Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2012 Feb;51(2):131-41. doi: 10.1111/j.1365-4632.2011.05191.x.
Head lice are transmitted by head to head contact. Optimal therapy includes malathion lotion 0.5% repeated in one week left on for 30 minutes to 8 hours. Spinosad topical suspension 0.9% repeated in one week left on for 10 minutes is another option. Scabies is transmitted mainly by direct contact but also via heavily infested fomites due to crusted scabies. Permethrin 5% cream to the body repeated in four days is often sufficient; however, scalp treatment with malathion lotion 0.5% is helpful in crusted scabies and in infested children. Oral ivermectin 200 mcg/kg is another option, repeated in four days. For scabies more than lice, fomites should be placed in a drier at 60 °C for 10 minutes to kill the arthropods. Treatment of close contacts in both cases will control outbreaks and repeated infestations. Both have been associated with methicillin-resistant Staphylococcus aureus infection. Bed bugs are a common cause for papular urticaria. Identification of the insect in the mattress or bedding confirms the diagnosis. Prevention involves encasing the mattress in a sealed plastic cover and extermination. Delusions of parasitosis is a diagnosis of exclusion that is best treated with an antipsychotic.
头虱通过头对头接触传播。最佳治疗方法包括马拉硫磷洗剂 0.5%，每周重复一次，涂抹 30 分钟至 8 小时。另一种选择是 0.9%螺旋霉素局部混悬剂，每周重复一次，涂抹 10 分钟。疥疮主要通过直接接触传播，但由于结痂疥疮和受严重污染的媒介物，也会通过接触传播。每周重复使用 5%扑灭司林乳膏涂抹全身通常就足够了；然而，对于结痂疥疮和受感染的儿童，头皮用马拉硫磷洗剂 0.5%治疗也有帮助。另一种选择是每周重复使用 200 mcg/kg 的伊维菌素口服。对于疥疮比虱子更严重的情况，应将污染物放在 60°C 的干燥器中 10 分钟以杀死节肢动物。在这两种情况下，对密切接触者进行治疗可以控制疫情和反复感染。两者都与耐甲氧西林金黄色葡萄球菌感染有关。臭虫是丘疹性荨麻疹的常见病因。在床垫或床上用品中发现昆虫可确诊。预防措施包括用密封塑料袋包裹床垫并进行消灭。寄生虫妄想症是一种排除性诊断，最好使用抗精神病药物治疗。
