Scabies, bedbugs, and body lice commonly cause pruritus and rash, and accurate diagnosis of the symptoms should include consideration for social drivers of health, such as housing status and living environment, according to a recent literature review presented in JAMA. It’s concerning because pruritus may persist after scabies treatment—largely due to misdiagnosis and inadequate treatment—and persistent scratching can present a risk for skin infection. While bedbug bites usually resolve after 1 week without treatment, professional pest management services are often needed to remove the infestations. Hot-water laundering of clothes and bedding is recommended for body lice. For most bites and rashes, treatment with mid potency topical corticosteroids and oral antipruritics is a first-line option.
Setting matters: The authors considered a broad range of global studies of health concerns related to infestations of scabies, bedbugs, and body lice. “The review associates these conditions with poverty, homelessness, and lack of personal hygiene,” says Alan A. Ayers, MBA, MAcc, President of Urgent Care Consultants and Senior Editor of The Journal of Urgent Care Medicine. “But in urgent care, they’re more often associated with college dorms, nursing homes, child care centers, hospitals, and camps.”
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