A 35-year-old man who is generally well was diagnosed with scabies 3 days ago presents with a chief complaint. “I do not think that skin medicine I was given worked. I am still really itchy and the rash looks the same”.  He reports using topical permethrin as advised. Physical exam reveals excoriated papules on the interdigital area and scattered similar areas in the axillary and groin regions.  Microscopic examination of skin scrapings supports the scabies diagnosis.  He is otherwise without new findings. The NP considers the following:

A. Another course of permethrin is advised, to be used as soon as possible.
B. A skin biopsy should be performed today.
C. Low dose topical corticosteroids and oral antihistamines should be prescribed.
D. A topical antibacterial is advised.

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