115 巻 (2005) 8 号 p. 1125-1129
Guideline has been prepared by the Japanese Dermatological Association to ensure proper diagnosis and treatment of scabies, as ivermectin became available on March 14, 2005 under “the special healthcare expenditure” system and its clinical use was expected to increase. For making proper diagnosis following three points should be taken into consideration, clinical findings, detection of the mite (Sarcoptes scabiei), and epidemiological findings. The diagnosis is confirmed if the mites or eggs are identified by microscopic examinations. Sulfur-containing ointments are only available drugs approved by health insurance coverage for treating scabies. Currently crotamiton cream, benzyl benzoate lotion, and γ-BHC ointment are also used clinically. It is important to apply the ointment to the whole body, including hands, fingers and genitals. The dosage for ivermectin is a single oral administration of approximately 200 μg/kg body weight with water on an empty stomach. Administration of a second dose is considered, if new specific lesions develop or the mites are detected. For treating keratotic (crusted or Norwegian) scabies, concomitant administration of oral ivermectin and the topical ointments as well as removal of thick scabs and infected regions in nails should be considered.