Scabies Patients Research Articles

Clinico-Dermoscopic Consensus in Patients of Scabies presenting in a Tertiary Care Hospital

Objective: To determine the concordance between clinical and dermoscopic findings in patients of scabies. Study Design: Cross-Sectional Study. Place and Duration of Study: Dermatology Department, PNS Shifa Hospital, Karachi Pakistan, from Jun 2022-Dec 2022. Methodology: All patients visiting Dermatology Outpatient during the study period with history of itching and age ranging from 18-50 years of either gender were included in this study after obtaining prior informed consent. Dermoscopic findings were recorded using HIEINE DELTA 20T dermoscope, captured at 10-16x magnification under standardized conditions of color and light, and stored using a 40-megapixel mobile camera for further investigation. Results: The age of patients ranged from 18 to 50 years with a median of 28.0(10.0). In the distribution of gender, 119(69.6%) were male while 52(30.4%) were female. Concordance between clinical and dermoscopic findings was noted in 91 patients (53.21%). Conclusion: Insignificant concordance was noted between clinical and dermoscopic findings among clinically suspicious patients of scabies.

Epidemiological Study on Three Hundred Patients of Scabies in the Industrial Area of Dhaka, Bangladesh

Background: Scabies is a common and highly contagious skin disease caused by a mite called sarcoptes scabiei. Objective: The aim of this study was to analyze the epidemiological factors associated with scabies infection in an industrial area. Methodology: Write the study design, study place, study period and study population here. It was considering age, sex, occupation, economical condition, educational status, family history of scabies of the selected patient. Results: The age group of 1 to 10 years (28.66%) and low socioeconomic condition (58.66%), illiterate (Primary 44.00%), overcrowding living (Madrasah 37.33%) showed the highest infestation rates. Write more findings here Conclusion: In conclusion an improvement of socio-economic conditions, improve living facilities, education, social awareness may contribute to a reduction in the number of scabies infections. Journal of Monno Medical College June, 2024; 10 (1):13-16

The impact of scabies in tent cities in Kahramanmaraş after the Turkish earthquakes: oral pharmacologic treatment efficacy

Background Our study was conducted to determine the impact of scabies in people living in collective living areas such as tent cities and container cities after the February 6 Kahramanmaraş earthquakes and to show the effectiveness of oral ivermectin treatment on scabies cases because topical treatments could not be used in this period when access to water was limited. Methods Among 233 patients diagnosed and treated with scabies in tent and container cities, 192 patients who met the criteria were included in the study. Descriptive statistics were given as number (n), percentage (%), mean, median, standard deviation (SD). In the comparison of categorical data, the chi-square test was applied; in the comparison of numerical data ANOVA analyses was applied. Results A total of 192 scabies patients (82.4%), 47.9% (N:92) of whom were women, were included in the study. The frequency of scabies in the total population in tent cities and container cities was found to be at least 0.54%. The most common symptoms were pruritis (99.0%) and rash (97.9%). The most common sites of lesion involvement were the umbilicus (87.0.%), forearm (75.0%), and back (70.3%). After the first dose of ivermectin, 159 (82.8%) patients showed complete recovery, while 30 (15.6%) patients showed partial recovery. 3 (1.6%) patients showed no improvement. After the second dose of ivermectin, 173 (90.1%) patients showed complete recovery. There were two (1.0%) patients who did not show improvement after two doses. Due to the deterioration of urban infrastructure after devastating earthquakes, the irregularity of mass living areas, the lack of hygiene conditions, and the difficulty of accessing clean, usable water, oral ivermectin may be the first choice for treatment in terms of ease of use and effectiveness.

Association between Scabies Treatment and Parkinson's Disease: A Nationwide, Population-Based Study.

Scabies is typically treated with scabicides like lindane, which poses a risk for acute neural toxicity. Lindane's prolonged use, particularly in agriculture, is linked to neurodegenerative diseases, including Parkinson's disease (PD), the second most common neurodegenerative disorder. This study aimed to evaluate whether scabies patients, particularly those treated with topical lindane, are at increased risk of developing PD. A nationwide population-based cohort study was conducted using data from Taiwan's National Health Research Institutes claims database from 2000 to 2018. The study included 27,173 patients with scabies, matched to a control group, with both groups followed for up to 18 years. The primary outcome was the incidence of newly diagnosed PD, and the hazard ratio (HR) for PD was calculated, focusing on those treated with topical lindane. Among the 54,346 patients, 1639 (3.0%) were newly diagnosed with PD, with 993 (60.6%) from the scabies group and 646 (39.4%) from the control group. Scabies patients had an adjusted hazard ratio (aHR) of 1.46 (95% CI 1.32-1.63) for developing PD compared to controls. However, patients treated with topical lindane had a significantly lower aHR for PD at 0.15 (95% CI 0.12-0.19; p < 0.001), with a lower cumulative incidence of PD also observed in this group (p < 0.001). Scabies patients are at a 1.46-fold increased risk of developing PD, but those treated with lindane exhibit a significantly lower risk, suggesting potential protective effects of lindane against PD.

Methicillin-Resistant Staphylococcus aureus Secondary Infection as a Comorbid in Crusted Scabies Patient

Introduction: Crusted scabies (CS) is characterized by uncontrolled proliferation of mites up to thousands. Complications include glomerulonephritis, rheumatic fever, and secondary infection which can cause bacteremia and sepsis. This case report describes a case of CS that was hospitalized with secondary complications of MRSA infection. Case Presentation: A 44-year-old woman complained of thick scales and itching all over her body for 6 months. Complaints begin with reddish bumps between the fingers, toes, body, genitals, and scalp, accompanied by itching, especially at night. The patient took self-purchased corticosteroids for this complaint for 6 months. Dermatology status all over the body showed erythematous papules plaques with greenish-yellow scales, blackish crusts, hyperkeratosis, and excoriation, also erythematous base erosions and blackish crusts in the right thoracic region. Ectoparasite scrapping examination showed large amounts of Sarcoptes scabiei, eggs, and scybala, so the patient was diagnosed with Crusted scabies. A wound culture and nasal swab showed MRSA. The patient died of septic shock on day 12 of treatment. Discussion: Crusted scabies is a highly contagious form of scabies, characterized by thickening of the skin layer and crusts. Long-term corticosteroid consumption in this case caused a compromised immune response so that the number of mites multiplied rapidly and increased the risk of MRSA infection. MRSA mortality rates range from 5-60%. Conclusion: Ignored cases of scabies can develop into crusted scabies which have a high risk of secondary infection, such as MRSA which can cause serious morbidity and even mortality.

Association of ABO and Rhesus blood groups with symptom emergence in scabies: a cross-sectional study.

Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite. It can lead to various clinical reactions, ranging from no symptoms at all to noticeable skin lesions and severe itching within the same household. We aimed to investigate the potential role of blood groups in the emergence of disease symptoms by comparing the scabies patients with asymptomatic co-residents. This study comprised 102 patients infected with scabies from index cases and 111 asymptomatic co-residents. The index cases where symptoms first appeared were excluded. Among patients with scabies, 34 individuals (33.3%) had type A blood group, 12 (11.8%) had type B, 27 (26.5%) had type AB, and 29 (28.4%) had type O. Of these patients, 101 (99%) were Rh+, while 1 (1%) was Rh-. In asymptomatic contacts, 61 individuals (55%) had type A, 9 (8.1%) had type B, 1 (0.9%) had type AB, and 40 (36%) had type O blood group. Of these, 102 (91.9%) were Rh+, and 9 (8.1%) were Rh-. A significant difference was observed between the two groups concerning the frequency of ABO, Rh, and ABO*Rh blood groups (p < 0.05). The prevalence of B + and AB + blood groups was higher in scabies patients compared to asymptomatic contacts. The study results showed a significant association between the emergence of scabies symptoms with blood groups. Our results highlight the importance of more research into the roles of blood group antigens in normal skin epithelium and their involvement in the etiopathogenesis of scabies.

Investigation of the effect of oral ivermectin on systemic inflammatory response and quality of life in scabies patients.

Scabies is a prevalent ectoparasitic infectious disease, caused by the mite Sarcoptes scabiei. As a consequence of the infestation, localised cutaneous inflammation, pruritus and polymorphic skin lesions develop. The primary symptoms of scabies manifest as hypersensitivity-like reactions and immune responses, the precise mechanisms of which remain poorly defined. The objective of this study was to evaluate the effects of oral ivermectin treatment in patients with scabies on the systemic immune response and the patient's quality of life (QoL). Patients admitted to the dermatology outpatient clinic and diagnosed with scabies were administered oral ivermectin treatment following diagnosis at week 0 and 2. Laboratory tests were conducted to measure complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels before treatment and at week 4. The systemic immune-inflammation index (SII) was calculated using the platelet, neutrophil and lymphocyte counts. Additionally, data pertaining to the Dermatological Life Quality Index (DLQI) were recorded. In 119 patients (51 males) diagnosed with scabies, increases in ESR, CRP, and SII values and decreases in inflammatory cell counts and DLQI scores were observed one month after treatment with oral ivermectin. The results of the study showed that the use of oral ivermectin, a scabicidal agent, triggered the inflammatory response and improved the QoL of the patients.

Diagnosing scabies in a patient with skin of colour using the burrow ink test.

A patient with skin of colour presented with a 3-month history of progressive itch and skin-coloured papules without visible burrows or dermoscopic features of scabies. However, a burrow ink test revealed skin burrows, confirming a clinical diagnosis for scabies. This case underscores the diagnostic utility of the burrow ink test for scabies in patients with darker skin.

Tissue and circulating levels of IL-17A and FoxP3+ in patients with scabies: Correlation with clinical features

The scabies mite is known to induce a complicated immune response that involves both innate and long-term adaptive immunity. Many immune effectors and pathways are involved. Th17/Treg balance can influence the complex immune response to scabies. The immunological effectors including IL-17A, as a pro-inflammatory cytokine, and Treg cells, anti-inflammatory regulatory T cells, are essential for preserving cutaneous immunological homeostasis. So, evaluating these immune effectors may help in comprehending the pathophysiology of scabies and facilitate the development of new treatment approaches. This study examined the expression of IL-17A and FoxP3+ in the skin and serum of 50 scabies patients and 25 healthy controls. An assessment of their correlation with clinical features was performed. Regarding tissue response, scabietic patients exhibited a significant increase in IL-17A and FoxP3+ expression in their epidermis and dermis compared to controls (P<0.001), but the correlation between these factors was not significant in either area (P>0.05). Also, patients showed a significant increase in serum IL-17A levels compared to controls (P<0.001), with a significant association between serum IL-17A levels and lesion severity, but no significant correlation was observed between skin and serum responses (P>0.05). In conclusion, there was increased expression of both IL-17A and FoxP3+, with FoxP3+ being significantly more abundant than IL-17A in the skin of scabies patients. Skin FoxP3+ up-regulation has been linked to the severity of the condition.

ASPEK NEUROSAINS DALAM PATOFISIOLOGI PRURITUS NOKTURNAL

Itching at night in scabies patients is considered a very disturbing symptom. It is known that the main role of the itch sensation and subsequent motor response is to remove environmental influences from the skin, especially arthropods. The purpose of this article is to provide an understanding of the overall physiology and associated pathophysiology of itch. This article focuses on the neuronal aspect, as the nervous system is necessary to perceive the sensation of itch, as well as the multidirectional connections between the nervous and immune systems that influence the transmission of itch from the skin to the spinal cord. Itching is felt by skin nerve fibers called pruriceptors. These primary afferent fibers function as antennae and continuously sense the skin environment to detect and respond to cues. All major afferents project to the dorsal part of the spinal cord. Peptidergic and nonpeptidergic neurons target different areas of the dorsal superficial lamina. Based on this review, it can be concluded that noxious and pruritic stimuli are mostly processed in the superficial dorsal horn, whereas deeper dorsal horn neurons receive nociceptive and pruritic input via polysynaptic innervation.

A qualitative, phenomenological study of scabies patients at Cikatomas Health Center

A qualitative, phenomenological study of scabies patients at Cikatomas Health Center

Dermatology Quality of Life and Depression, Anxiety, and Stress Scale-42 in Scabies Patients.

Scabies is a pruritic skin infestation with a globally increasing prevalence. Sleep problems and impaired social and personal interactions, mainly due to itching, have been reported. We aimed to determine the influence of scabies on quality of life and psychosocial health using Dermatology Life Quality Index (DLQI) and Depression Anxiety and Stress Scale-42 (DASS-42) and analyze whether there is a correlation between the two scales and any sociodemographic and clinical characteristic. Scabies patients (>16 years) who presented to our outpatient clinics were enrolled. Age, sex, occupation, marital status, and education level and clinical features were recorded. DLQI and DASS-42 were used. Possible influence of demographic and clinical characteristics on total scores were analyzed. The Spearman coefficient analysis was performed to determine whether there is a correlation between these scores. Of 92 patients (mean age:37.76±15.355, Female/Male: 1.09/1), 63% were married and 35.9% were high-school graduates; 27.2% and 23.9% were housewives and officers, respectively. Disease was generalized in 57.6% and duration of disease was mostly <4 weeks. Mean DLQI and DASS-42 scores were 13.16±7.638 and 42.10±30.644, respectively. Symptoms/feelings were affected predominantly. DLQI was affected 'severely' in 41.3% of patients. Impairment of DLQI is a significant predictive parameter for higher DASS levels. Scabies is not only associated with impairment in DLQI but may also lead to psychosocial problems. All scabies patients should be evaluated and consulted-if needed-for possible problems of psychosocial status, including depression, anxiety, and stress, as well as clinical symptoms and secondary complications.

Efficacy of combination therapy 5% permethrin cream and precipitated sulfur (ointment 2-4) compared with single therapy of 5% permethrin cream in children

Introduction: Scabies is a skin infestation with the main pruritus symptom caused by Sarcoptes scabiei. The common complaints are discomfort due to itching and a picture of lesions on the skin in the form of papules, pustules, or vesicles. The study aims to analyze the comparative efficacy of using a combination therapy of 5% permethrin cream and precipitated sulfur (ointment 2-4) compared with single therapy of 5% permethrin cream in pediatric scabies patients at the Outpatient Clinic Dr. Soetomo General Academic Hospital in the 2019-2020 period. Methods: This study is an analytical study using a cross-sectional retrospective method, which aims to compare the effectiveness of using a combination of 5% permethrin cream and precipitated sulfur(ointment 2-4) compared to 5% permethrin cream as a single therapy. Study data were processed using SPSS, followed by univariate and bivariate analyses using statistical methods and comparative tests. Results: This study found 88 new scabies patients, with the number of patients who received permethrin single therapy as many as 43 patients (51.1%), while those who received combination therapy were 45 patients (48.9%). Scabies treatment using combination therapy has better effectiveness than single therapy 5% permethrin cream when seen from the absence of new complaints and improvement of skin lesions after receiving treatment. Analysis of therapy results for the emergence of new complaints with a p-value of 0.010 showed significant results. Analysis of the results of therapy seen in skin lesions improved on single therapy with a p-value of 0.014, indicating significant results. Conclusion: Significant results were found in the group that received combination therapy treatment seen from the improvement of skin lesions and no new lesions were found, while there were no significant comparison results when seen from complaints of itching

Retrospective Evaluation of Misdiagnosed Scabies Cases: Clinical and Epidemiological Features and Resemblance to Other Dermatological Conditions

Background and Aim: Diagnosing scabies, a skin condition caused by mites, can be challenging due to its resemblance to other skin problems. Avoiding misdiagnoses could result in a significant reduction in treatment delays and complications. Our objective was to investigate scabies cases that initially posed diagnostic challenges.&#x0D; Methods: This retrospective study focused on scabies patients who were initially misdiagnosed despite routine clinical examinations and underwent histopathological examinations with different preliminary dermatological diagnoses. Inclusion criteria were in accordance with the 2020 International Alliance for the Control of Scabies Diagnosis Criteria. The study retrospectively compiled clinical, histopathological, and demographic characteristics, providing data on the challenges and delays in diagnosing scabies cases that mimic other dermatological conditions.&#x0D; Results: In a cohort of 27 scabies cases with diagnostic challenges, the majority were females (63%) with a mean age of 64.8±15.9 years. Pre-admission, 66.7% of the patients used systemic antihistamines, 52.4% used immunosuppressants, and 42.9% used topical scabies treatment. Secondary xerosis cutis and contact dermatitis were noted in 11.1% and 7.4% of cases. The most frequently considered differential diagnoses by dermatologists included prurigo subacuta (29.6%), dermatitis herpetiformis (18.5 %), lymphomatoid papulosis (14.8%), and vesicular/bullous pemphigoid (11.1 %).&#x0D; Conclusion: Previous treatments; prolonged infestations leading to severe secondary dermatological problems including prurigo subacuta, contact dermatitis, and xerotic eczema; atypical distribution of lesions; female prurigo; and elderly with prolonged pruritic atypical dermatoses or vesicular/bullous presentations should be kept in mind as clinical scenarios that may contribute to a delay in the diagnosis of scabies.

Implications from an Ongoing Scabies Outbreak During the COVID-19 Isolation Period: Clues for Controlling Scabies Today

Background: Contrary to the expectation that the number of scabies cases will decrease during the COVID-19 isolation period, scabies has been frequently reported in Turkey. &#x0D; Objective: The aim of this study is to investigate the epidemiological pattern of the scabies outbreak in the context of the pandemic to provide additional information for the control of the devastating scabies outbreak that continues today.&#x0D; Methods: Patients seen in our dermatology clinic before and during the pandemic were evaluated retrospectively. &#x0D; Results: There was no decrease in the rate of scabies patients among all dermatology admissions during the pandemic period (n=143/2912; 4.9%) compared to the pre-pandemic period (n=526/11679; 4.5%) (p=0.348). The high incidence of the new scabies cases before the detection of COVID-19 in the country decreased in the quarantine period. However, the high recurrent admissions of old scabies cases, who already got scabies before pandemic but could not be cured despite repeated treatments, contributed to the ongoing high prevalance of scabies during the pandemic (one-third of all scabies cases seen during the pandemic, n=30/87).&#x0D; Conclusions: We suggest that self-quarantine and increased hygiene during COVID-19 reduced re-infestations and led to a decrease in new cases. Treatment failure of old cases has been observed to contribute to the high prevalence of scabies in the pandemic. Permethrin resistance may have led to inadequate treatment success, given that treatment application errors, which may also lead to treatment failure, are managed with active surveillance in our patient population. Studies addressing permethrin resistance are needed as a priority.

Dermatoscopy assessment of treatment response of scabies patients

Objective: To assess the use of dermoscopy in managing scabies, highlighting its role in enhancing diagnostic accuracy and treatment efficacy. Methodology: This cross-sectional study included 60 patients of scabies and was undertaken at the Duhok Dermatology Teaching Center in Duhok city, from May 2023 to October 2023. Dermoscopy was compared with clinical diagnosis. For data analysis, SPPS was utilized. Results: A strong correlation was discovered between the efficacy of dermatoscopy and the evaluation of scabies cases' response to treatment, which was substantiated by a p-value of 0.0000 and a t-value of 10.225. based on the R-squared value of 0.643, which indicates that dermatoscopy may explain approximately 64.3% of the variability in treatment response evaluation. Conclusion: Dermoscopy significantly enhances the accuracy of scabies diagnosis, providing a reliable, non-invasive tool that complements clinical examination.

Study on clinical profile of scabies and comparison of efficacy of topical agents in treatment of scabies

Background: Scabies is an intensely pruritic mite infestation. It is a significant health problem in developing countries and remains a major issue despite available treatment modalities. Methodology: A prospective study was carried out over a year with 90 scabies patients at a tertiary care center after obtaining Ethical Clearance to study the clinical profile of scabies, compare the efficacy of various topical scabicidal agents, and evaluate improvement after treatment. After calculating the severity of pruritus and lesions, a detailed history was noted and randomly allotted to one of the treatment groups. Group A was treated with 1% GBHC lotion, Group B with 5% Permethrin cream, and Group C with 0.5% Ivermectin cream. Patients were advised to review in the second, third, and sixth weeks. Observation and results: Patients with 16-25 years of age were most susceptible. 17 out of 90 patients had secondary bacterial infections, the most common associated cutaneous disease followed by dermatophytosis. Statistically significant reduction in pruritis severity in the drug C vs drug A trial (Z = -4.810, p = &amp;lt;0.001) and Drug C vs drug B trial (Z= -4.795, p= &amp;lt;0.001). Group C (Ivermectin) causes much better improvement in itching and lesions than Group A (GBHC) and Group B (Permethrin). Conclusion: Among topicals, ivermectin can be preferred over permethrin and GBHC for treating scabies. Topical permethrin provides superior improvement when juxtaposed to GBHC and can be considered better than GBHC.

Comparison of Efficacy of Single Application Topical 5% Permethrin versus Single Dose Oral Ivermectin in the Treatment of Scabies

Aim: To compare the efficacy of a single application of topical 5% permethrin versus a single dose of oral ivermectin in the treatment of scabies. Methodology: Randomized controlled trial. Department of Dermatology, Pak Emirates Military Hospital (PEMH), Rawalpindi, from January 1, 2021, to June 30, 2021. Sixty scabies patients of both genders were included. 30 patients for 5% permethrin cream (group A), and 30 patients for the oral ivermectin group (group B). Follow-up with patients was done at weeks 1 and 2 after treatment. Age in this study was &gt; 5 years. Results: The mean of age was 27.700±8.43 years, duration of disease was 5.133±1.71 weeks, and weight was 71.366±11.31 kg in Group A, while in Group B, age was 30.366±9.37 years, duration of disease was 4.700±1.55 weeks, and weight was 73.433±10.82 kg. Efficacy was observed in 22 (73.3%) patients in group A and 21 (70%) patients in group B (P = 0.775). Conclusion: There is no significant efficacy difference between topical permethrin and oral ivermectin in treatment of scabies. Keywords: Efficacy, Permethrin, Ivermectin, Scabies

Profil Kejadian Skabies di RSUD DR. R.M. Djoelham Binjai Sumatera Utara Periode Januari 2017 – Desember 2021

&lt;p&gt;&lt;em&gt;Skabies is a skin infection caused by Sarcoptes scabiei, a type of small mite that lives in the skin of patients with scabies. The diagnosis is confirmed by anamnesis and physical examnation of dermatology, four cardinal sign of scabies are found, pruritus nocturnal, found infected canaliculi of skin infection and on skin scraping found the parasite Sarcoptes scabei. Descriptive retrospective research method using the result of the identification of scabies patients. The population in study were all new visiting patients diagnosed with scabies who were recorded in medical record the Dr. R.M. Djoelham Binjai Hospital for the periode January 2017-December 2021 totaling 126 patients. Data collection using secondary data with total sampling technique. The results of the prevalence of scabies patients aged 11-21 years were 61 patients (48,4 %), the average male gender is 85 patients (67,5%) and the work as a student is 42 patients (33,3%). It is necessary to carry out effective control and education on direct or indirect contact so that the chain of transmission is broken. &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Skabies, Incidence, Risk Factor. &lt;/em&gt;&lt;/p&gt;&lt;/div&gt;

A “forgotten” disease entity? Scabies with secondary infection in a housewife: case report

Background: In 2017, scabies was classified by WHO into the neglected tropical disease list , with an estimated 455 million annual incident cases. This disease has a high prevalence in many tropical environments with low income sources, especially in the Pacific Island countries. Scabies transmission occurs as a result of skin-to-skin contact and spreads easily in crowded living conditions. Objective: This case report aims to describe the risk factor, clinical features, and management of scabies patient with secondary infection. Case: A 17-year-old female presented with nocturnal itching on her hands and feet. She rarely washed sheets or dried mattresses. Physical examination revealed multiple erythematous papules, pustules, crusts, and skin erosions in the antebrachii and manus regions. Papules and pustules were also observed in the dorsum pedis regions. The patient was diagnosed with scabies and a secondary bacterial infection. Treatment included topical antiparasitic (Ointment 2-4) and sedating antihistamines (CTM) to alleviate itching, along with systemic antibiotics (Amoxicillin) to address the bacterial infection.Conclusion: The internal and external risk factors that underlie the development of scabies in this case are the patient's residence in densely populated environment, low level of personal hygiene, knowledge level patients who are less about scabies, and low socioeconomic level. The success of scabies management depends on effective therapy and health education about PHBS (Perilaku hidup Bersih dan Sehat).