Huisarts Nu december 2007; 36(10):537-551  

·        This risk population includes the elderly in nursing homes, the disabled and other institutionalised community residents, hospitalised patients, as well as those returning from a stay abroad or in situations where people are living in cramped, less sanitary housing conditions (e.g. dire housing conditions associated with refugees and illegal aliens).

·        Scabies is diagnosed mainly on the basis of case history (nocturnal itching, contact with persons infected with scabies) and clinical investigation. Whilst the presence of scabies burrows is pathognomonic, they are not easy to detect (evidence level 3).

·        The main conditions belonging to the differential diagnosis are: eczema, impetigo and prurigo. In the elderly, senile pruritus must also be considered in the differential diagnosis.

·        Conventional drug treatment is a topical cream or ointment, the first choice being permethrin 5% cream (evidence level 1) for anyone aged two months or older and for pregnant women. In addition, a number of hygienic measures must be observed.

·        In terms of prevention: detection and treatment of the source, including contact persons, are essential in avoiding further spread of the disease.