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    1. Chlamydial Infections

      Chlamydial Infections

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Screening for Chlamydial Infection
      7. Treatment of Adolescents and Adults
      8. Management of Sex Partners
      9. Treatment of Neonates and Children
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    2. Gonococcal Infections

      Gonococcal Infections

      1. Introduction
      2. Epidemiology in the United States
      3. Gonococcal Antimicrobial Susceptibility
      4. Microbiology, Pathogenesis, and Transmission
      5. Clinical Manifestations
      6. Laboratory Diagnosis
      7. Screening for Gonococcal Infection
      8. Treatment
      9. Management of Sex Partners
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    3. Syphilis

      Syphilis

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnostic Tests
      6. Screening for Syphilis
      7. Treatment
      8. Post-Treatment Follow Up
      9. Management of Sex Partners
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    4. Genital Herpes

      Genital Herpes

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Screening for HSV-2 Infection
      7. Treatment
      8. Genital HSV in Pregnancy and Neonatal Herpes
      9. Prevention
      10. Patient Counseling and Education
      11. Summary Points
    5. Human Papillomavirus Infection

      Human Papillomavirus Infection

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Diagnosis and Screening Tests
      6. Screening Recommendations for HPV-Related Cancers
      7. Treatment of Anogenital Warts
      8. Prevention of HPV Infection
      9. Counseling and Education
      10. Summary Points
    6. Pelvic Inflammatory Disease

      Pelvic Inflammatory Disease

      1. Introduction
      2. Epidemiology
      3. Microbiology and Pathogenesis
      4. Clinical Manifestations
      5. Diagnosis
      6. Treatment
      7. Management of Sex Partners
      8. Counseling and Education
      9. Summary Points
    7. Vaginitis

      Vaginitis

      1. Introduction
      2. Diagnostic Approach for Vaginitis
      3. Bacterial Vaginosis
      4. Trichomoniasis
      5. Vulvovaginal Candidiasis
      6. Summary Points
    8. Mpox

      Mpox

      1. Introduction
      2. Epidemiology
      3. Virology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Treatment
      7. Infection Control in Health Care Settings
      8. Prevention of Mpox Infection
      9. Counseling and Education
      10. Summary Points
    9. Mycoplasma genitalium

      Mycoplasma genitalium

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Antimicrobial Susceptibility in Mycoplasma genitalium
      5. Clinical Manifestations
      6. Laboratory Diagnostic Tests and Resistance Assays
      7. Diagnostic Testing and Screening Guidelines
      8. Treatment of Mycoplasma genitalium Infection
      9. Counseling and Education
      10. Summary Points
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    1. Chlamydial Infections

      Chlamydial Infections

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Screening for Chlamydial Infection
      7. Treatment of Adolescents and Adults
      8. Management of Sex Partners
      9. Treatment of Neonates and Children
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    2. Gonococcal Infections

      Gonococcal Infections

      1. Introduction
      2. Epidemiology in the United States
      3. Gonococcal Antimicrobial Susceptibility
      4. Microbiology, Pathogenesis, and Transmission
      5. Clinical Manifestations
      6. Laboratory Diagnosis
      7. Screening for Gonococcal Infection
      8. Treatment
      9. Management of Sex Partners
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    3. Syphilis

      Syphilis

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnostic Tests
      6. Screening for Syphilis
      7. Treatment
      8. Post-Treatment Follow Up
      9. Management of Sex Partners
      10. Counseling and Education
      11. Prevention
      12. Summary Points
    4. Genital Herpes

      Genital Herpes

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Screening for HSV-2 Infection
      7. Treatment
      8. Genital HSV in Pregnancy and Neonatal Herpes
      9. Prevention
      10. Patient Counseling and Education
      11. Summary Points
    5. Human Papillomavirus Infection

      Human Papillomavirus Infection

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Diagnosis and Screening Tests
      6. Screening Recommendations for HPV-Related Cancers
      7. Treatment of Anogenital Warts
      8. Prevention of HPV Infection
      9. Counseling and Education
      10. Summary Points
    6. Pelvic Inflammatory Disease

      Pelvic Inflammatory Disease

      1. Introduction
      2. Epidemiology
      3. Microbiology and Pathogenesis
      4. Clinical Manifestations
      5. Diagnosis
      6. Treatment
      7. Management of Sex Partners
      8. Counseling and Education
      9. Summary Points
    7. Vaginitis

      Vaginitis

      1. Introduction
      2. Diagnostic Approach for Vaginitis
      3. Bacterial Vaginosis
      4. Trichomoniasis
      5. Vulvovaginal Candidiasis
      6. Summary Points
    8. Mpox

      Mpox

      1. Introduction
      2. Epidemiology
      3. Virology, Pathogenesis, and Transmission
      4. Clinical Manifestations
      5. Laboratory Diagnosis
      6. Treatment
      7. Infection Control in Health Care Settings
      8. Prevention of Mpox Infection
      9. Counseling and Education
      10. Summary Points
    9. Mycoplasma genitalium

      Mycoplasma genitalium

      1. Introduction
      2. Epidemiology in the United States
      3. Microbiology, Pathogenesis, and Transmission
      4. Antimicrobial Susceptibility in Mycoplasma genitalium
      5. Clinical Manifestations
      6. Laboratory Diagnostic Tests and Resistance Assays
      7. Diagnostic Testing and Screening Guidelines
      8. Treatment of Mycoplasma genitalium Infection
      9. Counseling and Education
      10. Summary Points
  • Question
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  • Mpox
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  • Master
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  1. Quick Reference
  2. Scabies
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  • Module 1 Overview
    STD Question Bank
  • 0%Lesson 1
    Anogenital Warts
    Activities
    1. 0%Lesson 2
      Bacterial Vaginosis
      Activities
      1. 0%Lesson 3
        Candidiasis - Vulvovaginal
        Activities
        1. 0%Lesson 4
          Cervicitis
          Activities
          1. 0%Lesson 5
            Chancroid
            Activities
            1. 5A.Core Concepts
          2. 0%Lesson 6
            Chlamydial Infections
            Activities
            1. 0%Lesson 7
              Epididymitis
              Activities
              1. 0%Lesson 8
                Gonococcal Infections
                Activities
                1. 0%Lesson 9
                  Granuloma Inguinale (Donovanosis)
                  Activities
                  1. 0%Lesson 10
                    Hepatitis A
                    Activities
                    1. 0%Lesson 11
                      Hepatitis B
                      Activities
                      1. 0%Lesson 12
                        Hepatitis C
                        Activities
                        1. 0%Lesson 13
                          Genital Herpes
                          Activities
                          1. 0%Lesson 14
                            HIV Infection
                            Activities
                            1. 0%Lesson 15
                              HPV Infection: Prevention
                              Activities
                              1. 0%Lesson 16
                                HPV-Associated Cancers and Precancers
                                Activities
                                1. 0%Lesson 17
                                  Lymphogranuloma venereum (LGV)
                                  Activities
                                  1. 0%Lesson 18
                                    Mpox
                                    Activities
                                    1. 0%Lesson 19
                                      Mycoplasma genitalium
                                      Activities
                                      1. 0%Lesson 20
                                        Pediculosis Pubis
                                        Activities
                                        1. 0%Lesson 21
                                          Pelvic Inflammatory Disease (PID)
                                          Activities
                                          1. 0%Lesson 22
                                            Penicillin Allergy
                                            Activities
                                            1. 0%Lesson 23
                                              Proctitis, Proctocolitis, and Enteritis
                                              Activities
                                              1. 0%Lesson 24
                                                Scabies
                                                Activities
                                                1. 0%Lesson 25
                                                  Sexual Assault and Abuse and STIs
                                                  Activities
                                                  1. 0%Lesson 26
                                                    Syphilis
                                                    Activities
                                                    1. 0%Lesson 28
                                                      Trichomoniasis
                                                      Activities
                                                      1. 0%Lesson 29
                                                        Urethritis
                                                        Activities
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                                                        Lesson 24. Scabies

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                                                        Table of Contents
                                                        • Scabies
                                                        • References
                                                        • Tables
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                                                        References

                                                        • Anderson AL, Chaney E. Pubic lice (Pthirus pubis): history, biology and treatment vs. knowledge and beliefs of US college students. Int J Environ Res Public Health. 2009;6:592-600.
                                                          [PubMed Abstract] -
                                                        • Anderson KL, Strowd LC. Epidemiology, Diagnosis, and Treatment of Scabies in a Dermatology Office. J Am Board Fam Med. 2017 1/2;30:78-84.
                                                          [PubMed Abstract] -
                                                        • Belvisi V, Orsi GB, Del Borgo C, et al. Large Nosocomial Outbreak Associated with a Norwegian Scabies Index Case Undergoing TNF-α Inhibitor Treatment: Management and Control. Infect Control Hosp Epidemiol. 2015;36:1358-60.
                                                          [PubMed Abstract] -
                                                        • Bernigaud C, Fang F, Fischer K, et al. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model. PLoS Negl Trop Dis. 2016;10:e0005030.
                                                          [PubMed Abstract] -
                                                        • Burkhart CG, Burkhart CN. Oral ivermectin for Phthirus pubis. J Am Acad Dermatol. 2004;51:1037-8.
                                                          [PubMed Abstract] -
                                                        • Campbell JJ, Paulson CP, Nashelsky J. Clinical Inquiry: What is the most effective treatment for scabies? J Fam Pract. 2017;66:E11-E12.
                                                          [PubMed Abstract] -
                                                        • Chosidow O, Fuller LC. Scratching the itch: is scabies a truly neglected disease? Lancet Infect Dis. 2017;17:1220-1221.
                                                          [PubMed Abstract] -
                                                        • Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006;354:1718-27.
                                                          [PubMed Abstract] -
                                                        • Cook AM, Romanelli F. Ivermectin for the treatment of resistant scabies. Ann Pharmacother. 2003;37:279-81.
                                                          [PubMed Abstract] -
                                                        • Currie BJ, McCarthy JS. Permethrin and ivermectin for scabies. N Engl J Med. 2010;362:717-25.
                                                          [PubMed Abstract] -
                                                        • Dhana A, Yen H, Okhovat JP, Cho E, Keum N, Khumalo NP. Ivermectin versus permethrin in the treatment of scabies: A systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol. 2018;78:194-198.
                                                          [PubMed Abstract] -
                                                        • Dohvoma VA, Ebana Mvogo SR, Atangana PJA, Nyasse P, Epee E, Ebana Mvogo C. Phthirus pubis Infestation of the Eyelids Presenting as Chronic Blepharoconjunctivitis in a 6-Year-Old Girl: A Case Report. Case Rep Ophthalmol. 2018;9:30-34.
                                                          [PubMed Abstract] -
                                                        • Elosua-González M, García-Zamora E. Crusted Scabies. N Engl J Med. 2017;377:476.
                                                          [PubMed Abstract] -
                                                        • Flinders DC, De Schweinitz P. Pediculosis and scabies. Am Fam Physician. 2004;69:341-8.
                                                          [PubMed Abstract] -
                                                        • Fuentes-Suárez A, González-Márquez TN. "Acrobatic" Lice. N Engl J Med. 2017;377:e19.
                                                          [PubMed Abstract] -
                                                        • Gunning K, Pippitt K, Kiraly B, Sayler M. Pediculosis and scabies: treatment update. Am Fam Physician. 2012;86:535-41.
                                                          [PubMed Abstract] -
                                                        • Huffam SE, Currie BJ. Ivermectin for Sarcoptes scabiei hyperinfestation. Int J Infect Dis. 1998;2:152-4.
                                                          [PubMed Abstract] -
                                                        • Johnstone P, Stong M. Scabies. Am Fam Physician. 2015;92:919-20.
                                                          [PubMed Abstract] -
                                                        • Koch E, Clark JM, Cohen B, et al. Management of head louse infestations in the United States—a literature review. Pediatr Dermatol. 2016;33:466-72.
                                                          [PubMed Abstract] -
                                                        • Leone PA. Scabies and pediculosis pubis: an update of treatment regimens and general review. Clin Infect Dis. 2007;44 Suppl 3:S153-9.
                                                          [PubMed Abstract] -
                                                        • Marin-Cabanas I, Pascual JC. Image Gallery: Dermoscopy of phthiriasis pubis: a handy and useful tool. Br J Dermatol. 2016;175:e94.
                                                          [PubMed Abstract] -
                                                        • Micali G, Lacarrubba F, Verzì AE, Chosidow O, Schwartz RA. Scabies: Advances in Noninvasive Diagnosis. PLoS Negl Trop Dis. 2016;10:e0004691.
                                                          [PubMed Abstract] -
                                                        • Ortega-Loayza AG, McCall CO, Nunley JR. Crusted scabies and multiple dosages of ivermectin. J Drugs Dermatol. 2013;12:584-5.
                                                          [PubMed Abstract] -
                                                        • Roberts LJ, Huffam SE, Walton SF, Currie BJ. Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature. J Infect. 2005;50:375-81.
                                                          [PubMed Abstract] -
                                                        • Romani L, Whitfeld MJ, Koroivueta J, et al. Mass Drug Administration for Scabies Control in a Population with Endemic Disease. N Engl J Med. 2015;373:2305-13.
                                                          [PubMed Abstract] -
                                                        • Salavastru CM, Chosidow O, Boffa MJ, Janier M, Tiplica GS. European guideline for the management of scabies. J Eur Acad Dermatol Venereol. 2017;31:1248-1253.
                                                          [PubMed Abstract] -
                                                        • Salavastru CM, Chosidow O, Janier M, Tiplica GS. European guideline for the management of pediculosis pubis. J Eur Acad Dermatol Venereol. 2017;31:1425-1428.
                                                          [PubMed Abstract] -
                                                        • Shimose L, Munoz-Price LS. Diagnosis, prevention, and treatment of scabies. Curr Infect Dis Rep. 2013;15:426-31.
                                                          [PubMed Abstract] -
                                                        • Wendel K, Rompalo A. Scabies and pediculosis pubis: an update of treatment regimens and general review. Clin Infect Dis. 2002;35:S146-51.
                                                          [PubMed Abstract] -
                                                        • Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. Ectoparasitic infections. MMWR Recomm Rep. 2015;64(No. RR-3):1-137.
                                                          [2015 STD Treatment Guidelines] -

                                                        Tables

                                                        Table 1. 2021 STI Treatment Guidelines: Ectoparasitic Infections
                                                        Treatment of Scabies

                                                        Note: lindane was previously recommended as an alternative treatment for scabies, but lindane has been discontinued in the United States due to risk of neurotoxicity.
                                                        Recommended for Treatment of Scabies
                                                        Permethrin 5% cream

                                                        Permethrin 5% cream

                                                        Tradename:Acticin, Elimite, Nix
                                                        applied to all areas of the body from the neck down and washed off after 8–14 hours
                                                        Recommended for Treatment of Scabies
                                                        Ivermectin

                                                        Ivermectin

                                                        Tradename:Stromectol
                                                        200 μg/kg body weight orally, repeated in 14 days*
                                                        Note: *Oral ivermectin has limited ovicidal activity; a second dose is required for eradication.
                                                        Recommended for Treatment of Scabies
                                                        Ivermectin 1% cream

                                                        Ivermectin 1% cream

                                                        Tradename:Soolantra
                                                        applied to all areas of the body from the neck down and washed off after 8–14 hours^
                                                        Note: ^Repeat treatment in 1 week if symptoms persist
                                                        Source: Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. Ectoparasitic infections. MMWR Recomm Rep. 2021;70(No. RR-4):1-187. [2021 STI Treatment Guidelines]

                                                        Table 2. 2015 STD Treatment Guidelines: Ectoparasitic Infections
                                                        Treatment of Crusted Scabies

                                                        Substantial treatment failure might occur with a single-dose topical scabicide or with oral ivermectin treatment. Combination treatment is recommended.
                                                        Recommended for Treatment of Crusted Scabies
                                                        Permethrin 5% cream

                                                        Permethrin 5% cream

                                                        Tradename:Acticin, Elimite, Nix
                                                        topical, full-body application to be repeated daily for 7 days then 2 times per week until cure
                                                        Ivermectin

                                                        Ivermectin

                                                        Tradename:Stromectol
                                                        200 ug/kg body weight on days 1, 2, 8, 9, and 15+
                                                        Note: Additional ivermectin treatment on days 22 and 29 might be required for severe cases
                                                        Recommended for Treatment of Crusted Scabies

                                                        Tradename:
                                                        full-body application to be repeated daily for 7 days then 2x weekly until discharge or cure
                                                        Ivermectin

                                                        Ivermectin

                                                        Tradename:Stromectol
                                                        200 ug/kg body weight on days 1, 2, 8, 9, and 15+
                                                        Note: Additional ivermectin treatment on days 22 and 29 might be required for severe cases
                                                        Lindane should be avoided because of the risks for neurotoxicity with heavy applications or denuded skin

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