Can antiparasitic drugs, corticosteroids, and antihistamines help alleviate insect bite hypersensitivity?

Question

Hello doctor,

I have been dealing with this issue for nearly two years now. I consulted a doctor previously, but I am uncertain if the diagnosis she provided was accurate, as I did not experience any improvement. Currently, I am experiencing intense itching all over my abdomen, thighs, beside the armpit, and on my chest. While it appears to resemble a ringworm to me, I purchased a ringworm spray which has only exacerbated the itchiness. As a result, the affected areas have started to bleed. I am eager to find a solution to this problem and receive an accurate diagnosis.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your query and examined your picture (attachments removed to protect patient’s identity). It seems you may be suffering from either scabies or insect bite hypersensitivity. Scabies is an intensely itchy skin infestation caused by mites. The diagnosis of scabies can often be made clinically through the presence of a pruritic rash, with itching occurring predominantly at night and the characteristic linear burrows over the limbs. It is important to note that other family members can also be affected.

As for the treatment plan, on day one, you can apply a single application of Permethrin 5% cream below the neck, covering your entire body, during the night. Leave the cream on for 10 to 12 hours and then take a bath using a medicated soap that contains Permethrin for seven days. Additionally, take a single dose (12 mg) of tablet Ivermectin on the same day. Remember to wash your used clothes thoroughly and wear fresh clothes after your bath on the next day. On day two, apply Fluticasone 0.05% cream twice daily for five to seven days. Also, take tablet Levocetirizine once daily for the same duration to manage the itching and discomfort. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent. Please schedule a follow-up appointment for a review after one week to assess your progress.

Thanks and regards.