11-year-old boy is brought to the office by his parents due to a pruritic skin rash for 2 weeks

11-year-old boy is brought to the office by his parents due to a pruritic skin rash for 2 weeks. The rash started

on his hands and subsequently spread to the trunk and lower extremities. His mother reports that the patient is

constantly scratching the rash and his sleep is now disturl6ed due to intense pruritus. A cousin who recently visited

and shared a room with him had similar symptoms. The patient has had no fever and is up to date with routine

vaccinations. Physical examination shows numerous 2- to 3-mm erythematous papules and vesicles with

excoriation on his neck, hands, feet, and waistline. His chest and proximal arms and legs are unaffected. Which of

the following is the most appropriate initial intervention in management of this patient?

  • Q A. No intervention necessary
  • Q B. Oral acyclovir
  • 0 C. Oral clindamycin
  • 0 D. Topical clotrimazole
  • 0 E. Topical hydrocortisone
  • 0 F. Topical permethrin

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