Scabies affecting the genital area
Diagnosis:
Widespread itch, worse at night. Erythematous papular rash – lesions on genitals may be nodular (and may persist for weeks following successful treatment). Silvery lines and excoriation on finger web spaces, wrists, elbows and axillary folds.
Treatment:
Please see the East Region Formulary as patterns of resistance can change.
Patient Information:
- Spread by close body contact including, but not exclusively, sexual intercourse;
- Wash clothing and bedding (hot wash>50 degrees C) after treatment. Tumble drying or sealing clothes in a plastic bag for 72hrs will also kill mites;
- Discourage shaving of pubic hair;
- Regular partners and household contacts should be treated;
- Itch may persist for up to 4 weeks after treatment – discourage repeated re-treatment. This can be relieved with Crotamiton cream or lotion available OTC.
Pubic Lice (Phthirus Pubis)
Diagnosis:
Visual or microscopic identification of adult lice, eggs or faeces. The adults are usually seen at the base of pubic hairs. The eyebrows and lashes are occasionally affected.
Treatment: – please see the Formulary as above.
- Note that malathion should be applied topically to all surfaces below neck line, concentrating on hairy areas. Wash off after12 hours. Repeat application 7 days later. (One bottle is sufficient for 2 applications). Change bedlinen, wash most recently used clothes. (Normal washing only- no need for boiling)
- Eyebrows and lashes: Lice can be removed using forceps or treated with an application of yellow soft paraffin.
Patient Information:
- Spread by close body contact including, but not exclusively, sexual intercourse;
- Spread from clothing or bedding only occurs if it is used very soon (a few hours) after the infected individual;
- Discourage shaving of pubic hair;
- Regular partners should be treated.
C.M & S.W. 23-11-23
