:	24/5
Date	:	2018
Abstract	:	Scabies is an infestation of Sarcoptes scabiei resulting in intensely pruritic erythematous papules tipped with hemorrhagic crusts. Current guidelines and medication labels instruct application of topical permethrin 5% cream from neck down for treatment of adult patients with scabies. Although scalp and head involvement are observed in infants, it is rare in older children and adults. Herein, we present a case of an 11-month-old patient who had scalp involvement, and required a scalp-to-toes application of permethrin. We also present a 77-year-old patient with scabies involving the head, who failed initial treatment when permethrin was applied neck down, but had subsequent resolution when it was applied scalp-to-toes. These cases provide impetus for review of current guidelines to reflect application of topical permethrin 5% cream to all external surfaces of the body including the scalp and head.