Scabies Infestation Research Articles

Increasing incidence of reported scabies infestations in the Netherlands, 2011-2021.

Several Public Health Services and general practitioners in the Netherlands observed an increase in scabies in the Netherlands. Since individual cases of scabies are not notifiable in the Netherlands, the epidemiological situation is mostly unknown. To investigate the scabies incidence in the Netherlands, we described the epidemiology of scabies between 2011 and 2021. Two national data sources were analysed descriptively. One data source obtained incidence data of scabies (per 1,000 persons) of persons consulting in primary care from 2011-2020. The other data source captured the number of prescribed scabicides in the Netherlands from 2011-2021. To describe the correlation between the incidence of diagnoses and the number of dispensations between 2011 and 2020, we calculated a correlation coefficient. The incidence of reported scabies has increased by more than threefold the last decade (2011-2020), mainly affecting adolescents and (young) adults. This was also clearly reflected in the fivefold increase in dispensations of scabicide medication during 2011-2021. The incidence and dispensations were at an all-time high in 2021. We found a strong correlation between the reported incidence and the number of dispensations between 2011 and 2020. More awareness on early diagnosis, proper treatment and treatment of close contacts is needed.

Direct microscopy in the dermatology clinic: enhancing the management of skin infections and infestations.

SummaryDirect microscopy is a valuable skill in the management of skin infections and infestations, yet it is underutilized in dermatology clinics. This review details its use in identifying fungal skin infections and scabies infestations, outlining the steps involved in sample collection, preparation and interpretation.

Comparison of Permethrin-Based Treatment Strategies against Scabies in Infants and Young Children

To optimize the permethrin-based therapies for scabies infestations in infants and young children, the efficacies of 3 different regimens were evaluated. The retrospective analysis encompassed 85 infants and children aged <4years with scabies. The children had received either topical permethrin 5% on the entire body on days 1/8, on days 1/8/15, on days 1/8/15 plus interim applications restricted to hands and feet on days 2/3/4//9/10/11, or alternative treatments. The intensified regimen, consisting of full-body permethrin applied on days 1/8/15 and hands/feet on days 2/3/4//9/10/11, resulted in cure of scabies in 73.5% of the cases. The cure rates were significantly greater compared with full-body permethrin given on days 1/8, which led to eradication in 44%, and were greater compared with the clearance in children who had received full-body permethrin on days 1/8/15 (53.8%) or alternative treatments (60%). For patients in whom permethrin had previously been applied, the intensified regimen resulted in eradication of scabies in 71.4% of the cases, compared with 30% and 55.6% after full-body permethrin on days 1/8 and 1/8/15, respectively. The intensified regimen of full-body permethrin plus interim applications on hands/feet, which aims at reducing the number of mites present on the frequently heavily infested palmoplantar sites in addition to the standard entire body application, appears efficacious in curing scabies in young children.

Scabies Infestation and Risk of Acute Myocardial Infarction: A Population-Based Cohort Study.

Background: Scabies is an infectious inflammatory skin disease. Cytokine-mediated inflammatory responses may be one of the pathological mechanisms underlying myocardial infarction. Objective: We explore the association between scabies and subsequent acute myocardial infarction (AMI) and all-cause mortality; Methods: We conducted a nationwide population-based study using data from the National Health Insurance Research Database (NHIRD) in Taiwan. Patients with scabies (n = 30,184) and 120,739 controls without scabies were included. The primary outcomes were incidental AMI and all-cause mortality. Using Cox proportional-hazards regression analysis, we estimated the risk of acute myocardial infarction for the study cohort; Results: The mean age of the study cohort was 51.81 ± 19.89 years. The adjusted sub-distribution hazard ratios (aSHRs) of AMI were 1.214 (95% CI, 1.068–1.381) after adjusting for demographic characteristics, income, OPD utility frequency, days in hospital, co-morbidities, and medication. The adjusted hazard ratio (aHR) of all-cause mortality after adjusting for age, gender, income, OPD utility frequency, days in hospital, co-morbidities, co-medication, and urbanization was 1.612 (95% CI, 1.557–1.669). Conclusions: Our study showed that patients with scabies infestations were at higher risk for subsequent AMI and all-cause mortality.

Assessment of causes, knowledge and risk factors of scabies among general population in Wasit province, Iraq

Scabies is a serious global public health problem that may impact people from all socioeconomic types of life. Poverty and overcrowding appear to be the major causes of scabies infestation. The goal of this study was to determine the causes, risk factors, and awareness of scabies among the general population in the Wasit, Iraq. A total of 143 individuals were studied in this cross-sectional study at the Wasit province’s general hospitals/consulting dermatology rooms. Data collection extends from the 1st of April to the 1st of July 2021. A pre-tested questionnaire was adopted and filled through a face-to-face interview and indirect through an electronic platform published on social media. Data were analyzed using descriptive and analytical statistics. The sociodemographic features of the subjects revealed that there were 60 (42%) males and 83 females (58%). The majority (84.6%) of the respondents was from urban areas and (15.4%) were from rural areas. About (51.7%) of the participants have 5-7 members in their families. Scabies is a well-known dermatological disease, commonly seen in low socioeconomic and crowded families that share beds and towels. Thorough their medium education, participants have a good percentage of knowledge that scabies is contagious but curable.

Clinical and Histopathologic Features of Acquired Perforating Collagenosis: A Case Report.

A 51-year-old hypertensive and diabetic male patient, admitted due to acute kidney injury on top of chronic kidney disease, was referred to the dermatology service. He presented with a 3-month history of multiple discrete pruritic papules with keratotic plugs over the extensor aspects of the bilateral upper and lower extremities, initially managed as a case of scabies infestation but medications given provided no relief. Histopathologic analysis of a skin biopsy revealed findings of acquired perforating collagenosis. Resolution of lesions and pruritus were noted after starting on a topical corticosteroid ointment on the lesions, as well as hemodialysis to address the renal failure. Subsequent consults showed no recurrences and only a minor sequela of post-inflammatory hyperpigmentation.

Is there a really resistance to scabies treatment with permethrin? In vitro killing activity of permethrin on Sarcoptes scabiei from patients with resistant scabies.

Recently, there have been increased scabies infestations but many patients do not respond to treatment. Clinicians are hesitant to use permethrin despite the fact that treatment failure may be due to noncompliance with the treatment rather than permethrin resistance. We aimed to investigate the permethrin resistance of mites collected from patients who have endured scabies for at least 3months despite permethrin treatment. Parasites in patients who had scabies for at least 3months despite permethrin treatment were collected. Only parasites that were not damaged during sampling, not fragmented and had full motion were included. Parasites were divided into four groups, each with 15 parasites. Immersion oil was dripped on the control group and 5%, 7%, and 10% permethrin was added to the study groups. The responses of the parasites to the applied agents were examined using a digital microscope. All solutions, except the control group, killed the scabies mite. The mean survival time (ST) in the 5%, 7%, and 10% permethrin groups was 360 ± 33.2, 340 ± 31.4, and 320 ± 30.2min, respectively. There was no statistically significant difference in the mean ST in the permethrin groups. The mean ST in the control group was 46 ± 1.5h. The mean ST difference between the control and permethrin-treated groups was significant (p= 0.03). There was no resistance to permethrin, which should maintain its place as first line treatment of scabies. Treatment noncompliance, rather than permethrin resistance, seems to be the underlying factor in the chronicity of scabies.

CASE REPORT: Interprofessional Collaboration in the Management of Scabies Re-infestation: A Single Case Study in a Rural Area of East Nusa Tenggara Province, Indonesia

Mr. A presented with complaints of itching and reddish patches on his stomach, palms and fingers for about three weeks. The patient had been diagnosed with scabies infestation three times before and had previously been declared cured.Dermatological exam on this patient showed erythematous papules, rounded, well-defined, discrete spread and multiple measuring 0.2 x 0.2 cm on patient’s hand fingers, palm and abdomen. Excoriation and lichenification were also noticed.The presence of cuniculi were no longer found and some parts had undergone lichenification, marked by darkened skin color due to chronic scratching.The patient is a clove trader who often goes from one village to another to collect cloves. Every time he stops in a village, the patient will stay at a relative's house. He never brings personal towels and gloves while traveling. Often the towels and sarongs that are used by the host are lent to him. He always borrows towels and sarongs from the owner of the house where he is staying. Every time he comes home from traveling, the patient will suffer from itching which causes his wife and children to also get similar itching.

Scabies Infestation in the Pediatric Population

ABSTRACT Scabies infestation is a pruritic condition that is commonly seen in the pediatric population. Children are affected more than adults in certain geographic regions and can have variable clinical presentations. To avoid delays in diagnosis, healthcare providers should be aware of these differences. This article provides an overview of epidemiology and pathophysiology, clinical presentation and diagnosis, and management of scabies infestation, with a particular focus on infants and children.

Scabies Infestation in the Pediatric Population

Journal of the Dermatology Nurses’ Association: 11/12 2021 - Volume 13 - Issue 6 - p E30 doi: 10.1097/JDN.0000000000000655

Prevalence of scabies among secondary school students in Anambra State, Nigeria

Scabies has been listed as one of the Neglected Tropical Diseases. Therefore, this study aimed at estimating the prevalence of Scabies among Secondary School Students in Anambra State, Nigeria. A survey of Scabies infection was conducted in fifty (50) randomly selected secondary schools in the three geographical zones of Anambra State, Nigeria. A well-structured questionnaire was employed to elucidate information on age, sex and also on knowledge, attitude and perception (KAP). Focus group discussions, direct clinical observations and microscopic examinations using the skin scraping test method for the confirmation of scabies infestation were also employed. Data analysis was done using a statistical package for social sciences (SPSS) version 23 and Microsoft Excel version 16. Out of the five thousand (5000) students examined 500 (10.0%) were identified as positive from the research works, the sex-specific prevalent rate showed that 209 out of the 3000 females (6.97%) were positive while 291 out of the 2000 males (14.55%) were positive. The age-specific prevalence showed that age groups 10 to 12 years had the highest prevalence rate (29.0%) and 9.6% in both the male and female students respectively. The infectivity rate among urban and rural schools showed that rural students were more prone to scabies infections (14.12%) than their urban counterparts (5.88%) and the difference was statistically significant. The result of this study helped identify some students with Scabies infection in Anambra state Nigeria for appropriate treatment, prevention and control measures to curb the menace of Scabies infestation.

Risk factors for scabies treatment resistance: a retrospective cohort study.

In order to successfully treat scabies and to prevent its spread, it is important to identify the factors that can influence the outcome of scabies treatment. This study was designed to evaluate the risk factors associated with treatment resistance scabies during use of an effective topical medication. A retrospective cohort study was performed in patients with scabies infestations confirmed by potassium hydroxide (KOH) examinations. Patient characteristics, clinical features and treatment history were collected. The treatment resistance group included patients with persistent scabies infestations for more than 28 days after initiation of antiscabies treatment with 5% permethrin cream. In total, 138 patients with scabies infestations treated between January 2017 and December 2020 were included in this study. Of these, 100 (72.5%) patients were treated successfully, while 38 (27.5%) patients experienced treatment resistance. In the univariable analysis, risk factors for treatment resistance scabies included impaired cognitive function (OR = 2.66, 95% CI, 1.15-6.14), limited mobility (OR = 2.97, 95% CI, 1.30-6.83), inpatient status (vs. outpatient, OR = 3.3, 95% CI, 1.28-8.54), topical steroid use before diagnosis (OR = 3.52, 95% CI, 1.61-7.81), systemic steroid use before diagnosis (OR = 3.57, 95% CI, 1.26-10.34) and a positive KOH exam after the first treatment (OR = 7.25, 95% CI, 3.24-17.11). In the multivariable analysis, limited mobility (OR = 3.46, 95% CI, 1.02-12.11) and topical steroid use before diagnosis (OR = 3.65, 95% CI, 1.41-9.75) were significant predictive factors for treatment resistance scabies. Scabies patients with limited mobility and topical steroid use before diagnosis are at high risk of treatment resistance. Dermatologists should take these findings into consideration when treating patients with scabies infestations.

Comparison of Clinical Assessment and Adhesive-Tape Laboratory Microscopic of Sarcoptes scabiei for Scabies Diagnostic

Scabies infestation caused by Sarcoptes scabiei mite that infected the skin by making the tunnel burrow. Diagnosis of scabies infestation commonly relies on clinical assessment (CA). However, some scabies symptoms are similar to other diseases. Diagnosis of confirmed scabies can be made by identifying egg or Sarcoptes scabiei mite or scybala through skin scraping laboratory microscopic examination, which was the adhesive tape microscopic (AT) a noninvasive alternative. We aimed to compare the scabies diagnostic accuracy of CA and AT in Islamic Boarding School. This study was an analytical observational cross-sectional study. The population was 94 students of Islamic Boarding School, determining the sample base on purposive sampling technique. There were 34 samples with presumptive scabies analyzed with CA by two clinicians and AT by two trained laboratory technicians. The result showed that the number of patients who positive scabies by CA was 14 (41.18 percent) and 31 (91.18 percent) by AT. Sensitivity was 41.93 percent for CA and 92.85 percent for AT, and the difference was significantly based on Cohen's kappa (ⱪ=0.024). The number of positive cases with both techniques was 13 (38.24 percent). The number of patients positive with only CA was 1 (2.93 percent), and only AT was 18 (22.9 percent). The accuracy of CA was only 44,11 percent. The study concluded that CA is low accuracy than AT. The adhesive tape test is easy, needs no expensive equipment. It is recommended that adhesive tape test for screening purposes. The appropriate comprehensive of both methods for scabies diagnostic is highly recommended.

Reemergence of Scabies Driven by Adolescents and Young Adults, Germany, 2009-2018.

To validate anecdotal evidence on scabies infestations, we analyzed inpatient and outpatient claims data in Germany. Scabies diagnoses increased 9-fold and treatment failure 4-fold during 2009–2018, driven mainly by persons 15–24 years of age. Prevention and control in young adults appear key because of these persons’ high mobility and social connectivity.

Risk factors associated with scabies infestation among primary schoolchildren in a low socio-economic area in southeast of Iran

BackgroundScabies is a neglected tropical disease caused by the mite Sarcoptes scabiei that burrows under the skin. It is a major health problem in tropical areas, largely affecting children. Scabies is common and highly contagious and in schoolchildren spreads quite rapidly, due to overcrowding and close contact within the schools. This study aimed to determine the risk factors associated with scabies infestation among primary schoolchildren in Bashagard County, one of the low socio-economic areas in southeast of Iran.MethodsTo conduct this community-based, descriptive, and cross-sectional study, four primary schools were randomly selected in the Bashagard County. All students in these schools were selected and examined for scabies. Clinical examination and sociodemographic profile of students were assessed using a pre-tested structured questionnaire. Chi-square test, and binary logistic regression were used to analyse the factors associated with scabies infestation by SPSS version 21 software.ResultsOut of 480 studied schoolchildren, 15 cases of scabies with a prevalence of 3.1 % were observed. The frequency of infestation in males was 1.6 % and it was 4.7 % in females. Independent factors associated with a high risk of scabies infestation in unadjusted analysis were being student of grade 5–6 (cOR = 13.12, 95 % CI 2.92–58.89, p = 0.0001), low educational level of father (cOR = 4.37, 95 % CI 0.97–19.59, p = 0.036), low educational level of mother (cOR = 4.14, 95 % CI 1.92–18.57, p = 0.045), joblessness of father (cOR = 14.77, 95 % CI 4.97–43.89, p = 0.0001), employment of mother (cOR = 5.28, 95 % CI 1.38–20.16, p = 0.007), large family size (cOR = 3.34, 95 % CI 1.05–10.64, p = 0.031), use of shared articles (cOR = 33.37, 95 % CI 10.82–102.90, p = 0.0001), and absence of bathroom in the house (cOR = 11.77, 95 % CI 2.16–63.94, p = 0.0001).ConclusionsResults of this study confirmed that scabies is still one of the most important health problems in the primary schools of the Bashagard County. Low socioeconomic status and personal hygiene of the schoolchildren were the most important factors influencing the prevalence of scabies. Improvement of socioeconomic conditions and implementation of appropriate educational programs and active surveillance system to quickly detect and treat scabies cases are necessary in order to reduce the prevalence of scabies in schoolchildren in this area.

First Description of the Composition and the Functional Capabilities of the Skin Microbial Community Accompanying Severe Scabies Infestation in Humans.

Epidemiological studies link Sarcoptes scabiei infection and impetigo. Scabies mites can promote Streptococcus pyogenes (Group A Streptococcus) and Staphylococcus aureus infections by breaching the skin barrier and excreting molecules that inhibit host innate immune responses. However, little is known about the composition and the function of the scabies-associated microbiota. Here, high-throughput whole-metagenome sequencing was used to explore the scabies-associated microbiome. Scabies mites including their immediate microenvironments were isolated from two patients with severe scabies in Northern Australia. Two ~45–50 million paired-end reads Illumina libraries were generated of which ~2 (5.1%) and 0.7 million (1.3%) microbial reads were filtered out by mapping to human (hg19) and mite draft genomes. Taxonomic profiling revealed a microbial community dominated by the phylum Firmicutes (A: 79% and B: 59%) and genera that comprise Streptococcus, Staphylococcus, Acinetobacter, and Corynebacterium. Assembly of the metagenome reads resulted in genome bins representing reference genomes of Acinetobacter baumannii, Streptococcus dysgalactiae (Group C/G), Proteus mirablis and Staphylococcus aureus. The contigs contained genes relevant to pathogenicity and antibiotics resistance. Confocal microscopy of a patient skin sample confirmed A. baumannii, Streptococci and S. aureus in scabies mite gut and faeces and the surrounding skin. The study provides fundamental evidence for the association of opportunistic pathogens with scabies infection.

Prevalence of scabies and impetigo in school-age children in Timor-Leste

BackgroundScabies and impetigo are endemic in many tropical, low- and middle-income countries. Mass drug administration (MDA) with ivermectin has emerged as a control strategy for these conditions. In 2019, Timor-Leste Ministry of Health planned to implement MDA including ivermectin for the control of lymphatic filariasis, so we undertook a baseline assessment of scabies and impetigo to better understand local epidemiology and contribute to future surveys assessing the impact of MDA.MethodsA cross-sectional school survey was conducted in April–May 2019 at six primary schools in a semi-urban (Dili) and two rural (Ermera and Manufahi) settings. Children under 19 years of age present at school on survey days were eligible to participate, of whom we enrolled 1183. Trained health workers interviewed and examined 1043 participants to clinically diagnose scabies using the 2020 International Alliance for the Control of Scabies (IACS) diagnostic criteria, as well as impetigo. Prevalence was adjusted for age and sex. Mixed-effects logistic regression models were used to analyse odds of scabies and impetigo infection. All models accounted for clustering at the school level through the use of random effect terms. Population attributable risk of scabies as a cause of impetigo was also estimated.ResultsThe overall weighted prevalence of scabies was 30.6%. Children in rural Manufahi were more likely to have scabies than those in semi-urban Dili (53.6% vs 28.2%, adjusted odds ratio [AOR] 3.5). Most cases of scabies were mild (3 to 10 lesions), and lesions were usually distributed on more than one body region. Scabies prevalence was lower among 10 to 14 year olds compared to 5 to 9 year olds. Overall weighted prevalence of impetigo was 11.3%. Relative to Dili, children in rural Ermera and Manufahi were twice as likely to have impetigo. Impetigo was twice as common in children with scabies than in those without, corresponding to an attributable risk of scabies as a cause of impetigo of 22.7%.ConclusionsScabies and impetigo prevalence in Timor-Leste is among the highest reported globally, particularly in rural areas. Scabies infestation was strongly associated with impetigo. Comprehensive control strategies are urgently needed in Timor-Leste.Graphical

Review of Scabies Infestation and Selected Common Cutaneous Infections.

1. Ross Brockman, DO* 2. Sabra Leitenberger, MD* 1. *Department of Dermatology, Oregon Health and Science University, Portland, OR * Abbreviations: CDC: : Centers for Disease Control and Prevention CLIA: : Clinical Laboratory Improvement Amendments of 1988 CNS: : central nervous system EH: : eczema herpeticum FDA: : Food and Drug Administration GABHS: : group A β -hemolytic Streptococcus HFMD: : hand-foot-mouth disease HSV: : herpes simplex virus MC: : molluscum contagiosum PCR: : polymerase chain reaction Scabies is a common infestation of childhood but it can have an atypical appearance during infancy, with exuberant inflammation and pustules. We review the diagnosis and management of scabies, with emphasis on issues specific to the pediatric population. There is a wide range of infections that can also cause pustules in early childhood, and several of the most common are highlighted in this article to help the clinician differentiate these entities and select appropriate treatment strategies based on best-available evidence. After completing this article, readers should be able to: 1. Recognize the variable presentation of scabies in infants, children, and immunosuppressed individuals. 2. Understand best-practice strategies for treating scabies, including that the first-line medication is permethrin 5% cream and all household contacts should be treated. 3. Inflammation of molluscum lesions is often related to immune response and imminent clearance. 4. Topical corticosteroids may be used to treat underlying dermatitis in eczema herpeticum, provided the patient is receiving adequate systemic antiviral treatment. 5. Atypical presentations of hand-foot-mouth disease can mimic eczema herpeticum. 6. Onychomadesis may occur after hand-foot-mouth disease. In this article, scabies infestation in infants and young children is covered in detail. In addition, the following common diagnoses with infectious etiologies that can also cause widespread pustules in children are reviewed: molluscum contagiosum, 2 manifestations of herpes simplex virus (HSV) infections (eczema herpeticum [EH] and neonatal HSV), hand-foot-mouth disease (HFMD), and impetigo. Tips on how to recognize these entities, information on pathophysiology, and treatment updates are reviewed herein and summarized in the Table. It is important to consider that a full differential diagnosis of a pustular rash in children may additionally include many other infectious and noninfectious etiologies. …

Control and Prevention of Transmission of Skin Infections

Skin infections are the most common skin diseases found in densely populated, slum neighborhoods including boarding schools / pesantren. Skin infections can occur at any age, closely related to environmental influences, hosts and causative agents. Common skin infections in congested conditions are scabies infestations, dermatophytosis and pyoderma. Knowledge of skin infection symptoms, personal and environmental hygiene are also determinants of disease transmission. Some efforts to control and prevent the transmission of skin infections include screening for infectious diseases, treatment and providing counseling about skin diseases and ways to prevent transmission.

Control and Prevention of Transmission of Skin Infections

Skin infections are the most common skin diseases found in densely populated, slum neighborhoods including boarding schools / pesantren. Skin infections can occur at any age, closely related to environmental influences, hosts and causative agents. Common skin infections in congested conditions are scabies infestations, dermatophytosis and pyoderma. Knowledge of skin infection symptoms, personal and environmental hygiene are also determinants of disease transmission. Some efforts to control and prevent the transmission of skin infections include screening for infectious diseases, treatment and providing counseling about skin diseases and ways to prevent transmission.