What next?

Hello,

My brother was diagnosed with scabies in May this year, although by that time the infestation was quite advanced, because various GPs+urologist he saw kept saying it was only an allergy.  After visiting his first dermatologist, and "scabies" diagnosis (he had intense itching, little bumps/pimples on his tighs, penis, etc), he was treated with benzyl benzoate, however the problem recurred 2-3 weeks later.  Then he was treated with boric acid, Eurax, twice, the itching, however continued -although lessened after application of cremes.  

Then several weeks ago, he asked for another dermatologist's opinion and she diagnosed eczema, and said it was not scabies (at least not at the time he saw her), and prescribed various ointments.

Today (7 months after his inital diagnosis) he went to another dermatologist who now says that what appears as an allergy on his tighs, lower stomach and scrotum is still allergy against scabies, and prescribed another benzyl benzoate treatment.  She said this allergy could last for months.  He was determined to seek all allergy testing, but she refused.  

As you may imagine, we are completely confused, since diagnosis ranged from scabies, eczema, dehydorsis (at one point in time he also had blisters on his hands, but those disappeared).  

My questions are:  can allergy to scabies really last for months?  Could it be eczema or an allergy?  Could scabies lead to eczema?  My brother is quite disturbed by itching, he is a student, and it's hard for him to concentrate.  He also seems confused and a bit obsessed about all this.

Any advice is appreciated.  Is there a medicine that could help him?  

Thanks and happy holidays.

[Alan Rockoff, MD]

1. Can allergy to scabies really last for months. No.
2. Could it be eczema or an allergy?  Yes, eczema.
3. Could scabies lead to eczema?  Yes, if he scratched a lot and irritated the skin.

I'm skeptical that it was scabies to start with, but it doesn't matter, because it surely isn't scabies now.  Your brother scratched either from having scabies or from being told he had scabies, and now the skin is raw and sensitive.

My advice is to go back to dermatologist # 2, who seems to have the right idea.  I seriously doubt that further scabies treatments are necessary or advisable.  It may take a few weeks of intensive topical treatment, but your brother should heal up just fine once he stops thinking about bugs.

Take care.

Dr. Rockoff