Parasitic skin infections in the elderly: recognition and drug treatment

There are many parasitic infections of medical importance, which can produce both systemic disease as well as skin lesions. For the most part, treatment of these infections in the elderly does not differ very much from that of younger patients. However, one must be aware that the geriatric population can present with certain challenges with regard to diagnosis of these diseases because history taking may be more difficult and patients often already have a set of other medical problems, which may overshadow the skin lesions. In addition, the clinical manifestations of these infections may not appear classical and may be altered. Dosages of drugs used to treat these infections, even topical agents, may require adjustments in this population. The recognition of scabies in elderly people living together is important and early treatment with topical scabiecides, including oral ivermectin, will help to control the spread of the infestation. Pediculosis may be a cause of pruritus in the elderly and can be treated with malathione, lindane or permethrin. Less common parasitic infections in the elderly, including cutaneous larva migrans and cutaneous leishmaniasis, present with a characteristic clinical picture and can be effectively treated with oral thiabendazole and intravenous antimonials.