We unfortunately are experiencing an epidemic of Norwegian scabies. It
started in a nursing home, and has spread to the community hospital, a home
for mentally handicapped, and is now spreading widely in the general
community. It is very resistant to treatment. We have involved public
health. The only effective treatment ( and we have tried the lot)seems to be
Lyclear dermal cream, with it's high concentration of permethrin. One trick
we have learnt is to ensure that if a carer applies the cream it must be
worked in under the finger nails. Self application usually achieves this
adequately.
The reason for this note is a request for information. It occurred to me
last night as I lay in bed suffering the inevitable psychogenic itch after
seeing yet another case, what on earth is the natural history of untreated
scabies? What must life have been like for our ancestors? Does it stabilise
into something like a chronic lichenified eczema? Does the body eventually
come up with some effective immune response? Is there any natural immunity
to it, since not all close contacts seem to get it? Does anybody out there
know - perhaps smeone who has worked in the third world. I believe mange
mite in animals is a type of scabies. Any info from the veterinary world?
Peter Fellows
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