The American journal of emergency medicine
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Chronic pruritus accounts for approximately 1 % of all physician visits, and providers are often confronted with how to treat patients with pruritus. Scabies is oftentimes a concern by both patients and providers, and anti-scabietic treatments are generally considered safe and effective. However, the pruritus will continue if there is an alternate etiology. ⋯ While scabies is one cause of chronic pruritus, its misdiagnosis may increase the chance that at-risk individuals, often those with prior substance abuse or psychiatric disorders, develop a persistent concern for ongoing infestation. It is possible that, in treating chronic pruritus with repeated empiric anti-scabietic treatments, the prescribing physician may contribute to the development of DI. We review the approach to a patient with chronic pruritus and ways to avoid unnecessary repeated anti-scabietic treatments.