By Gary M. White, MD
Nodular scabies is the presence of inflammatory papules or nodules during or soon after a scabies infestation.
- Inflammatory nodules may develop during active scabies infestation or post effective treatment as a hypersensitivity reaction.
- When present, they should be evaluated with magnification, eg loop or dermatoscope, for the presence of mites [JAAD 2014:71:1022].
Red nodules develop either where a scabies mite currently is (look for a burrow atop each papulonodule) or has been. Histologic studies have shown scabies bug parts may be present in the dermis of some lesions.
- If live mite are present, treat for scabies.
- if no mites there or elsewhere, intralesional triamcinolone, e.g. 5 mg/cc x 0.1 cc each.
- Potent topical steroid to each lesion BID x 2 weeks.
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