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Scabies and Eczema — SCE Dermatology MCQ

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HardCutaneous InfectionScabies and EczemaSCE Dermatology

Classical scabies is confirmed in an adult care-home resident. He is not immunosuppressed and has no features of crusted scabies. Which initial regimen best limits treatment failure and onward transmission?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Apply permethrin 5% over the whole body for 8–12 hours, repeat after 7 days and treat close contacts concurrently

The best answer is “Apply permethrin 5% over the whole body for 8–12 hours, repeat after 7 days and treat close contacts concurrently”. This regimen uses full-body treatment, repeats after one week and treats close contacts concurrently. The neck-down alternative uses correct permethrin concentration, but leaves coverage incomplete, delays the second treatment and limits contact treatment to symptomatic people. Ivermectin is not the default initial choice in this uncomplicated case.

Reference: UKHSA scabies management guidance: https://www.gov.uk/government/publications/scabies-management-advice-for-health-professionals/ukhsa-guidance-on-the-management-of-scabies-cases-and-outbreaks-in-long-term-care-facilities-and-other-closed-settings