Cases Of Scabies Research Articles

Dealing with Scabies in a Hospital Ward.

A case of scabies has been diagnosed in the Medical Ward where Sophie works, and the hospital is having to take appropriate measures. Scabies mites can spread quickly, and staff who are in contact with the infected patient risk catching the parasites and contaminating their own family in turn. One of the night nurses is probably infected.

Efficacy and safety of a lindane 1% treatment regimen for scabies, confirmed by dermoscopy-guided skin scraping with microscopic examination.

This is the first study investigating scabies treatment since 1992 to involve examination of patients with microscopically confirmed scabies. To assess the efficacy of 1% lindane cream in treating microscopically confirmed scabies, and to determine the utility of dermoscopy-guided skin scraping with microscopic examination (DSGSS-ME) in evaluating the efficacy of scabies treatment. This retrospective study analysed patients treated for scabies between January 2012 and December 2013. From the hospital database, 287 cases of scabies were identified and 50 were enrolled in the study. Patients were treated with 1% lindane cream twice weekly (days 0 and 1) and were evaluated with DSGSS-ME on day 7. Treatment and evaluations were repeated once weekly until a negative DSGSS-ME result was obtained. The cumulative efficacy of lindane 1% cream was 40% (20/50) after 1 week, 88% (44/50) after 2 weeks and 98% (49/50) after 3 weeks of treatment. There was a statistically significant difference between the 1- and 2-week (P = 0.03), and 1- and 3-week (P = 0.02) treatments. A total of 90 post-treatment DSGSS-MEs were performed, with a sensitivity of 97.3% (95% CI 85.8-99.9) and a negative predictive value of 98.2% (95% CI 90.1-100). Specificity and positive predictive value were 100%, as this procedure cannot yield false-positive results, because it relies on finding mites, eggs or faeces. We suggest that a twice-weekly schedule (on consecutive days) of 1% lindane treatment lasting at least 2 weeks is required to clear scabies. DSGSS-ME appears to be a good method to evaluate the efficacy of scabies treatment. This study introduces a safe and effective method to treat scabies, and to accurately monitor infestation status in patients.

Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area.

Background/objectivesScabies is a major global public health issue that might affect people from all socioeconomic levels. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions. Scabies often spreads among schoolchildren quite rapidly, owing to their close contact and overcrowding within the schools. However, limited information is available about its risk factors and the socioeconomic correlates among schoolchildren in Egypt. This study aimed to assess the prevalence of scabies and its risk factors among primary schoolchildren in Kafr El-Sheikh administrative area, Egypt.MethodsThis cross-sectional descriptive study was performed on primary schoolchildren in urban and rural areas of Kafr El-Sheikh administrative area. A predesigned questionnaire was used for data collection from the randomly selected 2,104 children, and clinical dermatological examination was done for them.ResultsOut of 2,104 children studied, there were 92 cases of scabies with a prevalence of 4.4%. The prevalence of scabies infestation in male students was 3.9%, while it was 4.8% in females, with no statistical significance. The results showed significant variations in the risk of scabies infestation by factors such as residence, paternal education and occupation, maternal education, sleeping with others, having animals at home, dealing with animals outside the house, type of building for living, family history of itchy rash, and sharing clothes with others.ConclusionIn our community, scabies is still an important health problem affecting schoolchildren, especially in rural areas. It is characterized by a complex web of causation, particularly poor living conditions and low level of parents’ education.

Topical Permethrin Treatment in 106 Cases of Scabies

Topical Permethrin Treatment in 106 Cases of Scabies

Scabies in Children in Sector Gaza

Objectives: To present a profile of scabies in children in sector Gaza. Methods: All patients who were seen in the outpatient clinic in Jordanian hospital in Gaza between 25/11/2010 and 24/01/2011 and who presented with itching, were examined for scabies. Patients were divided into three age groups: group I: 0-4 years, group II: 4-8 years and group III: 8-14 years. Results: A total of 5430 children were seen in outpatient clinic for various diseases and conditions during the study period. 145 cases of scabies were reported with 98 males and 47 females. Scabies was higher in age group II: age 4-8 years, followed by group III; 8-14 years. The incidence of scabies among children seen in the clinic was 0.02% and was higher in males. The commonest manifestation was night itching followed by skin marks. Conclusion: Scabies is a common disease among children in Gaza. Major contributing factors to this disease are: crowding, poor hygiene, scarce water supplies and low socio-economic class.

Utilizing a Hospital Point of Dispensing (HPOD) Architecture for Control of a Scabies Outbreak at an Acute Care Hospital

A case of Norwegian scabies was retrospectively identified following discharge from a >500 bed acute-care hospital, prompting prophylaxis 197 staff. Secondary transmission was identified, necessitating additional prophylaxis of 113 patients, 259 staff, and notification of 485 discharged patients. Continued transmission prompted declaration of outbreak status in collaboration with the health department. A large-scale, synchronized response to stem recurrent transmission between patients and care givers became necessary for optimal management of the outbreak.

Control of scabies outbreaks in an Italian hospital: An information-centered management strategy

Scabies is a dermatologic infestation caused by Sarcoptes scabiei. In industrialized countries, hospitals and other health structures can sometimes be hit. The optimal management of scabies outbreaks still has to be established, mass prophylaxis being one possible option. To identify the optimal approach to containing this re-emerging disease, a local health authority in Lombardy, Northern Italy, carried out an epidemiologic study into 2 scabies epidemics that took place from September to December 2012 in a 600-bed hospital with 26,000 admissions a year. Over a 3-month period, there were 12 cases of scabies on 4 wards; 43 contacts received prophylaxis. When the first cases were identified, an information campaign involving all hospital personnel was immediately set up. Regular staff meetings were organized, and information leaflets were distributed to patients. Family doctors of discharged patients were informed of the outbreak. A management model based on an information-centered strategy was used in place of mass prophylaxis to deal with scabies epidemics. The success of this approach was confirmed by the managers of the hospital involved (reduced expenditure for prophylactic drugs) and by hospital staff who did not have to deal with potential drug adverse effects.

A Case of Infantile Scabies with Multiple Skin Lesions

A Case of Infantile Scabies with Multiple Skin Lesions

Epidemiological Pattern of Scabies and Its Social Determinant Factors in West of Iran

Objectives: Scabies has a different epidemiological distribution among different communities worldwide due to different social factors, management approaches and healthcare policies. The present study came to address outbreaks of scabies according to the social factors in west of Iran. Methods: In a cross-sectional study, using the census sampling method, all consecutive patients with the primary diagnosis of scabies based on clinical manifestations referred to healthcare center throughout the two great provinces of Hamadan and Kermanshah at western Iran between March 2006 and February 2010 were enrolled into the study. The baseline characteristics were collected from recorded files at the healthcare centers or by interviewing with the affected patients. Results: Among 3,625,966 subjects covered by the two studied provinces, 177 cases of scabies (170 cases in Kermanshah and 7 cases in Hamadan) were identified by medical staff at the healthcare centers according to clinical manifestations (85.3%) and laboratory microscopic assessments (14.7%). The highest and the lowest prevalence rates were specified to 2009 (58.2%) and 2008 (1.7%). Regarding gender distribution of disease, 53.1% of men and 46.9% of women suffered from scabies with no significant discrepancy. In respect to age distribution of disease, the highest rates of scabies were revealed in the ages ranged 17 to 30 years (31.6%), followed by younger than 17 years (30.5%). The prevalence of scabies was dependently associated with residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas. Conclusion: West region of Iran especially Kermanshah province faced with high prevalence and this high disease burden can be determined by some potential factors such as residency in rural areas, family history of scabies, lower educational level, household density, lower monthly income, low personal hygiene, the existence of livestock or rodents at home, seasonal conditions, and movement to contaminated areas.

HTLV-1 molecular epidemiology in central Australia: Two distinctive HTLV-1 Subtype C lineages in Indigenous Australians

HTLV-1 infects approximately 5-10 million people worldwide. It is widely distributed, with clusters of high endemicity in certain geographic areas or ethnic groups. Seven main HTLV-1 subtypes have been described and the Melanesian/Australian subtype C is only found in Oceania. In Australia, HTLV-1 is endemic with ATLL, TSP/HAM, bronchiectasis, ID and severe scabies cases reported. However, HTLV-1 clinical significance is debated and only one partial HTLV-1 sequence from an Aboriginal Australian (MSHR-1) is available. Therefore, establishing a large HTLV-1 sequence database is essential for the understanding of the epidemiology and pathogenesis of this virus in Indigenous people. Samples were obtained from 23 HTLV-1 patients originated from four broad geographical and language-based areas. Sequence comparison indicated that the 23 new HTLV-1 LTR and Tax-Gag sequences belong to the subtype C as MSHR-1 strain. Phylogenetic analyses evidenced two main clades (Solomon Islands/Vanuatu versus Australia) within subtype C. Interestingly, the Australian clade can be itself divided into two clusters: the first comprising strains characterized among most of the Indigenous Australians from the North and the second including a majority of individuals originating from the South and Central Australia. Thus, there is a clear evidence of a specific HTLV-1 clustering according to the childhood residence of the HTLV-1 infected individuals, and subsequently their language group affinity. Taking into account that non-human primates have never been found in Australia, we believe that these HTLV-1 subtype C variants have been present among the first ancestors of modern Indigenous Australians for several tens of millennia.

Gale sarcoptique : aspects épidémiologiques, cliniques et thérapeutiques à Bangui

The scabies infects about 300 million people worldwide. Its spread is linked to living conditions especially in economically poor countries. In Central African Republic (CAR) we do not have data on this disease often causes morbidity and expenses, and the disease is often confused and poorly treated. The authors' goal was to describe the epidemiological, clinical and therapeutic characteristics of scabies in Bangui. This was a cross-sectional study by counting records of cases of scabies observed in the dermatology and venereology department of Bangui from 1 January 2006 to 31 December 2010. The diagnosis was based mainly on the combination of a concept of pruritus predominantly night with the notion of contagion and preferential localization of lesions. Three hundred and seventy six cases of scabies were identified from a total of 6391 patients (a hospital prevalence of 5.88%) with high frequency among the population aged 0 to 9 years (33%), an important achievement of the disadvantaged classes (preschool age and pupils / students respectively 25.5% and 26.3%), a prevalence of scabies nodules as type of clinical lesion, localization predominantly on buttocks and the most common complication of eczema-type (19.9 %). Benzyl benzoate solution at 25% applied for 2 consecutive days yielded very satisfactory results (96.7% on day 28) in all forms. The scabies is present in CAR with classical clinical and epidemiological aspects. We recommend first-line benzyl benzoate in two days of application.

Nodular scabies: a classical case report in an adolescent boy.

This case report presents a classical case of nodular scabies in a 12year boy who complained of itching for 20-21days before presentation to the hospital. Application of Betnovate ointment (Betamethasone valerate 0.1%) before presentation to the hospital had provided only 2-3days of relief from itching. Dermatological examination revealed skin colored to erythematous papule of 3-4mm on the body with predilection for web space of fingers and flexural areas and nodules on the scrotum and groin. Based on this, clinical diagnosis of scabies with nodular scabies was made on the child. The scraping obtained from the web-space of the child showed mite under the light microscope, which confirms the diagnosis. Treatment with topical permethrin 5% lotion resulted in 50-70% subsidence of itching within a day, and improvement in impetigo lesions of his father in 5days. However, the scrotal and groin nodular lesion of the child persisted with severe itching. Treatment with topical steroid and tacrolimus 0.1% ointment did not show much improvement. Intralesional injection of triamcinolone (5mg/ml) on the nodule resulted in 30-40% subsidence in itching and 50-60% reduction in the size of the lesion over 2-3weeks.

Diagnóstico por Teledermatologia em paciente do Alto Rio Solimões: um caso de escabiose crostosa

Teledermatology uses telecommunication technology and informatics on dermatologic practice without the presence of a specialist. This paper describes the diagnostic process of a Crusted Scabies (Norwegian Scabies) case in an elderly patient from the Alto Solimoes River region using teledermatology resources. Moreover, the authors discuss the progress of these technologies, which allow healthcare assistance for those living in remote indigenous and riverine communities, particularly in isolated areas of the Legal Amazon where many diseases are neglected or underdiagnosed.

Bullous scabies in an adult: A case report with review of literature

Scabies is an infestation caused by Sarcoptes scabiei, characterized by polymorphous lesions that may include burrows, papules, nodules, excoriation, and crusts. Vesicular and bullous lesions are rather rare. Bullous scabies is regarded as a distinct subtype of scabies, closely resembling bullous pemphigoid. Here, we report a case of bullous scabies in an adult male and review the literature.

Polarizable elements in scabies infestation: a clue to diagnosis

The diagnosis of scabies infestation is straightforward in cases where mite parts are largely visible; however, mites are often not captured in a specimen's planes of section. Polariscopic examination is a fast and simple adjunctive diagnostic tool to light microscopy. We describe the unique polariscopic findings in scabies infestation. Two cases of crusted scabies and eight cases of typical scabies were subjected to polariscopic examination. Diagnostic mite parts were visualized in at least one section in all cases. Attached and detached spines as well as scybala (fecal material) are polarizable. Specifically, spines show a polarizable outer sheath with dark central core while scybala show peripherally concentrated, stippled birefringence. Similar stippled birefringence is visible within the gut of some mites whereas significant birefringence is not appreciated in other mite parts. These results suggest that polariscopic examination is a helpful clue in the diagnosis of scabies infestation, especially in cases where the body of the mite is not visualized.

Two Cases of the Norwegian Scabies-Infested Patients with Chronic Disease in Elderly Care Unit

Dong Il Jeong, MD, Min Seong Kim, MD, Joon Ho Jeon, MD, Tae Hyung Kwon, MD, Myung Ki Hyun, MD, Yong Kyu Lee, MD Department of Internal Medicine, Good Gang-An Hospital, Busan, 2Hyun‵s Skin & Laser Clinic, Busan, Korea The scabies mite is an ectoparasite, which is able to infest humans. The incidence of scabies decreased during the past 20 years in Korea. However, the incidence is likely to increase again, and may be delayed or missed diagnosis recently. Its clinical presentation is typical, although in a host with compromised immune system, like the mentally retarded and elderly patients, the clinical presentation may be altered. Because a delay in diagnosis may induce rapid spread of the scabies mite, immediate diagnosis and treatment are necessary. We report two cases of scabies in elderly patients from different nursing homes. These patients were transferred to our center for treatment of pneumonia and chronic renal disease. They revealed pruritus and skin rashes after the treatment of further underlying diseases. We consulted to a dermatologist because of worsening symptoms, despite an application of medication with antihistamine and topical steroid, scabies was diagnosed. The symptom improved with topical 1% gamma-benzene hexachloride, an effective scabies drug. We suggest that geriatrists should suspect scabies who presents with pruritus that is persistent or resistant to conventional treatment, especially patients transferred from nursing homes.

La gale en France entre 1999 et 2010 : augmentation de l’incidence et implications en santé publique

Scabies is a contagious parasitic infestation that is benign in most cases; however, delay in diagnosis and treatment can cause numerous problems for patients and people in their vicinity, as well as a risk of secondary spread. Following numerous reports suggesting increased incidence of scabies in France, we analysed various available indicators. We analysed spontaneous and mandatory reports submitted to public health bodies as well as sales figures for scabies treatments in France over the period between 1999 and 2010. Reports submitted to public health structures suggest an increase in the number of cases of scabies both within the community and in healthcare establishments. An increase was seen in regional and national sales of scabies treatments. At the national level, between 2005 and 2009, sales rose from 283 to 402 bottles per 100,000 persons per year (+10% per year) for benzyl benzoate and from 216 to 495 treatments per 100,000 persons per year (+22%) for ivermectin. Based on these data, the minimum estimated annual incidence of scabies in France is 328 cases per 100,000 persons. There is some discussion surrounding the interpretation of these data, particularly the bias associated with reporting practice and with the protocols used to treat affected subjects and those in their vicinity. However, all of the information gathered indicates a real increase in the incidence of scabies in France, as a result of which we recommend increased information for the general public, clinical practitioners and public health partners in order to ensure early diagnosis and treatment.

Pre-emptive diagnosis of a case of scabies by dermatopathology

A 39-year-old woman reported to her general practitio-ner with a new pigmented skin lesion on her right pectoral region. Dermatoscopically there were no suspicious features and the decision was made to monitor it over a three-month period. At follow-up imaging there was some minor change, possibly related to technical factors (the original camera/dermatoscope combination was not available), and after dis-cussion with the patient a decision was made to perform an excisional biopsy. The pathologist reported the lesion as a: “… dysplastic naevus of the compound type” with “… mild atypia and active lymphocytic regression.” He made the addi-tional comment: “Two apparent scabies mites are present.” This was not expected, as the patient had complained of no symptoms of scabies and no skin eruption had been observed to suggest that diagnosis.The patient returned for her routine postoperative review one week after the excision. She now complained of an intensely itchy skin eruption and wondered if she was having an allergic reaction to the local anaesthetic or antiseptic skin preparation solution used at the time of surgery. Examination

Prevalence of scabies among school-aged children in Katanga rural community in Kaduna state, Northwestern Nigeria

Background: Scabies is a common parasitic infestation of global proportion. It is a highly contagious skin disease which affects both males and females of all socioeconomic status and race. It is related primarily to poverty and overcrowding, which is also found in most rural communities. This study aimed at assessing the prevalence of scabies among school-aged children in Katanga community. Materials and Methods: In a descriptive cross-sectional study, pre-tested semi-structured questionnaire was administered to 206 school children aged 5-12 years through a total population study in Katanga rural community. Data collected were analyzed using SPSS version 17. Results: In this study, 45 (21.8%) children had skin infections, 33 (73.3%) of these skin infections were associated with itching and 6 cases of scabies were found giving a prevalence rate of 2.9% in the community. Conclusion: This study has shown that scabies is a disease associated with poverty, overcrowding, and sometimes water shortage, and is still endemic in rural communities in Northern Nigeria causing a substantial burden. These findings, coupled with the potential for clinical complications and a heavy socioeconomic impact, suggest that it is time for more concerted actions in terms of provision of adequate domestic water supply and improvement of personal and environmental hygiene against this disease in Nigeria.

Scabies: A Review of Diagnosis and Management Based on Mite Biology

Scabies is a contagious parasitic dermatitis that is a significant cause of morbidity, especially outside of the United States. Scabies is diagnosed most often by correlating clinical suspicion with the identification of a burrow. Although scabies should be on the differential for any patient who presents with a pruritic dermatosis, clinicians must consider a wide range of diagnostic possibilities. This approach will help make scabies simultaneously less over- and underdiagnosed by clinicians in the community. Atypical or otherwise complex presentations may necessitate the use of more definitive diagnostic modalities, such as microscopic examination of KOH prepared skin scrapings, high-resolution digital photography, dermoscopy, or biopsy. Scabies therapy involves making the correct diagnosis, recognizing the correct clinical context to guide treatment of contacts and fomites, choosing the most effective medication, understanding how to use the agent properly, and following a rational basis for when to use and reuse that agent. Although the development of new therapeutic agents is always welcome, tried and true treatments are still effective today. Permethrin is the gold standard therapy, with malathion being an excellent topical alternative. Ivermectin is an effective oral alternative that is especially useful in crusted scabies, patients who are bed ridden, and in institutional outbreaks. Despite the availability of effective therapeutics, treatment failures still occur, mostly secondary to application error (ie, failure to treat the face and scalp or close contacts, failure to reapply medication) or failure to decontaminate fomites. Because increasing resistance to scabies treatments may be on the horizon, we propose that standard of care for scabies treatment should involve routine treatment of the scalp and face and re-treating patients at day 4 on the basis of the scabies life cycle to ensure more efficient mite eradication. Practitioners should attempt to treat all close contacts simultaneously with the source patient. To eradicate mites, all fomites should be placed in a dryer for 10 minutes on a high setting, furniture and carpets vacuumed, and nonlaunderables isolated for a minimum of 2 days, or, for those who wish to be rigorous, 3 weeks.