Clinically, he has crusted, scaly lesions over the ears, neck, axilla, finger & toe webspaces and groin along with some erythematous papular scaly lesions and scratch marks over the trunk.

I have given him topical betamethasone valearate 0.25% with 2% salicylic ointment BD for 5 days before an overnight application of topical Permethrin.

Other mates in the nursing home needs to be treated as well.

I think in Norweigian Scabies ,you need to consider topical + oral Ivermectin as the thick scales can sometimes protect the mites from topical Rx
Alternatively consider two doses of Ivermectin 2 weeks apart along with treating others that have come in contact with & general measures (Submitted By: Dr Kiran Shahid)

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