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Scabies — SCE Dermatology MCQ

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EasyCutaneous InfectionScabiesSCE Dermatology

A 25-year-old man presents with itchy papules and burrows on his finger webs, wrists, and genitalia. His partner has similar symptoms. Dermatoscopy shows a 'delta-wing jet' sign at the end of a burrow. What is the first-line treatment?

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Correct answer: E — Permethrin 5% cream applied to whole body for 8-12 hours repeated after 7 days

Permethrin 5% cream applied to the entire body (including head/neck in infants/elderly/immunocompromised) overnight for 8-12 hours, repeated after 7 days, is first-line treatment for scabies per BAD/NICE guidelines. The delta-wing jet sign on dermatoscopy represents the mite (Sarcoptes scabiei) at the end of a burrow and is pathognomonic. All household contacts and sexual partners must be treated simultaneously, regardless of symptoms. Bedding and clothing should be washed at 60°C or bagged for 72 hours. Oral Ivermectin is second-line or used for crusted scabies.

Reference: BAD 2017 Scabies Guidelines; NICE CKS