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Australian Family Physician 2017Scabies is a common, yet neglected, skin disease. Scabies occurs across Australia, but most frequently in socioeconomically disadvantaged populations in tropical...
BACKGROUND
Scabies is a common, yet neglected, skin disease. Scabies occurs across Australia, but most frequently in socioeconomically disadvantaged populations in tropical regions, including in remote Aboriginal and Torres Strait Islander communities. In temperate settings, the disease clusters in institutional care facilities.
OBJECTIVE
The objective of this article is to provide updates on the clinical diagnosis and treatment approaches for scabies in Australia.
DISCUSSION
Clinical examination remains the mainstay of diagnosis, although dermatoscopy is a useful adjunct. Scabies presents with severe itch and a papular rash, with a predilection for the hands, feet and genitalia. The distribution may be more widespread in infants and older people. Secondary bacterial infection is also common in patients with scabies. Crusted scabies is a rare but highly infectious variant. Topical permethrin is highly effective for individual treatment, but less practical for treatment of asymptomatic contacts and control of outbreaks. Oral ivermectin is a safe and effective alternative, and is now listed on the Pharmaceutical Benefits Scheme as a third-line treatment.
Topics: Australia; Benzoates; Coinfection; Communicable Diseases; Humans; Ivermectin; Permethrin; Public Health; Scabies; Skin Diseases, Vesiculobullous; Toluidines; Urticaria
PubMed: 28472570
DOI: No ID Found -
Clinical Microbiology Reviews Apr 2007Scabies is a worldwide disease and a major public health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal... (Review)
Review
Scabies is a worldwide disease and a major public health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia, prevalences of up to 50% among children have been described, despite the availability of effective chemotherapy. Sarcoptic mange is also an important veterinary disease engendering significant morbidity and mortality in wild, domestic, and farmed animals. Scabies is caused by the ectoparasitic mite Sarcoptes scabiei burrowing into the host epidermis. Clinical symptoms include intensely itchy lesions that often are a precursor to secondary bacterial pyoderma, septicemia, and, in humans, poststreptococcal glomerulonephritis. Although diagnosed scabies cases can be successfully treated, the rash of the primary infestation takes 4 to 6 weeks to develop, and thus, transmission to others often occurs prior to therapy. In humans, the symptoms of scabies infestations can mimic other dermatological skin diseases, and traditional tests to diagnose scabies are less than 50% accurate. To aid early identification of disease and thus treatment, a simple, cheap, sensitive, and specific test for routine diagnosis of active scabies is essential. Recent developments leading to the expression and purification of S. scabiei recombinant antigens have identified a number of molecules with diagnostic potential, and current studies include the investigation and assessment of the accuracy of these recombinant proteins in identifying antibodies in individuals with active scabies and in differentiating those with past exposure. Early identification of disease will enable selective treatment of those affected, reduce transmission and the requirement for mass treatment, limit the potential for escalating mite resistance, and provide another means of controlling scabies in populations in areas of endemicity.
Topics: Allergens; Animals; Australia; Cross Reactions; Humans; Immunoassay; Pyroglyphidae; Sarcoptes scabiei; Scabies
PubMed: 17428886
DOI: 10.1128/CMR.00042-06 -
South African Family Practice :... Jul 2021Scabies is a parasitic infestation of the skin caused by the mite Sarcoptes scabiei var. hominis. It is common in tropical areas, including the sub-tropical areas of...
Scabies is a parasitic infestation of the skin caused by the mite Sarcoptes scabiei var. hominis. It is common in tropical areas, including the sub-tropical areas of Southern Africa. Predisposing factors are overcrowding, poor personal hygiene, low socio-economic standards and impaired host immunity. Although it can occur at any age, scabies is commonly seen in children and young adults. It is not a fatal disease; however, it can cause severe morbidity and poor quality of life. Scabies can complicate with pyoderma which may result in post-streptococcal glomerulonephritis. There are two clinical variants, classic scabies and the much rarer crusted scabies (Norwegian scabies).
Topics: Animals; Child; Humans; Neglected Diseases; Quality of Life; Sarcoptes scabiei; Scabies; Skin
PubMed: 34342482
DOI: 10.4102/safp.v63i1.5224 -
Parasite (Paris, France) Sep 2008Scabies is an intensely pruritic disorder induced by an immune allergic response to infestation of the skin by the mite Sarcoptes scabiei. The biology of the mite, the... (Review)
Review
Scabies is an intensely pruritic disorder induced by an immune allergic response to infestation of the skin by the mite Sarcoptes scabiei. The biology of the mite, the clinical aspects and diagnosis of scabies infestations as well as the treatment of choice with 5% permethrin dermal cream and the use of scabicides based on other chemical substances are reviewed.
Topics: Animals; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Permethrin; Pruritus; Sarcoptes scabiei; Scabies; Treatment Outcome
PubMed: 18814689
DOI: 10.1051/parasite/2008153248 -
Acta Dermato-venereologica Mar 2023The aim of this multi-centre French retrospective study was to identify severe, i.e. crusted and profuse, scabies patients. Records were retrieved from 22 Dermatology or... (Review)
Review
The aim of this multi-centre French retrospective study was to identify severe, i.e. crusted and profuse, scabies patients. Records were retrieved from 22 Dermatology or Infectious Diseases departments in the Ile-de-France from January 2009 to January 2015 to characterize epidemiology, demography, diagnosis, contributing factors, treatment features, and outcomes in severe scabies. A total of 95 inpatients (57 crusted and 38 profuse) were included. A higher number of cases was observed among elderly patients (>75 years), mostly living in institutions. Thirteen patients (13.6%) reported a history of previously treated scabies. Sixty-three patients (66.3%) had been seen by a previous practitioner for the current episode (up to 8 previous visits). Initial misdiagnosis (e.g. eczema, prurigo, drug-related eruptions, psoriasis) was documented in 41 patients (43.1%). Fifty-eight patients (61%) had already received 1 or more previous treatments for their current episode. Forty percent received corticosteroids or acitretin for an initial diagnosis of eczema or psoriasis. Median time from the onset of symptoms to the diagnosis of severe scabies was 3 months (range 0.3-22). Itch was present in all patients at diagnosis. Most patients (n=84, 88.4%) had comorbidities. Diagnostic and therapeutic approaches varied. Complications occurred in 11.5% of cases. To date, there is no consensus for diagnosis and treatment, and future standardization of is required for optimal management.
Topics: Aged; Humans; Retrospective Studies; Scabies; Patients; Eczema; Drug Eruptions; Psoriasis; Multicenter Studies as Topic
PubMed: 36861856
DOI: 10.2340/actadv.v103.5351 -
Journal of the American Board of Family... Jan 2017Scabies is a neglected skin disease, and little is known about current incidence and treatment patterns in the United States. The purpose of this study was to examine...
BACKGROUND
Scabies is a neglected skin disease, and little is known about current incidence and treatment patterns in the United States. The purpose of this study was to examine demographic data, treatment types, success of treatment, and misdiagnosis rate of scabies in an outpatient dermatology clinic.
METHODS
A retrospective chart review of patients diagnosed with scabies within the past 5 years was performed.
RESULTS
A total of 459 charts were identified, with 428 meeting inclusion criteria. Demographic data, diagnostic method, treatment choice, misdiagnosis rate, treatment failure, and itching after scabies are also reported. Children were the largest age group diagnosed with scabies, at 38%. Males (54%) were diagnosed with scabies more than females. The majority of diagnoses were made by visualizing ova, feces, or mites on light microscopy (58%). At the time of diagnosis, 45% of patients had been misdiagnosed by another provider. Topical permethrin was the most common treatment used (69%), followed by a combination of topical permethrin and oral ivermectin (23%), oral ivermectin (7%), and other treatments (1%).
CONCLUSION
Our findings suggest that more accurate and faster diagnostic methods are needed to limit unnecessary treatment and expedite appropriate therapy for scabies.
Topics: Administration, Cutaneous; Administration, Oral; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Ambulatory Care; Animals; Antiparasitic Agents; Child; Child, Preschool; Diagnostic Errors; Drug Therapy, Combination; Female; Humans; Incidence; Infant; Infant, Newborn; Ivermectin; Male; Microscopy; Middle Aged; Neglected Diseases; Permethrin; Retrospective Studies; Scabies; Sex Factors; Southeastern United States; Treatment Failure; Young Adult
PubMed: 28062820
DOI: 10.3122/jabfm.2017.01.160190 -
Postgraduate Medical Journal Jan 2005Scabies is a common dermatological problem managed by general physicians, family physicians, and dermatologists. Scabies manifests itself in various forms in different... (Review)
Review
Scabies is a common dermatological problem managed by general physicians, family physicians, and dermatologists. Scabies manifests itself in various forms in different individuals. The treatment of scabies has undergone developments with the evolution of new treatment strategies and antiectoparasitic drugs. The advent of drugs such as permethrin and ivermectin has revolutionised treatment. Management of scabies not only includes prescribing the drugs but also educating patients properly about the method of application of the drug. Treatment failures may result for various reasons and must be managed appropriately.
Topics: Administration, Cutaneous; Administration, Oral; Humans; Insecticides; Scabies; Treatment Failure
PubMed: 15640423
DOI: 10.1136/pgmj.2003.018390 -
PLoS Neglected Tropical Diseases May 2018Scabies was added to the WHO Neglected Tropical Diseases portfolio in 2017, and further understanding of the disease burden is now required. There are no uniformly...
BACKGROUND
Scabies was added to the WHO Neglected Tropical Diseases portfolio in 2017, and further understanding of the disease burden is now required. There are no uniformly accepted test methods or examination procedures for diagnosis, which limits the interpretation of research and epidemiological findings. The International Alliance for the Control of Scabies (IACS) designated harmonization of diagnostic procedures as a priority for the development of a global control strategy. Therefore, we aimed to develop consensus criteria for the diagnosis of scabies.
METHODOLOGY / PRINCIPAL FINDINGS
We conducted an iterative, consensus (Delphi) study involving international experts in the diagnosis of scabies. Panel members were recruited through expression of interest and targeted invitation of experts. The Delphi study consisted of four rounds of anonymous surveys. Rounds 1 and 2 involved generation and ranking an extensive list of possible features. In Rounds 3 and 4, participants were presented results from previous rounds and indicated agreement with a series of draft criteria. Panel participants (n = 34, range per Round 28-30) were predominantly highly experienced clinicians, representing a range of clinical expertise and all inhabited continents. Based on initial rounds, a draft set of criteria were developed, incorporating three levels of diagnostic certainty-Confirmed Scabies, Clinical Scabies and Suspected Scabies. Consensus was reached in Round 4, with a very high level of agreement (> 89%) for all levels of criteria and subcategories. Adoption of the criteria was supported by 96% of panel members.
CONCLUSIONS / SIGNIFICANCE
Consensus criteria for scabies diagnosis were established with very high agreement. The 2018 IACS Criteria for the Diagnosis of Scabies can be implemented for scabies research and mapping projects, and for surveillance after control interventions. Validation of the criteria is required.
Topics: Adult; Consensus; Delphi Technique; Female; Humans; Male; Middle Aged; Scabies
PubMed: 29795566
DOI: 10.1371/journal.pntd.0006549 -
Transactions of the Royal Society of... Jan 2022Scabies is a neglected tropical disease (NTD) of the skin that is caused by the mite Sarcoptes scabiei. It is considered to be an important public health problem in many... (Review)
Review
Scabies is a neglected tropical disease (NTD) of the skin that is caused by the mite Sarcoptes scabiei. It is considered to be an important public health problem in many regions. The disease is at its most prevalent in low-resource countries where there are overcrowded living conditions coupled with poor hygiene. In some regions, mass drug administration using ivermectin is a key population-based approach to the control of scabies. Before starting a patient on specific treatment, confirming the diagnosis by accurate and rapid identification of the organism is critical. Different laboratory-based techniques for scabies have been developed in the last few decades. These include direct microscopy and histopathology. More recently, serological testing, dermoscopy and different molecular techniques have been developed as diagnostic methods for scabies. To date, none of these, apart from microscopy and dermoscopy, has been translated into routine clinical laboratory practice. A simple point-of-care or laboratory test would provide a rapid and confirmed diagnosis and early institution of effective treatment. In this review we present an update on the laboratory techniques currently in use for the identification of scabies.
Topics: Animals; Humans; Ivermectin; Neglected Diseases; Sarcoptes scabiei; Scabies; Skin
PubMed: 33763705
DOI: 10.1093/trstmh/trab049 -
Dermatology (Basel, Switzerland) 2009
Topics: Humans; Scabies; Skin
PubMed: 19270437
DOI: 10.1159/000207688