A 37-year-old HIV+ male.Recently discharged from hospital; was hospitalized for 2 weeks.9-week history of non-pruritic eruption, almost generalized; medium-potency topical steroids alleviate scale, but lesions are persistent. No sick contacts Initial evaluation Patient presents with almost generalized, thickly crusted papules and plaques, including on the scalp, ears, palms, and soles Skin scraping from the palms reveals numerous scabetic mites The patient is prescribed: Ivermectin, two doses of 200 mcg/kg given 14 days apart Permethrin 5% cream, 3 applications applied overnight, 7 days apart Triamcinolone 0.1% ointment b.i.d.
(started 24 hours after first anti-parasitic treatment) Hydroxyzine 50 mg at bedtime Close contacts, including sexual partners and household members, should also all be treated at the same time as the patient Instructions for decontamination protocol are given…
