Abstract
BackgroundScabies is an ancient disease (documented as far back as 2500 years ago). It affects about 300 million people annually worldwide, and the prevalence is as high as about 60 % in Indigenous and Torres Strait Islander children in Australia. This is more than six times the rate seen in the rest of the developed world. Scabies is frequently complicated by bacterial infection leading to the development of skin sores and other more serious consequences such as septicaemia and chronic heart and kidney diseases. This causes a substantial social and economic burden especially in resource poor communities around the world.DiscussionVery few treatment options are currently available for the management of scabies infection. In this manuscript we briefly discuss the clinical consequences of scabies and the problems found (studies conducted in Australia) with the currently used topical and oral treatments. Current scabies treatment options are fairly ineffective in preventing treatment relapse, inflammatory skin reactions and associated bacterial skin infections. None have ovicidal, antibacterial, anti-inflammatory and/or anti-pruritic properties. Treatments which are currently available for scabies can be problematic with adverse effects and perhaps of greater concern the risk of treatment failure. The development of new chemical entities is doubtful in the near future. Though there may be potential for immunological control, the development of a vaccine or other immunotherapy modalities may be decades away.SummaryThe emergence of resistance among scabies mites to classical scabicides and ineffectiveness of current treatments (in reducing inflammatory skin reactions and secondary bacterial infections associated with scabies), raise serious concerns regarding current therapy. Treatment adherence difficulties, and safety and efficacy uncertainties in the young and elderly, all signal the need to identify new treatments for scabies.
Highlights
Summary: The emergence of resistance among scabies mites to classical scabicides and ineffectiveness of current treatments, raise serious concerns regarding current therapy
Scabies infestation has a negative impact on the quality of life for infected individuals resulting in substantial stigmatisation and ostracism [8]. In this manuscript we focus on the challenges found with diagnosis and treatment, emerging resistance among scabies mites, and the need for further research in this
A positive response to therapy cannot exclude the spontaneous disappearance of a skin condition other than scabies, and a negative response to the first-line treatment option does not exclude scabies, especially with growing resistance among scabies mites [9]
Summary
Diagnosis At present there is no accurate means of diagnosing scabies in various clinical settings. A positive response to therapy cannot exclude the spontaneous disappearance of a skin condition other than scabies, and a negative response to the first-line treatment option does not exclude scabies, especially with growing resistance among scabies mites [9] Recent findings in this field, e.g. serodiagnosis [10] shows promising potential; more research is required to evaluate its efficiency in tropical clinical settings. Mass drug administration (MDA) programs have been attempted to use ivermectin to control scabies in endemic communities around the world [26] Such programs’ superiority over alternative topical treatment is questionable [27, 28]. Authors’ details 1Senior Lecturer in Pharmaceutics, Faculty of Health University of Canberra, Canberra, Australia 2Professor in Pharmacy, Associate Dean of Research, University of Tasmania, Hobart, Tasmania, Australia
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