Overview
Dermatosis caused by mites, such as scabies and demodicosis, are parasitic skin conditions resulting from infestation by mites like Sarcoptes scabiei and Demodex species, respectively. These conditions manifest with characteristic symptoms including pruritus, rash, and skin lesions 1.Diagnosis
Clinical presentation of pruritic rash, often with burrows in scabies 1.
Skin scrapings for microscopic examination to identify mites or eggs 1.
Patch testing or specific diagnostic criteria may be used in some cases, though less common 1.Management
First-line treatments:
- Permethrin 5% cream applied overnight and washed off next day (for scabies) 1.
- Ivermectin oral medication (200 mcg/kg single dose or 12 mg daily for 2 days) (for scabies, especially in resistant cases) 1.
Adjunctive treatments:
- Benzyl benzoate emulsion (250 mg/mL) applied twice daily for 2-3 days (alternative to permethrin) 1.
- Topical corticosteroids for symptomatic relief of pruritus 1.Special Populations
Pregnancy: Permethrin is generally considered safe; ivermectin should be used cautiously and only if benefits outweigh risks 1.
Pediatrics: Dosage adjustments may be necessary; permethrin is commonly used but ensure proper application to avoid toxicity 1.
Elderly: Increased susceptibility to complications; thorough treatment and monitoring for secondary infections are crucial 1.
Comorbidities: Patients with atopic dermatitis or immunosuppression may require extended treatment courses and closer follow-up 1.Key Recommendations
Use permethrin 5% cream for scabies treatment, ensuring thorough coverage of all body areas 1 (Evidence: Strong).
Consider ivermectin for resistant cases or immunocompromised patients, adhering to dosing guidelines 1 (Evidence: Moderate).
Implement adjunctive topical corticosteroids for managing severe pruritus 1 (Evidence: Moderate).References
1 Cohen PR, Miller JC, Burrall BA. Longevity in dermatologists-why do so many dermatologists live so long?. Dermatology online journal 2025. link
2 Ang PS, Ng MSY, Teo DCH, Dorajoo SR, Tan FM, Mai AQ et al.. A Mixed-Methods Evaluation to Identify Industry Knowledge Needs and Challenges in Health Product Defect and Recall Reporting in Singapore. Drug safety 2025. link
3 Derrick KM, Golbari NM, Siegel DM. Economics of a Dermatology Practice. Dermatologic clinics 2023. link
4 Thomas E, Coombs J, Kim J, Hyde M. A survey of fellow members of the Society of Dermatology Physician Assistants. JAAPA : official journal of the American Academy of Physician Assistants 2013. link