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Scabies outbreak in shelter — MCCQE Part 1 MCQ

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ModerateRashScabies outbreak in shelterMCCQE Part 1

A 39-year-old man staying in a shelter presents with intense nocturnal itch. Examination shows excoriated papules and burrows on the finger webs and wrists. Several residents have similar symptoms. What is the most appropriate next step in management?

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Correct answer: E — Treat him and close contacts with permethrin and coordinate shelter outbreak control

Burrows, web-space involvement, nocturnal itch and clustered cases indicate scabies; treatment includes permethrin for the patient and close contacts plus environmental measures and outbreak coordination. Antihistamines may relieve itch but do not eradicate mites. Waiting for biopsy is unnecessary in a typical outbreak.

Reference: Canadian Public Health scabies outbreak guidance