Guideline for the Diagnosis and Treatment of Scabies—Second Edition—

Abstract

Guideline has been prepared by the Japanese Dermatological Association to ensure proper diagnosis and treatment of scabies, as oral therapy became available on August, 2006 under health insurance 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 var. hominis), and epidemiological findings. The diagnosis is confirmed if the mites or eggs are identified by microscopic examinations or dermatoscopy examination. Sulfur-containing ointments, with only limited usefulness, 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 hyperkeratotic (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. Some safe and useful ointments are needed to be approved by health insurance