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Itchy 2

Step 1: View clinicals

A 26 year old man presents with diffuse itching over his body. The itching is most prominent over the hands and genitals, is worse at night, and disturbs his sleep. He has noted similar symptoms in his wife and son. He does not have a history of dermatological diseases and his medical history is unremarkable.

Step 2: Order all relevant investigations

Microscopy of Skin Scrapings

Microscopy of scrapings from a burrow demonstrates the Sarcoptes scabiei mite.

Microscopy of Plucked Pubic Hair

No nits or pubic lice are seen

Skin Patch Test

The patch test fails to elicit any form of contact dermatitis

HIV Screening

The HIV screening test is negative

Step 3: Select appropriate management

5% Permethrin Topically
Oral Antihistamines
Oral Antibiotics
Fumigate Living Areas

Score: ★★☆