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Centre of Evidence of Dermatology Best practice guidelines

Guidelines classic scabies: in children < 15kg, pregnant or breastfeeding women Updated on january 2024

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Clinical scenario No. 2/3 - Scabies, gynecologic clicnical case

Back to decision-making tree Print last updated on 10/06/2024

Presentation 1/3

Classic scabies in a 39-year-old woman 27 weeks pregnant:

What treatment and management are needed?

See propositions

×

Therapeutic treatment suggestions

Pregnant women in 2nd-3rdtrimester (>15 weeks pregnant)

Local treatment
  • permethrin 5% cream1
  • or
  • benzyl benzoate 10% skin emulsion2
  • or
  • ivermectin at 0.2 mg/kg (2 doses: on D0 and again between D8 and D14, mid meal)
    • off-label, recommended as 1st-line treatment where skin condition is poor during 2nd and 3rd trimesters
Related environmental measures3
Treatment of partner
ivermectin at 0.2 mg/kg (2 doses: D0 and between D8 and D14)

Howto

  1. Apply a thin layer over the entire body, excluding the face, in the evening. Leave on overnight (minimum 8 hours) and rinse off in the morning. Repeat application between D8 and D14.
  2. Apply over the entire body, excluding the face. Leave on for 24 hours then rinse off. Repeat between D8 and D14.
  3. Decontamination of bedding and clothing by machine washing at 50°C or 3 days in a sealed bag, treatment of mattress, furniture and car seats with anti-parasitic spray.

Presentation 2/3

Classic scabies in a 35-year-old woman 10 weeks pregnant:

What treatment and management are needed?

See propositions

×

Therapeutic management

Pregnant women in 1st trimester (≤15weeks pregnant)

1st-line local treatment
  • permethrin 5% cream1
  • or
  • benzyl benzoate 10% skin emulsion2
    • not recommended in the presence of atopic dermatitis due to the excipient 96% ethanol
Related environmental measures3
Treatment of other family members (father, 8-and 4-year-old children):
ivermectin 0.2mg/kg (2 doses: D0 and between D8 and D14, mid meal)
Contact the preschool co-ordinator regarding a possible epidemic.

En pratique

  1. Apply a thin layer over the entire body, excluding the face, in the evening. Leave on overnight (minimum 8 hours) and rinse off in the morning. Repeat application between D8 and D14.
  2. Apply over the entire body, excluding the face. Leave on for 24 hours then rinse off. Repeat between D8 and D14.
  3. Decontamination of bedding and clothing by machine washing at 50°C or 3 days in a sealed bag, treatment of mattress, furniture and car seats with anti-parasitic spray.

Presentation 3/3

Classic scabies in a woman 10 weeks pregnant:

What treatment and management are needed?

See propositions

×

Therapeutic management

Eczematous classic scabies in a patient 10 weeks pregnant

Treatment
  • ivermectin oral at a dose of 0.2 mg/kg (2 doses: D0 and between D8 and D14, mid meal)
    • off-label, recommended as 2nd-line treatment where skin condition is poor (regardless of the pregnancy term)
  • moisturizers
  • topical steroids for atopic dermatitis lesions 24-48 hours after the first dose of oral ivermectin
Related environmental measures3
Decontamination of bedding and clothing by machine washing at 50°C or 3 days in a sealed bag, treatment of mattress, furniture and car seats with anti-parasitic spray.
Management of other family members
  • they should only be treated a second time if pruritus or skin lesions.
Follow-up appointment
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➜ Breastfeeding woman case

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