How is a subcutaneous mite treated in a human? - briefly
Systemic acaricidal therapy, typically oral ivermectin, is the primary treatment, often supplemented with topical agents such as permethrin. In refractory or extensive disease, surgical removal of affected tissue may be indicated.
How is a subcutaneous mite treated in a human? - in detail
Subcutaneous mite infestations require prompt diagnosis and targeted therapy to eradicate the parasite and prevent tissue damage. Diagnosis is confirmed by skin scraping, punch biopsy, or dermatoscopy, which reveal the mite within the dermal layer and associated inflammatory cells.
Pharmacologic management includes:
- Topical acaricides: 5% permethrin cream applied once daily for three consecutive days, then repeated after one week. Alternative agents such as benzyl benzoate 25% lotion or sulfur ointment 5% may be used when permethrin is unavailable.
- Systemic therapy: Ivermectin 200 µg/kg orally as a single dose, repeated after 7 days for persistent cases. In severe or refractory infestations, a second dose may be administered after another week.
- Adjunct anti‑inflammatory treatment: Short courses of oral corticosteroids (e.g., prednisone 0.5 mg/kg for 5 days) reduce intense pruritus and edema. Topical corticosteroids (clobetasol propionate 0.05%) applied twice daily for up to 2 weeks aid symptom control.
Supportive measures:
- Hygiene: Wash all clothing, bedding, and towels in hot water (≥60 °C) and dry at high temperature to eliminate environmental stages.
- Environmental decontamination: Vacuum living areas, seal vacuum bags, and treat pets if they serve as reservoirs.
- Patient education: Explain the life cycle of the mite, emphasize completion of the full treatment regimen, and advise on avoidance of re‑exposure.
Follow‑up evaluation occurs 2–4 weeks after therapy completion. Clinical assessment should verify disappearance of lesions, absence of live mites on repeat scraping, and resolution of pruritus. Persistent symptoms warrant reassessment for secondary infection, drug resistance, or alternative diagnoses.