How to treat a subcutaneous mite in a human? - briefly
Treat the infestation with oral ivermectin (200 µg/kg) as a single dose, repeating after 7–10 days if necessary, and apply topical permethrin 5 % cream to the lesion for 8–12 hours. Support therapy includes antihistamines for itching and wound care to prevent secondary infection.
How to treat a subcutaneous mite in a human? - in detail
A subcutaneous mite infestation in a patient requires prompt diagnosis, targeted pharmacotherapy, and supportive care to prevent tissue damage and secondary infection.
The diagnostic work‑up begins with a thorough skin examination. Lesions typically appear as erythematous nodules or cyst‑like swellings, often containing a central punctum. Dermoscopy may reveal the mite’s body or burrow. Definitive identification relies on skin scrapings, punch biopsies, or fine‑needle aspiration examined under light microscopy or, when available, confocal laser scanning microscopy. Molecular methods such as PCR can confirm species when morphological features are ambiguous.
Pharmacological management consists of systemic acaricides and anti‑inflammatory agents:
- Oral ivermectin – 200 µg/kg as a single dose; repeat after 7 days if clinical response is inadequate. Adjust dosage for hepatic impairment.
- Albendazole – 400 mg twice daily for 3 days as an alternative when ivermectin is contraindicated.
- Topical permethrin 5 % cream – applied once daily for 3 days, useful for localized lesions or in combination with oral therapy.
- Corticosteroids – oral prednisone 0.5 mg/kg for 5–7 days to reduce inflammatory edema; taper if prolonged therapy is required.
- Analgesics – NSAIDs or acetaminophen for pain control.
Adjunctive measures enhance recovery:
- Wound care – gentle cleansing with saline, debridement of necrotic tissue, and sterile dressings to prevent bacterial superinfection.
- Antibiotic prophylaxis – oral amoxicillin‑clavulanate 875/125 mg twice daily for 7 days if signs of secondary infection appear (purulence, increased warmth, fever).
- Patient education – avoidance of scratching, proper hygiene, and monitoring for recurrence.
Follow‑up appointments at 1‑week and 4‑week intervals assess lesion resolution, verify eradication via repeat microscopy, and identify potential complications such as granuloma formation or scarring. Persistent nodules after treatment may necessitate surgical excision under local anesthesia.
In immunocompromised individuals, consider extended ivermectin regimens (e.g., three weekly doses) and close surveillance, as atypical presentations and relapse rates are higher.
Overall, an evidence‑based protocol combining systemic acaricidal therapy, anti‑inflammatory medication, meticulous wound management, and regular monitoring provides effective eradication of subcutaneous mite infections in humans.