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Bassi A, Piccolo V, Argenziano G, Cutrone M, Mazzatenta C. Effective and safe use of benzyl benzoate in young children at the same concentrations as adults: A matter of vehicle? J Eur Acad Dermatol Venereol 2024. [PMID: 39073052 DOI: 10.1111/jdv.20266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Affiliation(s)
- Andrea Bassi
- Division of Dermatology, Azienda USL Toscana Nord Ovest, Lucca, Italy
| | - Vincenzo Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, Vicenza, Italy
| | - Carlo Mazzatenta
- Division of Dermatology, Azienda USL Toscana Nord Ovest, Lucca, Italy
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2
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Sharaf MS. Scabies vaccines: where we stand and challenges ahead. Parasitol Res 2024; 123:285. [PMID: 39046602 PMCID: PMC11269436 DOI: 10.1007/s00436-024-08298-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
Scabies is an itchy skin disease caused by the burrowing mite, Sarcoptes scabiei. During their lifespan, female mites invade the stratum corneum and create tunnels in which they reside, move, feed, deposit fecal pellets, and lay eggs. Globally, more than 200 million people are estimated to be affected by scabies annually. Currently, using scabicidal agents is the only approved method for treating scabies. However, resistance to commonly used agents such as permethrin and ivermectin has been observed in scabies mites. Therefore, the development of vaccines for scabies, either as a preventative measure or for treatment, is crucial to control such neglected diseases. Since the host could evolve a protective immune response that could prevent re-infestation by scabies mites, vaccine development is theoretically possible. This review aims to provide a comprehensive overview of the ongoing challenges regarding the currently available control measures for scabies. It also explores the promising path of scabies vaccine development, highlighting the current state of research and challenges that need to be addressed to develop new and innovative measures for both treating and preventing scabies infections.
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Affiliation(s)
- Mahmoud S Sharaf
- Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.
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3
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Uzun S, Durdu M, Yürekli A, Mülayim MK, Akyol M, Velipaşaoğlu S, Harman M, Taylan-Özkan A, Şavk E, Demir-Dora D, Dönmez L, Gazi U, Aktaş H, Aktürk AŞ, Demir G, Göktay F, Gürel MS, Gürok NG, Karadağ AS, Küçük ÖS, Turan Ç, Ozden MG, Ural ZK, Zorbozan O, Mumcuoğlu KY. Clinical practice guidelines for the diagnosis and treatment of scabies. Int J Dermatol 2024. [PMID: 38922701 DOI: 10.1111/ijd.17327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.
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Affiliation(s)
- Soner Uzun
- Department of Dermatology and Venereology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Murat Durdu
- Department of Dermatology, Adana Dr. Turgut Noyan Application and Research Center, Başkent University Faculty of Medicine, Adana, Turkey
| | - Aslan Yürekli
- Training and Research Hospital Dermatology Department, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mehmet K Mülayim
- Faculty of Medicine, Department of Dermatology and Venereology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Melih Akyol
- Department of Dermatology and Venereology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Sevtap Velipaşaoğlu
- Department of Social Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mehmet Harman
- Department of Dermatology and Venereology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Ayşegül Taylan-Özkan
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - Ekin Şavk
- Department of Dermatology and Venereology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Devrim Demir-Dora
- Department of Medical Pharmacology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Levent Dönmez
- Department of Public Health, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Umut Gazi
- Department of Medical Microbiology and Clinical Microbiology, Near East University, Nicosia, Cyprus
| | - Habibullah Aktaş
- Department of Dermatology and Venereology, Karabük University Faculty of Medicine, Karabük, Turkey
| | - Aysun Ş Aktürk
- Department of Dermatology and Venereology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Gülay Demir
- Vocational School of Health Services, Sivas Cumhuriyet University, Sivas, Turkey
| | - Fatih Göktay
- Private Dermatology and Venereology Clinic, İstanbul, Turkey
| | - Mehmet S Gürel
- Department of Dermatology and Venereology, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Neşe G Gürok
- University of Health Sciences Fethi Sekin City Hospital, Dermatology and Venereology Clinic, Elazığ, Turkey
| | - Ayşe S Karadağ
- Private Dermatology and Venereology Clinic, İstanbul, Turkey
| | - Özlem S Küçük
- Department of Dermatology and Venereology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Çağrı Turan
- Department of Dermatology and Venereology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Müge G Ozden
- Department of Dermatology, Ondokuz Mayıs University Medical Faculty, Samsun, Turkey
| | - Zeynep K Ural
- Department of Dermatology and Venereology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Orçun Zorbozan
- Department of Medical Parasitology, Bakırcay University Faculty of Medicine, İzmir, Turkey
| | - Kosta Y Mumcuoğlu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, the Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
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4
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Tehrani JM, Vos IA, Kisabacak R, Topper MK, Steinhorst J, Phillips RO, Abass KM, Osei-Mireku S, Anokye CO, Adu Poku JK, Stienstra Y, Amoako YA. Traditional healers' perception on scabies causation and management in Ghana. Trop Med Int Health 2024; 29:477-488. [PMID: 38599337 DOI: 10.1111/tmi.13989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. METHODS A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. RESULTS Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. CONCLUSION The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.
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Affiliation(s)
- Jian M Tehrani
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ingmar A Vos
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Robin Kisabacak
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marten K Topper
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jonathan Steinhorst
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Samuel Osei-Mireku
- Agogo Presbyterian Hospital, Agogo, Ghana
- The Trust Hospital, Accra, Ghana
| | | | | | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Yaw Ampem Amoako
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Chiriac A, Diaconeasa A, Miulescu R, Chiriac AE, Wollina U. Scabies in infants and children - a narrative review. Eur J Pediatr 2024; 183:2527-2536. [PMID: 38536458 DOI: 10.1007/s00431-024-05535-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024]
Abstract
Scabies is a human ectoparasitosis caused by Sarcoptes scabei var. hominis. World-wide around 300 million patients are affected. Infants and children have the highest incidence rates. Poverty and overcrowding are social factors contributing to a higher risk of transmission and treatment failure. The leading symptom of the infestation is itch. Complications are bacterial infections that are responsible for mortality. Diagnosis is clinical. Non-invasive imaging technologies like dermoscopy can be used. Polymerase chain reaction (PCR) is less sensitive and specific than microscopy of skin scrapings. Treatment of choice is topical permethrin 5%. Ivermectin is the only oral drug FDA-approved for scabies. It should be used in cases non-responsive to topical therapy and in case of high number of infested patients in addition to topical therapy. Pseudo-resistance to treatment is not uncommon. New drugs are on the horizon. What is Known: • Pruritus is the leading symptom causing sleep disturbances and scratching with the risk of secondary bacterial infections. • Treatment failure is related to inappropriate application of topical drugs and asymptomatic family members. What is New: • COVID-19 pandemic and migration are contributing to an increased incidence of scabies. • New compounds to treat scabies are on the horizon.
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Affiliation(s)
- Anca Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
- Apollonia University, Iasi, Romania
- Romanian Academy, P. Poni Institute of Macromolecular Chemistry, Iasi, Romania
| | - Adriana Diaconeasa
- Dermatology Ambulatory Care Center, "Grigore Alexandrescu" Clinical Emergency Hospital for Children, Bucharest, Romania
| | | | - Anca E Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
- Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse 41, 01067, Dresden, Germany.
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6
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Salavastru CM, Cretu S, Dascalu M, Sendrea AM, Suru A, Tiplica GS. Scabies treatment with benzyl benzoate in patients younger than 2 years: A single-centre experience. J Eur Acad Dermatol Venereol 2024. [PMID: 38702971 DOI: 10.1111/jdv.20048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/10/2024] [Indexed: 05/06/2024]
Affiliation(s)
- C M Salavastru
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
| | - S Cretu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - M Dascalu
- Department of Computer Science, National University of Science and Technology POLITEHNICA Bucharest, Bucharest, Romania
| | - A M Sendrea
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - A Suru
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Paediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
- Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - G S Tiplica
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
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7
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Galván-Casas C, Ortiz-Álvarez J, Martínez-García E, Corbacho-Monné M. Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:475-492. [PMID: 38061452 DOI: 10.1016/j.ad.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 01/28/2024] Open
Abstract
Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.
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Affiliation(s)
- C Galván-Casas
- Unidad Skin Neglected Tropical Diseases and Sexually Transmitted Infections; Fundación Lucha contra las Infecciones, Badalona, Barcelona, España; Servicio de Dermatología, Hospital Universitario de Móstoles, Móstoles, Madrid, España.
| | - J Ortiz-Álvarez
- Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - E Martínez-García
- Servicio de Dermatología, Hospital Virgen de la Victoria, Málaga, España
| | - M Corbacho-Monné
- Servicio de Dermatología, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España
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8
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Galván-Casas C, Ortiz-Álvarez J, Martínez-García E, Corbacho-Monné M. [Translated article] Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T475-T492. [PMID: 38479688 DOI: 10.1016/j.ad.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/21/2023] [Indexed: 05/05/2024] Open
Abstract
Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.
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Affiliation(s)
- C Galván-Casas
- Unidad Skin Neglected Tropical Diseases and Sexually Transmitted Infections; Fundació Lluita contra les Infeccions, Badalona, Barcelona, Spain; Servicio de Dermatología, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain.
| | - J Ortiz-Álvarez
- Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - E Martínez-García
- Servicio de Dermatología, Hospital Virgen de la Victoria, Málaga, Spain
| | - M Corbacho-Monné
- Servicio de Dermatología, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
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9
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Wu X, Yang F, Zhang R. Frequent Misdiagnosis of Scabies as Eczema in China: A Descriptive Study of 23 Cases. Int J Gen Med 2024; 17:1615-1623. [PMID: 38690199 PMCID: PMC11060170 DOI: 10.2147/ijgm.s458731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
Objective To outline the clinical manifestations observed in patients with scabies misdiagnosed as generalized eczema, analyse the factors contributing to these misdiagnoses and explore potential reasons for the resurgence of scabies. Patients and Methods A retrospective analysis was performed to investigate the patients with scabies misdiagnosed as generalized eczema. Results We included 23 patients, with twelve (52.17%) being male and eleven (47.83%) female. The illness duration ranged from 0.5 to 7 months. Among all patients, 12 (52.17%) were residents of nursing homes, 5 (21.74%) were staff members of these facilities, 4 (17.39%) were caregivers of long-term hospitalized relatives, 1 (4.35%) was a construction worker, and 1 (4.35%) had a history of tourism. The rash predominantly affected the trunk and extremities, 12 patients (52.17%) are each involved the perineum and fingers webbings. The presentations included erythema, papules, and nodules. The main complaint of all patients was nocturnal itch. Under direct microscopy, 5 patients (21.74%) tested positive for scabies mites, and 3 (13.04%) showed histopathological features consistent with scabies. All patients were initially misdiagnosed with generalized eczema. Conclusion Over half of all patients diagnosed with scabies either resided or worked in long-term care facilities. The lack of awareness of scabies among medical staff in long-term care facilities readily led to frequent misdiagnosis. Comprehensive measures should be implemented urgently to strengthen disease management.
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Affiliation(s)
- Xumei Wu
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
- Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Feifei Yang
- Department of Dermatology, Tongzhou Maternal & Child Health Hospital of Beijing, Beijing, People’s Republic of China
| | - Ruina Zhang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
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10
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Luque-Luna M, Corbella-Bagot L, Giavedoni P. [Permethrin-resistant scabies]. Med Clin (Barc) 2024; 162:403-404. [PMID: 38184464 DOI: 10.1016/j.medcli.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Mar Luque-Luna
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
| | - Lluís Corbella-Bagot
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - Priscila Giavedoni
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
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11
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Betlloch-Mas I, Boluda-Verdú E, Jara-Rico N, Sánchez-García V, Berbegal-De Gracia L, Chiner-Vives E. Scabies in Infants: Series of 51 Cases. CHILDREN (BASEL, SWITZERLAND) 2024; 11:443. [PMID: 38671660 PMCID: PMC11048914 DOI: 10.3390/children11040443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
We conducted a two-year retrospective evaluation of infants aged under two years with a confirmed, clinical, or suspected diagnosis of scabies in a healthcare center in Alicante (Spain) to determine possible factors associated with diagnostic delay and poor treatment response. We collected epidemiological, clinical, diagnostic, and treatment variables. After describing our findings as mean values and percentages, we compared categorical variables using the Student's t-test and the Mann-Whitney U test, and we compared continuous variables with the Chi2 test and Pearson's correlation coefficient. We included 51 infants (19 boys and 32 girls) with a mean age of 15 months. The main source of contagion was the family; half of the infants lived with four or more people. According to the International Consensus Criteria for the Diagnosis of Scabies, confirmed scabies was diagnosed in 45% of cases and clinical scabies in 47%, and 45% of cases had a diagnostic delay. Lesions mainly affected the hands, feet, and trunk, with papules in 92% of cases and burrows in 55%. The predominant symptoms were pruritus (94%) and irritability (69%). Regarding treatment, 98% of the infants received topical permethrin and 35% received oral ivermectin. Treatment failed in 76% of infants. Living in large family units was associated with a higher risk of contagion and therapeutic failure. Diagnostic delay was associated with previous misdiagnosis.
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Affiliation(s)
- Isabel Betlloch-Mas
- Department of Clinical Medicine, Miguel Hernández University, Carretera Alicante-Valencia N-332, 03550 Sant Joan d’Alacant, Spain;
- Department of Dermatology, Dr. Balmis General University Hospital, 03010 Alicante, Spain; (N.J.-R.); (V.S.-G.); (L.B.-D.G.)
- ISABIAL Research Institute, 03010 Alicante, Spain
| | - Elena Boluda-Verdú
- Department of Clinical Medicine, Miguel Hernández University, Carretera Alicante-Valencia N-332, 03550 Sant Joan d’Alacant, Spain;
| | - Noelia Jara-Rico
- Department of Dermatology, Dr. Balmis General University Hospital, 03010 Alicante, Spain; (N.J.-R.); (V.S.-G.); (L.B.-D.G.)
- ISABIAL Research Institute, 03010 Alicante, Spain
| | - Verónica Sánchez-García
- Department of Dermatology, Dr. Balmis General University Hospital, 03010 Alicante, Spain; (N.J.-R.); (V.S.-G.); (L.B.-D.G.)
- ISABIAL Research Institute, 03010 Alicante, Spain
| | - Laura Berbegal-De Gracia
- Department of Dermatology, Dr. Balmis General University Hospital, 03010 Alicante, Spain; (N.J.-R.); (V.S.-G.); (L.B.-D.G.)
- ISABIAL Research Institute, 03010 Alicante, Spain
| | - Eusebi Chiner-Vives
- Department of Pulmonology, San Juan de Alicante University Hospital, 03010 Alicante, Spain;
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Sánchez-Díaz M, Hernández-Martín Á, Descalzo MÁ, García-Doval I, Salavastru CM. European survey on the management of scabies by dermatologists in children under 2 months, pregnancy and breastfeeding woman. J Eur Acad Dermatol Venereol 2024. [PMID: 38563258 DOI: 10.1111/jdv.20005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Manuel Sánchez-Díaz
- "Juan de Azúa" Fellow, Research Unit, Spanish Academy of Dermatology and Venereology, Madrid, Spain
- Dermatology Department, Hospital Universitario Virgen de Las Nieves, IBS Granada, Granada, Spain
| | - Ángela Hernández-Martín
- Dermatology Department, Hospital Universitario Niño Jesús, Madrid, Spain
- Research Unit, Spanish Academy of Dermatology and Venereology, Madrid, Spain
| | | | - Ignacio García-Doval
- Research Unit, Spanish Academy of Dermatology and Venereology, Madrid, Spain
- Dermatology Department, Hospital Do Meixoeiro, Vigo, Spain
| | - Carmen Maria Salavastru
- Pediatric Dermatology Department, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
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Meyersburg D, Hoellwerth M, Brandlmaier M, Handisurya A, Kaiser A, Prodinger C, Bauer JW. Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial. Br J Dermatol 2024; 190:486-491. [PMID: 38112640 DOI: 10.1093/bjd/ljad501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Scabies is a pruritic parasitic infestation of the skin. High-income countries have reported an increasing incidence over the last few years. Studies have indicated a reduction in the sensitivity of scabies mites to the standard treatment of choice, topical permethrin 5%. OBJECTIVES To evaluate in a head-to-head manner the efficacy of two topical scabicides [permethrin 5% and benzyl benzoate 25% (BB)] in the treatment of scabies using the same administration modality; and to address potential confounding factors such as incorrectly performed treatment and hygiene measures. METHODS In total, 110 patients with dermoscopy-verified scabies infestation were enrolled and randomized into two equally sized groups in a double-blinded manner. Fifty-five received topical permethrin 5% and 55 received topical BB 25%, both for daily use over a period of three consecutive days. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit. RESULTS Treatment resulted in a dermoscopy-verified cure rate of 27% in the permethrin group and 87% in the BB group. The tolerability and safety profile of permethrin 5% cream was excellent, while the BB emulsion produced a burning sensation in 43% of patients. CONCLUSIONS Topical permethrin demonstrated a lack of efficacy in the majority of scabies cases, whereas BB demonstrated an excellent cure rate and reasonable tolerability. Considering the reduced sensitivity of scabies mites to permethrin 5%, our results suggest that BB is an appropriate first-line therapy in the treatment of scabies.
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Affiliation(s)
- Damian Meyersburg
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Magdalena Hoellwerth
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Matthias Brandlmaier
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Andreas Kaiser
- Department of Psychosomatics and Inpatient Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
| | - Christine Prodinger
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Johann W Bauer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University Salzburg, Salzburg, Austria
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14
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Blaizot R, Armanville F, Michaud C, Boceno C, Dupart O, Pansart C, Niemetzky F, Couppie P, Nacher M, Adenis A, Chosidow O, Duvignaud A. Scabies in French Guiana: Quantitative and qualitative factors associated with therapeutic failure. J Eur Acad Dermatol Venereol 2024; 38:602-612. [PMID: 38041562 DOI: 10.1111/jdv.19688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Strategies for the control of scabies should be adapted to local settings. Traditional communities in French Guiana have non-Western conceptions of disease and health. OBJECTIVES The objectives for this study were to explore knowledge, attitudes and practices to identify potential factors associated with the failure of scabies treatment in these communities. METHODS Patients with a clinical diagnosis of scabies, seen at either the Cayenne Hospital or one of 13 health centres between 01 April 2021 and 31 August 2021, were included as participants, and were seen again after 6 weeks to check for persistence of lesions. Factors associated with treatment failure were looked for both at inclusion and at 6 weeks. Semi-structured interviews were conducted with a diversified subsample of participants. RESULTS In total, 164 participants were included in the quantitative component, and 21 were interviewed for the qualitative component. Declaring that the second treatment dose had been taken was associated with therapeutic success. Western treatments were not always affordable. Better adherence was observed with topical treatments than with oral ivermectin, whereas permethrin monotherapy was associated with failure. Scabies-associated stigma was high among Amerindians and Haitians but absent in Ndjuka Maroons. Participants reported environmental disinfection as being very complex. CONCLUSIONS The treatment of scabies in traditional Guianan communities may vary depending on local perceptions of galenic formulations, disease-associated stigma and differences in access to health care. These factors should be taken into account when devising strategies for the control of scabies aimed at traditional communities living in remote areas, and migrant populations.
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Affiliation(s)
- R Blaizot
- Centre Hospitalier de Cayenne, Service de Dermatologie, Cayenne, French Guiana
- Centre Hospitalier de Cayenne Inserm CIC 1424, Centre d'Investigations Cliniques, Cayenne, French Guiana
- UMR 1019 Tropical Biomes and Immunophysiopathology (TBIP), Université de Guyane, Cayenne, French Guiana
- Groupe Infectiologie Dermatologique- Infections Sexuellement Transmissibles, Société Française de Dermatologie, Paris, France
- Centre Hospitalier de Cayenne, Centres Délocalisés de Prévention et de Soins, Cayenne, French Guiana
| | - F Armanville
- Centre Hospitalier de Cayenne, Centres Délocalisés de Prévention et de Soins, Cayenne, French Guiana
| | - C Michaud
- Centre Hospitalier de Cayenne, Centres Délocalisés de Prévention et de Soins, Cayenne, French Guiana
| | - C Boceno
- Centre Hospitalier de Cayenne, Permanence d'Accès aux Soins de Santé, Cayenne, French Guiana
| | - O Dupart
- Centre Hospitalier de Cayenne, Permanence d'Accès aux Soins de Santé, Cayenne, French Guiana
| | - C Pansart
- Centre Hospitalier de Cayenne, Permanence d'Accès aux Soins de Santé, Cayenne, French Guiana
| | - F Niemetzky
- Centre Hospitalier de Cayenne, Centres Délocalisés de Prévention et de Soins, Cayenne, French Guiana
| | - P Couppie
- Centre Hospitalier de Cayenne, Service de Dermatologie, Cayenne, French Guiana
- UMR 1019 Tropical Biomes and Immunophysiopathology (TBIP), Université de Guyane, Cayenne, French Guiana
| | - M Nacher
- Centre Hospitalier de Cayenne Inserm CIC 1424, Centre d'Investigations Cliniques, Cayenne, French Guiana
| | - A Adenis
- Centre Hospitalier de Cayenne Inserm CIC 1424, Centre d'Investigations Cliniques, Cayenne, French Guiana
| | - O Chosidow
- Groupe Infectiologie Dermatologique- Infections Sexuellement Transmissibles, Société Française de Dermatologie, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire La Pitié-Salpêtrière, Paris, France
| | - A Duvignaud
- Department of Infectious Diseases and Tropical Medicine, CHU Bordeaux, Bordeaux, France
- Bordeaux Population Health Centre, University of Bordeaux, INSERM UMR 1219, IRD EMR 271, Bordeaux, France
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15
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Mbuagbaw L, Sadeghirad B, Morgan RL, Mertz D, Motaghi S, Ghadimi M, Babatunde I, Zani B, Pasumarthi T, Derby M, Kothapudi VN, Palmer NR, Aebischer A, Harder T, Reichert F. Failure of scabies treatment: a systematic review and meta-analysis. Br J Dermatol 2024; 190:163-173. [PMID: 37625798 DOI: 10.1093/bjd/ljad308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Treatment failure is considered to be an important factor in relation to the increase in scabies incidence over the last decade. However, the regional and temporal differences, in addition to the predictors of therapy failure, are unclear. OBJECTIVES We aimed to conduct a systematic review of the prevalence of treatment failure in patients with scabies and investigation of associated factors. METHODS We searched MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, Global Health and the Cochrane Central Register of Controlled Trials from inception to August 2021 for randomized and quasi-randomized trials, in addition to observational studies that enrolled children or adults diagnosed with confirmed or clinical scabies treated with permethrin, ivermectin, crotamiton, benzyl benzoate, malathion, sulfur or lindane, and measured treatment failure or factors associated with treatment failure. We performed a random effects meta-analysis for all outcomes reported by at least two studies. RESULTS A total of 147 studies were eligible for inclusion in the systematic review. The overall prevalence of treatment failure was 15.2% [95% confidence interval (CI) 12.9-17.6; I2 = 95.3%, moderate-certainty evidence] with regional differences between World Health Organization regions (P = 0.003) being highest in the Western Pacific region (26.9%, 95% CI 14.5-41.2). Oral ivermectin (11.8%, 95% CI 8.4-15.4), topical ivermectin (9.3%, 95% CI 5.1-14.3) and permethrin (10.8%, 95% CI 7.5-14.5) had relatively lower failure prevalence compared with the overall prevalence. Failure prevalence was lower in patients treated with two doses of oral ivermectin (7.1%, 95% CI 3.1-12.3) compared with those treated with one dose (15.2%, 95% CI 10.8-20.2; P = 0.021). Overall and permethrin treatment failure prevalence in the included studies (1983-2021) increased by 0.27% and 0.58% per year, respectively. Only three studies conducted a multivariable risk factor analysis; no studies assessed resistance. CONCLUSIONS A second dose of ivermectin showed lower failure prevalence than single-dose ivermectin, which should be considered in all guidelines. The increase in treatment failure over time hints at decreasing mite susceptibility for several drugs, but reasons for failure are rarely assessed. Ideally, scabicide susceptibility testing should be implemented in future studies.
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Affiliation(s)
- Lawrence Mbuagbaw
- Biostatistics Unit/The Research Institute, St Joseph's Healthcare, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact
- Department of Anesthesia
| | - Behnam Sadeghirad
- Department of Health Research Methods, Evidence, and Impact
- Department of Anesthesia
- Michael G. DeGroote National Pain Centre
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact
- Evidence Foundation, Cleveland Heights, OH, USA
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Dominik Mertz
- Department of Health Research Methods, Evidence, and Impact
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Maryam Ghadimi
- Department of Health Research Methods, Evidence, and Impact
| | | | - Babalwa Zani
- Knowledge Translation Unit, University of Cape Town Lung Institute, Rondebosch, South Africa
| | | | | | | | | | | | - Thomas Harder
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Felix Reichert
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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16
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Morris GC, Haddow L, Sashidharan P. Is scabies an increasing problem in the UK, and how should the UK Health Security Agency and sexual health services respond? Sex Transm Infect 2024; 100:60. [PMID: 38233022 DOI: 10.1136/sextrans-2023-055991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Affiliation(s)
| | - Lewis Haddow
- Wolverton Centre for Sexual Health, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK
| | - Parameswaran Sashidharan
- Homerton Sexual Health Service, Clifden Centre, Homerton Healthcare NHS Foundation Trust, London, UK
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17
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Aramburu-González A, Gardeazábal-García J, Acebo-Mariñas E. [Translated article] Survey on Scabicides: Prescribing Habits and Perceived Effectiveness. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T113-T115. [PMID: 37923072 DOI: 10.1016/j.ad.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2023] Open
Affiliation(s)
- A Aramburu-González
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.
| | - J Gardeazábal-García
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - E Acebo-Mariñas
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
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18
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Fernández Camporro Á, Navarro Fernández Í, Arcos González P. Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:76-79. [PMID: 37356548 DOI: 10.1016/j.ad.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 06/27/2023] Open
Abstract
Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.
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Affiliation(s)
- Á Fernández Camporro
- Servicio de Dermatología, Hospital Universitario de Cabueñes, Gijón, Asturias, España; Departamento de Medicina, Universidad de Oviedo, Oviedo, España.
| | - Í Navarro Fernández
- Servicio de Dermatología, Hospital Universitario de Cabueñes, Gijón, Asturias, España
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Fernández Camporro Á, Navarro Fernández Í, Arcos González P. [Translated article] Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T76-T79. [PMID: 37923075 DOI: 10.1016/j.ad.2023.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2023] Open
Abstract
Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.
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Affiliation(s)
- Á Fernández Camporro
- Servicio de Dermatología, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain.
| | - Í Navarro Fernández
- Servicio de Dermatología, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
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20
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Baffa ME, Filippeschi C, Tronconi G, Diociaiuti A, El Hachem M, Oranges T. Sulfur 17% ointment for topical treatment of scabies in children: old but gold. Int J Dermatol 2024; 63:e19-e20. [PMID: 37950367 DOI: 10.1111/ijd.16898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/03/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Maria E Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Cesare Filippeschi
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Greta Tronconi
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Andrea Diociaiuti
- Dermatology Unit and Genodermatosis Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - May El Hachem
- Dermatology Unit and Genodermatosis Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Teresa Oranges
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital, IRCCS, Florence, Italy
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21
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Aramburu-González A, Gardeazábal-García J, Acebo-Mariñas E. Survey on Scabicides: Prescribing Habits and Perceived Effectiveness. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:113-115. [PMID: 37704172 DOI: 10.1016/j.ad.2022.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 09/15/2023] Open
Affiliation(s)
- A Aramburu-González
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, España.
| | - J Gardeazábal-García
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, España
| | - E Acebo-Mariñas
- Servicio de Dermatología, Hospital Universitario Cruces, Barakaldo, Bizkaia, España
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Potestio L, Scalvenzi M, Martora F, Costanzo L, Gallo L. Comment on 'Permethrin-unresponsive scabies in London, UK: a wake-up call'. Clin Exp Dermatol 2023; 49:80-81. [PMID: 37683073 DOI: 10.1093/ced/llad309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/13/2023] [Indexed: 09/10/2023]
Abstract
Regarding scabies management, permethrin is the most prescribed first-line treatment. However, cases of treatment resistance have been reported, leading to the need for new drugs.
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Affiliation(s)
- Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Costanzo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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23
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Buettcher M, Stebler AK, Theiler M, Kobylinski K, Pfister M. National survey in Switzerland calls for improved diagnosis and treatment in children with scabies. Swiss Med Wkly 2023; 153:40129. [PMID: 38579328 DOI: 10.57187/smw.2023.40129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
AIM OF THE STUDY The global prevalence of scabies is estimated to be up to 200 million cases annually, with young children particularly affected. In Europe, most cases are thought to originate in migrant populations. Scabies management is challenging in children. To identify knowledge gaps and research needs, we aimed to descriptively evaluate the management of children with scabies by different Swiss healthcare providers. METHODS An invitation for an anonymous online survey (36 questions) was sent to members of Swiss societies of dermatologists, general practitioners, paediatricians, paediatric dermatologists, paediatric infectious diseases specialists, and tropical medicine specialists, inviting clinicians to participate from 25th May to 8th August 2020. One reminder invitation was sent. Hospital pharmacies and the distributor of permethrin were contacted to report consumption trends of scabicides in 2018 and 2019. RESULTS The survey was completed by 248 clinicians: 146 (59%) paediatricians, 47 (19%) dermatologists, 28 (11%) general practitioners, 6 (2%) paediatric dermatologists, 13 (5%) paediatric infectious diseases specialists, and 8 (3%) tropical medicine specialists. Most consulted up to 10 scabies cases within a 16-month period, with similar numbers in migrant and Swiss children. Dermoscopy was used by 24% of non-dermatologists. Non-dermatologists did not consider co-treatment of close contacts in up to 59% of cases. While permethrin was the first-line treatment, treatment failures were frequently reported in children aged <5 years. Up to 67% of paediatric dermatologists regularly used oral ivermectin off-label in children weighing <15 kg. None of the paediatric dermatologists, 15% of the dermatologists, and 9% of the non-dermatologists used only one treatment cycle.Scabicide consumption increased. Treatment studies on ivermectin use in children weighing <15 kg had the highest research priority. CONCLUSION In Switzerland, scabies is a frequent dermatosis in migrant and Swiss children. While accessible, optimal diagnostics are underutilised, and treatment is suboptimal. Permethrin resistance appears to be an increasing problem. Dermatologists regularly use ivermectin off-label in children weighing <15 kg. Treatment studies on ivermectin use in children weighing <15 kg, user-friendly diagnostic tools, new treatment protocols, and child-friendly dosage forms are needed to improve the diagnosis and treatment of children with scabies.
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Affiliation(s)
- Michael Buettcher
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, Basel, Switzerland
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Lucerne Children's Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland
- Faculty of Health Science and Medicine, University Lucerne, Lucerne, Switzerland
| | - Anita K Stebler
- Master of Medicine Student, Faculty of Medicine, University Basel, Basel, Switzerland
| | - Martin Theiler
- Paediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Kevin Kobylinski
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Marc Pfister
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, Basel, Switzerland
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Rinaldi F, Chirico R, Trink A, Pinto D. Resistance and Pseudo-resistance to permethrin: the importance of controlling scabies. Front Cell Infect Microbiol 2023; 13:1297337. [PMID: 38029237 PMCID: PMC10679459 DOI: 10.3389/fcimb.2023.1297337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
| | | | | | - Daniela Pinto
- HMAP, Human Microbiome Advanced Project, Milan, Italy
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25
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Richardson NA, Cassell JA, Head MG, Lanza S, Schaefer C, Walker SL, Middleton J. Scabies outbreak management in refugee/migrant camps in Europe 2014-2017: a retrospective qualitative interview study of healthcare staff experiences and perspectives. BMJ Open 2023; 13:e075103. [PMID: 37940153 PMCID: PMC10632829 DOI: 10.1136/bmjopen-2023-075103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES Provide insights into the experiences and perspectives of healthcare staff who treated scabies or managed outbreaks in formal and informal refugee/migrant camps in Europe 2014-2017. DESIGN Retrospective qualitative study using semistructured telephone interviews and framework analysis. Recruitment was done primarily through online networks of healthcare staff involved in medical care in refugee/migrant settings. SETTING Formal and informal refugee/migrant camps in Europe 2014-2017. PARTICIPANTS Twelve participants (four doctors, four nurses, three allied health workers, one medical student) who had worked in camps (six in informal camps, nine in formal ones) across 15 locations within seven European countries (Greece, Serbia, Macedonia, Turkey, France, the Netherlands, Belgium). RESULTS Participants reported that in camps they had worked, scabies diagnosis was primarily clinical (without dermatoscopy), and treatment and outbreak management varied highly. Seven stated scabicides were provided, while five reported that only symptomatic management was offered. They described camps as difficult places to work, with poor living standards for residents. Key perceived barriers to scabies control were (1) lack of water, sanitation and hygiene, specifically: absent/limited showers (difficult to wash off topical scabicides), and inability to wash clothes and bedding (may have increased transmission/reinfestation); (2) social factors: language, stigma, treatment non-compliance and mobility (interfering with contact tracing and follow-up treatments); (3) healthcare factors: scabicide shortages and diversity, lack of examination privacy and staff inexperience; (4) organisational factors: overcrowding, ineffective interorganisational coordination, and lack of support and maltreatment by state authorities (eg, not providing basic facilities, obstruction of self-care by camp residents and non-governmental organisation (NGO) aid). CONCLUSIONS We recommend development of accessible scabies guidelines for camps, use of consensus diagnostic criteria and oral ivermectin mass treatments. In addition, as much of the work described was by small, volunteer-staffed NGOs, we in the wider healthcare community should reflect how to better support such initiatives and those they serve.
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Affiliation(s)
- Naomi A Richardson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | - Jackie A Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | - Michael G Head
- Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Stefania Lanza
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
| | | | - Stephen L Walker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jo Middleton
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
- NIHR Global Health Research Unit on Neglected Tropical Diseases, and NIHR Applied Research Collaboration Kent, Surrey and Sussex, Brighton and Sussex Medical School, Falmer, UK
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Fidanzi C, Manzo Margiotta F, Bevilacqua M, D'Erme AM, Bagnoni G, Dini V, Janowska A. Persistence of itching in patients after scabies therapy: What to do? Travel Med Infect Dis 2023; 56:102652. [PMID: 37832709 DOI: 10.1016/j.tmaid.2023.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Affiliation(s)
| | | | | | - Angelo Massimiliano D'Erme
- Melanoma and Skin Cancer Unit AVNO (Area Vasta Nord Ovest) and Unit of Dermatology, Livorno Hospital, Livorno, Italy
| | - Giovanni Bagnoni
- Melanoma and Skin Cancer Unit AVNO (Area Vasta Nord Ovest) and Unit of Dermatology, Livorno Hospital, Livorno, Italy
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27
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Suárez-Amor Ó, Monteagudo B, Cabanillas M. Comment on «Epidemic Scabies: New Treatment Challenges in an Ancient Disease». ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:926. [PMID: 37356544 DOI: 10.1016/j.ad.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 06/27/2023] Open
Affiliation(s)
- Ó Suárez-Amor
- Dermatología, Hospital Ribera Juan Cardona, Ferrol, España.
| | - B Monteagudo
- Servicio de Dermatología. Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - M Cabanillas
- Dermatología, Hospital Ribera Juan Cardona, Ferrol, España
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Riebenbauer K, Purkhauser K, Walochnik J, Urban N, Weber PB, Stamm T, Handisurya A. Detection of a knockdown mutation in the voltage-sensitive sodium channel associated with permethrin tolerance in Sarcoptes scabiei var. hominis mites. J Eur Acad Dermatol Venereol 2023; 37:2355-2361. [PMID: 37356045 DOI: 10.1111/jdv.19288] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/01/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Increasing evidence has sparked a debate on the loss of sensitivity of scabies mites to conventional permethrin therapy. Mutations in the voltage-sensitive sodium channels (VSSC) were associated with knockdown resistance (kdr) in many arthropods, but have never been identified in Sarcoptes scabiei variatio (var.) hominis mites. OBJECTIVES To identify factors contributing to therapy failure. METHODS Sixty-seven mites were collected from 64 scabies-infested patients in Vienna, Austria, of whom 85.9% were refractory to prior permethrin-based treatments, and genotyped for the presence of nucleotide polymorphisms in Domain II of the VSSC, known to be associated with kdr. Information regarding previous antiscabietic therapies, decontamination procedures and possible re-infestations by contacts as well as the response to re-imposed therapies were obtained. RESULTS Sequence alignment comparisons revealed previously unidentified mutations in the coding region of Domain II of the VSSC. A novel A1663T transversion was detected in 97.0% of the mites, resulting in a non-synonymous substitution from methionine to leucine, M918L, a mutation known to confer kdr in other arthropods. In addition, a synonymous G1659A transition was identified in one mite, which otherwise showed a nucleotide sequence identical to the wild-type reference. No major inconsistencies were observed within the previous therapeutic and decontamination procedures, which could have accounted for the observed non-responsiveness to permethrin-based therapies. Subsequent cure of infestation was achieved in 65.6% of the participants, predominantly by combination therapies with topical permethrin and systemic ivermectin. However, in 14.6% of the cured cases, permethrin monotherapy sufficed for eradication of scabies, albeit in some cases prolonged exposure was necessary. CONCLUSIONS The kdr-associated M918L mutation in the VSSC gene has now emerged in S. scabiei var. hominis mites. Hence, loss of sensitivity to permethrin due to kdr-type resistance may be more prevalent than anticipated and may be decisive for the therapy responsiveness of scabies-infested patients.
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Affiliation(s)
- K Riebenbauer
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - K Purkhauser
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - J Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - N Urban
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P B Weber
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - T Stamm
- Center for Medical Data Science, Institute of Outcomes Research, Medical University of Vienna & Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - A Handisurya
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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29
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Suárez-Amor Ó, Monteagudo B, Cabanillas M. [Translated article] Comment on "Epidemic Scabies: New Treatment Challenges in an Ancient Disease". ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T926. [PMID: 37678631 DOI: 10.1016/j.ad.2023.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Ó Suárez-Amor
- Dermatología, Hospital Ribera Juan Cardona, Ferrol, Spain.
| | - B Monteagudo
- Servicio de Dermatología, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - M Cabanillas
- Dermatología, Hospital Ribera Juan Cardona, Ferrol, Spain
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30
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Cheraghi S, Babataheri S, Soraya H. The Detrimental Effect of Pre-Treatment with Ivermectin on Myocardial Ischemia. Pharmacology 2023; 109:1-9. [PMID: 37879298 DOI: 10.1159/000534206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Ivermectin (IVM) is a broad-spectrum anti-parasitic agent with potential antibacterial, antiviral, and anti-cancer effects. There are limited studies on the effects of IVM on cardiovascular diseases, so the present study sought to determine the effects of pre-treatment with IVM on myocardial ischemia in both ex vivo and in vivo. METHODS In the ex vivo part, two groups of control and treated rats with IVM (0.2 mg/kg) were examined for cardiac function and arrhythmias by isolated heart perfusion. In the in vivo part, four groups, namely, control, IVM, Iso (MI), and Iso + IVM 0.2 mg/kg were used. Subcutaneous injection of isoproterenol (100 mg/kg/day) for 2 consecutive days was used for the induction of myocardial infarction (MI) in male Wistar rats. Then electrocardiogram, hemodynamic factors, cardiac hypertrophy, and malondialdehyde (MDA) levels were investigated. RESULTS The ex vivo results showed that administration of IVM induces cardiac arrhythmia and decreases the left ventricular maximal rate of pressure increase (contractility) and maximal rate of pressure decline (relaxation). The isoproterenol-induced MI model used as an in vivo model showed that cardiac hypertrophy were increased with no improvement in the hemodynamic and electrocardiogram pattern in the IVM-treated group in comparison to MI (Iso) group. However, the MDA level was lower in the IVM-treated group. CONCLUSION IVM pre-treatment demonstrates detrimental effects in cardiac ischemia through exacerbation of cardiac arrhythmia, myocardial dysfunction, and increased cardiac hypertrophy. Therefore, the use of IVM in ischemic heart patients should be done with great caution.
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Affiliation(s)
- Sara Cheraghi
- Department of Pharmacology and Toxicology, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
| | - Shabnam Babataheri
- Department of Pharmacology and Toxicology, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamid Soraya
- Department of Pharmacology and Toxicology, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
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31
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Micallef D, Boffa MJ. Worldwide prevalence of scabies: Some knowns but still many unknowns. J Eur Acad Dermatol Venereol 2023; 37:1687-1688. [PMID: 37622220 DOI: 10.1111/jdv.19292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/26/2023]
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32
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Scanni G. A linear cob-led torch may become a new dermatological tool for scabies diagnosis. Skin Res Technol 2023; 29:e13399. [PMID: 37522503 PMCID: PMC10318614 DOI: 10.1111/srt.13399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Gaetano Scanni
- Department of PreventionDermatology Unit, ASL BariBariItaly
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Sponselli S, De Maria L, Caputi A, Stefanizzi P, Bianchi FP, Delvecchio G, Foti C, Romita P, Ambrogio F, Zagaria S, Giannelli G, Tafuri S, Vimercati L. Infection Control among Healthcare Workers and Management of a Scabies Outbreak in a Large Italian University Hospital. J Clin Med 2023; 12:jcm12113830. [PMID: 37298025 DOI: 10.3390/jcm12113830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/25/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in Operative Units with a scabies prevalence higher than 2%, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases at high scabies risk underwent a dermatological examination, and the infested HCWs were suspended from work until definitive healing. Mass drug administration was established for all HCWs working in Operative Units with a scabies prevalence higher than 2%. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. Between 11 October 2022 (date of the first diagnosed scabies case) and 6 March 2023 (the end of incubation period related to the last case detected), the frequency of scabies was 0.35% (21 scabies cases/6000 HCWs). The duration of the outbreak in our hospital was 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and having an allergy to dust mites. We obtained a low frequency of scabies infection, limiting the duration of the outbreak and the related economic burden.
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Affiliation(s)
- Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | | | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Francesca Ambrogio
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Silvia Zagaria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
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Al-Dabbagh J, Younis R, Ismail N. The current available diagnostic tools and treatments of scabies and scabies variants: An updated narrative review. Medicine (Baltimore) 2023; 102:e33805. [PMID: 37233429 PMCID: PMC10219715 DOI: 10.1097/md.0000000000033805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
Scabies is a neglected tropical disease that continues to have global impacts and long-term health consequences. It is caused by the mite Sarcoptes scabei var. hominis, which is an obligate ectoparasite that lives in the epidermis of the human skin. Scabies is common in poor communities due to overcrowding in places like old age homes, prisons, and homeless and displaced children. However, developed countries are also susceptible to scabies infestations, such as in institutional outbreaks or small epidemics under war conditions or during natural disasters. The diagnosis of scabies may be assisted by invasive and noninvasive tools; However, the history and examination findings are usually adequate to confirm the clinical suspicion. Here, we present an updated review of scabies by focusing on the diagnostic approaches, treatment, and prevention of scabies.
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Affiliation(s)
| | - Razan Younis
- Faculty of Medicine, Tartous University, Tartous, Syria
| | - Nemat Ismail
- Faculty of Medicine, Tishreen University, Latakia, Syria
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35
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Feng S, Shi M, Yin Z, Di W, Guillot J, Fang F. Can Ivermectin kill Sarcoptes scabiei during the molting process? PLoS Negl Trop Dis 2023; 17:e0011337. [PMID: 37196006 DOI: 10.1371/journal.pntd.0011337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/30/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Sarcoptes scabiei is a permanent obligate ectoparasite that lives and reproduces in the epidermis of humans and other mammals worldwide. There is a lack of information on the molting process of Sarcoptes scabiei. Ivermectin is widely used to treat Sarcoptes infection in humans and animals, while the survival of molting Sarcoptes mites in the presence of ivermectin is unknown. The aim of the present study is to investigate the molting process of Sarcoptes mites and assess the activity of ivermectin during the molting process of Sarcoptes mites. METHODOLOGY/PRINCIPAL FINDINGS molting Sarcoptes mites were incubated at 35°C and 80% relative humidity and observed hourly until complete molt. Of the 192 molting mites recorded, the longest molt periods for larvae and nymphs were 23 and 30 h, respectively. The activity of ivermectin on molting Sarcoptes mites was also assessed using two concentrations of the drug (0.1 and 0.05 mg/ml). The exposure time for molting mites was determined by 100% mortality of female mites exposed to the solution of ivermectin. While all female mites were killed after exposure to 0.1 mg/ml ivermectin for 2 h and and 0.05 mg/ml for 7 h, 32% and 36% of molting mites survived and successfully molted, respectively. CONCLUSIONS/SIGNIFICANCE The present study demonstrated that molting Sarcoptes mites are less susceptible to ivermectin than active mites. As a consequence, mites may survive after two doses of ivermectin given 7 days apart due not only to hatching eggs but also to the resistance of mites during their molting process. Our results provide insight into the optimal therapeutic regimens for scabies and highlight the need for further research on the molting process of Sarcoptes mites.
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Affiliation(s)
- Shenrui Feng
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Minmin Shi
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Zhijuan Yin
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Wenda Di
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Jacques Guillot
- Dermatology-Parasitology-Mycology Departement, ONIRIS, Nantes, France
| | - Fang Fang
- Parasitology Department, College of Animal Science and Technology, Guangxi University, Nanning, China
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36
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Bassi A, Piccolo V, Mazzatenta C. "One-shot" combined therapy with oral ivermectin and local benzyl benzoate: is the current best therapeutic option in the era of permethrin resistant scabies? Travel Med Infect Dis 2023; 53:102585. [PMID: 37149241 DOI: 10.1016/j.tmaid.2023.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/26/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Andrea Bassi
- Division of Dermatology, Azienda USL Toscana Nord Ovest, Lucca, Italy.
| | - Vincenzo Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carlo Mazzatenta
- Division of Dermatology, Azienda USL Toscana Nord Ovest, Lucca, Italy
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37
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Feng Y, Feng J, Qin B. Answer to April 2023 Photo Quiz. J Clin Microbiol 2023; 61:e0130322. [PMID: 37078716 PMCID: PMC10117119 DOI: 10.1128/jcm.01303-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
Read the full article for the answer.
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Affiliation(s)
- Yifei Feng
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Jianqing Feng
- Department of Dermatology, Taicang Hospital of Traditional Chinese Medicine, Suzhou, China
| | - Bing Qin
- Intensive Care Unit, Taicang Hospital of Traditional Chinese Medicine, Suzhou, China
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38
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Vázquez-Prieto S, Vaamonde A, Paniagua E. Study of the Use of Permethrin 5% Cream in Galicia (Spain) between 2018 and 2021. Infect Dis Rep 2023; 15:222-230. [PMID: 37102983 PMCID: PMC10138315 DOI: 10.3390/idr15020023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Drug utilization studies can provide direct insights into how a drug is used in real-world conditions and can give a rough estimate of the proportion of the study population treated with it. In the present work, we examined the consumption of permethrin 5% cream in the four provinces of Galicia (a Spanish autonomous community) and described the seasonal variability and the annual evolution of its consumption between 2018 and 2021. A descriptive, cross-sectional, and retrospective study of the consumption of this drug, expressed in defined daily dose per 1000 inhabitants per day (DID), was carried out. The results obtained revealed differences between the amounts consumed in the four Galician provinces (p < 0.001). No specific geographical pattern was observed; however, the results suggested a marked seasonality and a slightly increasing global trend in the consumption of permethrin 5% cream throughout the study period. Since the only authorized indication of this drug in the study area is the treatment of scabies, this work may give an idea of the epidemiological situation of the disease in Galicia and serve to establish public health strategies against this parasitosis.
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Affiliation(s)
- Severo Vázquez-Prieto
- Universidad de Los Lagos, Osorno, Chile
- Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - Antonio Vaamonde
- Departamento de Estadística e Investigación Operativa, Universidad de Vigo, 36310 Vigo, Spain
| | - Esperanza Paniagua
- Laboratorio de Parasitología, Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain
- Instituto de Investigación en Análisis Químicos y Biológicos (IAQBUS), Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Skayem C, Askour M, Gary C, Hemery F, Mahé E, Caux F, Dupin N, Senet P, Greder-Belan A, Hillion B, Meni C, Saiag P, Bellaud G, Bleibtreu A, Lariven S, Bollens D, Descamps V, Molina JM, Bouchaud O, Vittecoq D, Do-Pham G, Foulet F, Botterel F, Chosidow O, Bernigaud C. Severe Scabies: A French Multi-centre Study Involving 95 Patients with Crusted and Profuse Disease and Review of the Literature. Acta Derm Venereol 2023; 103:adv00878. [PMID: 36861856 PMCID: PMC9993169 DOI: 10.2340/actadv.v103.5351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/01/2023] [Indexed: 03/03/2023] Open
Abstract
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.
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Affiliation(s)
- Charbel Skayem
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France.
| | - Majda Askour
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Charlotte Gary
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Francois Hemery
- Service d'Information Médicale, DSIGHM, APHP, Hôpital Henri-Mondor, Créteil, France
| | - Emmanuel Mahé
- Dermatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Frederic Caux
- Dermatology Department, APHP, Hôpital Avicenne, Bobigny, France
| | - Nicolas Dupin
- Dermatology Department, APHP, Hôpital Cochin, Pavillon Tarnier, Paris, France
| | - Patricia Senet
- Dermatology Department, APHP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Alix Greder-Belan
- Service de Médecine Interne et Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier de Versailles, Hôpital Mignot, Le Chesnay, France
| | - Brigitte Hillion
- Dermatology Department, Centre Hospitalier Marne la Vallée, Jossigny, France
| | - Cecile Meni
- Dermatology Department, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Philippe Saiag
- Dermatology Department, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Guillaume Bellaud
- Infectious Diseases Department, APHP, Hôpital Tenon, Hôpitaux Universitaires Paris-Est, Paris, France
| | - Alexandre Bleibtreu
- Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Sylvie Lariven
- Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Diane Bollens
- Infectious Diseases Department, APHP, Hôpital Saint-Antoine, Paris, France
| | - Vincent Descamps
- Dermatology Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Jean-Michel Molina
- Infectious Diseases Department, APHP, Hôpital Saint-Louis, Paris, France
| | - Olivier Bouchaud
- Infectious Diseases Department, APHP, Hôpital Avicenne, Bobigny, France
| | - Daniel Vittecoq
- Infectious Diseases Department, APHP, CHU Bicêtre, Le Kremlin Bicêtre, France
| | - Gia Do-Pham
- Service de Médecine Interne, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Francoise Foulet
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Francoise Botterel
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Olivier Chosidow
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Charlotte Bernigaud
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France.
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Balestri R, Magnano M, Infusino SD, Girardelli CR, Ioris T, Rech G. Oral ivermectin to treat scabies: a comparison of two different regimens. Clin Exp Dermatol 2023; 48:232-234. [PMID: 36702573 DOI: 10.1093/ced/llac092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/22/2022] [Indexed: 01/09/2023]
Abstract
As Sarcoptes scabiei is becoming less sensitive to permethrin, clinicians have started to prescribe oral ivermectin (OI) as a first-line treatment. Guidelines suggest OI 200 µg kg-1 as two doses, 1 week apart. However, the black box of the ivermectin registered in Italy recommends a single dose. To compare these two regimens, we collected 71 cases of scabies and treated them according to this protocol [single-dose group (SDG)]. This population was compared to 68 patients who received two doses 1 week apart [double-dose group (DDG)]. Clearance of the disease was achieved in 98% of DDG patients. In the SDG, treatment was successful in only 58% of patients. This study confirms that the absence of a second intake of OI is one of the main predictors of treatment failure (P < 0.001), which may also increase the likelihood of emerging resistance in S. scabiei.
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Affiliation(s)
| | - Michela Magnano
- Division of Dermatology, STI Clinic, Trento Hospital, Trento, Italy
| | | | | | - Tommaso Ioris
- Division of Dermatology, STI Clinic, Trento Hospital, Trento, Italy
| | - Giulia Rech
- Division of Dermatology, STI Clinic, Trento Hospital, Trento, Italy
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Amoako YA, van Rietschoten LS, Oppong MN, Amoako KO, Abass KM, Anim BA, Laryea DO, Phillips RO, Stienstra Y. Beliefs, attitudes and practices towards scabies in central Ghana. PLoS Negl Trop Dis 2023; 17:e0011175. [PMID: 36812249 PMCID: PMC9987785 DOI: 10.1371/journal.pntd.0011175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/06/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Scabies commonly affects poor populations in low-middle-income countries. The WHO has advocated for country-driven and country-owned control strategies. Knowledge of context specific issues will be important for design and implementation of scabies control interventions. We aimed to assess beliefs, attitudes and practices towards scabies in central Ghana. METHODOLOGY/PRINCIPAL FINDINGS Data was collected via semi-structured questionnaires for people who had active scabies or scabies in the past year and people who never had scabies in the past. The questionnaire covered several domains: knowledge about the causes and risk factors; perceptions towards stigmatisation and consequences of scabies in daily life; and treatment practices. Out of 128 participants, 67 were in the (former) scabies group and had a mean age of 32.3 ± 15.6 years. Overall scabies group participants less often indicated a factor to predispose to scabies than community controls; only 'family/friends contacts' was more often mentioned in the scabies group. Scabies causation was attributed to poor hygiene, traditional beliefs, heredity and drinking water. Individuals with scabies delay care seeking (median time from symptom onset to visiting the health centre was 21 [14 - 30] days) and this delay is enhanced by their beliefs (like witchcraft and curses) and a perception of limited disease severity. Compared to past scabies participants in the dermatology clinic, participants with past scabies in the community tended to have a longer delay (median [IQR] 30 [14-48.8] vs 14 [9.5-30] days, p = 0.002). Scabies was associated with health consequences, stigma, and loss of productivity. CONCLUSION/SIGNIFICANCE Early diagnosis and effective treatment of scabies can lead to persons less frequently associating scabies with witchcraft and/ or curses. There is the need to enhance health education to promote early care seeking, enhance knowledge of communities on impact and dispel negative perceptions about scabies in Ghana.
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Affiliation(s)
- Yaw Ampem Amoako
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Lotte Suzanne van Rietschoten
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michael Ntiamoah Oppong
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwabena Oppong Amoako
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. [Translated article] Epidemic Scabies: New Treatment Challenges in an Ancient Disease. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T132-T140. [PMID: 36462668 DOI: 10.1016/j.ad.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
Scabies which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications, such as spinosad or, especially, moxidectin, offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - A Boada
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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43
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Pruritic papules and nodules as sign of persistent scabies infestation despite treatment according to current guidelines evidence for treatment resistance to ivermectin, benzylbenzoat and permethrin proven by videomicroscopy. IDCases 2023; 31:e01678. [PMID: 36660738 PMCID: PMC9843168 DOI: 10.1016/j.idcr.2023.e01678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Scabies infestation is a growing public health issue due to its world wide increase of incidence. The objective of this study was to proof treatment resistance towards treatment, which was applied according to international guidelines. This is a controversial issue since treatment failures were believed to be due to false application oft he treatment. Here, we proof fort he first time this treatment resistance by videomicroscopic evaluation. Additionally an escalation therapy is described, which led to an effective treatment.
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Meyersburg D, Welponer T, Kaiser A, Selhofer S, Tatarski R, Handisurya A, Bauer JW. Comparison of topical benzyl benzoate vs. oral ivermectin in treating scabies: A randomized study. J Eur Acad Dermatol Venereol 2023; 37:160-165. [PMID: 36097258 PMCID: PMC10087012 DOI: 10.1111/jdv.18573] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/18/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scabies is an itchy, parasitic infection of the skin. Recent reports indicate there is a decreasing efficacy of the standard treatment of choice, topical 5% permethrin cream. OBJECTIVE To evaluate the comparative efficacy, safety and tolerability of topical benzyl benzoate (BB) with oral ivermectin in the treatment of scabies. METHODS Patients with dermoscopy-verified scabies visiting the dermatologic outpatient clinic were assessed for enrolment in the study. In total, 224 patients were enrolled and sequentially randomized into two equally sized groups. Group A received topical 25% or 10% BB for the daily use over a period of three consecutive days, group B received oral ivermectin (200 μg/kg body weight) twice, 1 week apart. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit. RESULTS Treatment resulted in a cure rate of 87% in group A and 86% in group B. After initial therapy failure in group A, six out of eight patients showed treatment response upon repeated application of BB, five of five when retreated with ivermectin and two of two with BB plus ivermectin, respectively. In group B, successful retreatment was observed in three out of three patients with ivermectin, two of two patients with BB and 11 of 11 patients with the combination of BB plus ivermectin, respectively. Tolerability and safety profile of oral ivermectin was excellent, while BB produced short burning sensations in 14%. CONCLUSION Topical BB and oral ivermectin have shown comparable good therapeutic efficacy. Therefore, both agents constitute an adequate first-line therapy in the treatment of scabies. A combination of both agents may be considered in recalcitrant and extensively infested cases, additionally to crusted scabies.
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Affiliation(s)
- Damian Meyersburg
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Tobias Welponer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Andreas Kaiser
- Department of Psychosomatics and Inpatient Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
| | - Sylvia Selhofer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Rafaella Tatarski
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | | | - Johannes Wolfgang Bauer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
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Colombo M, Morelli S, Sacra M, Trezza G, Paoletti B, Traversa D, Di Cesare A. An Uncommon and Severe Clinical Case of Sarcoptes scabiei Infestation in a Cat. Pathogens 2022; 12:pathogens12010062. [PMID: 36678410 PMCID: PMC9864773 DOI: 10.3390/pathogens12010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/09/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
The burrowing mite Sarcoptes scabiei causes sarcoptic mange in dogs and other mammals, including humans. Despite S. scabiei infests several animals, little is known about the epidemiology, clinical features, and treatment of sarcoptic mange in cats. A few reports have shown that clinical signs of S. scabiei infestation in cats may vary from non-pruritic crusted lesions to itchy and mild lesions, while severe signs are very infrequent. The present report describes a severe case of S. scabiei infestation in a stray cat from Italy, characterized by bilateral alopecia, diffuse and multifocal hyperpigmented, crusted, erythematous, scaled, and exfoliated lesions. The cat was FIV-positive and also infected by the cestode Dipylidium caninum. After treatment with a broad-spectrum parasiticide and an antibiotic, the cat showed an almost complete clinical recovery in 4 weeks. Unfortunately, no further clinical examinations were performed due to the lack of compliance of the owner and to the death of the cat for causes unrelated to sarcoptic mange. This clinical case indicates that under certain circumstances, S. scabiei can reproduce and cause severe clinical signs in cats which are usually considered non-permissive hosts for this mite, and in which the disease is usually self-limiting. Clinic-pathological, epidemiological, and zoonotic implications are discussed.
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Affiliation(s)
- Mariasole Colombo
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Simone Morelli
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
- Correspondence:
| | - Marzia Sacra
- Clinica Veterinaria Borghesiana, 00132 Rome, Italy
| | - Gaia Trezza
- Clinica Veterinaria Borghesiana, 00132 Rome, Italy
| | - Barbara Paoletti
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Donato Traversa
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Angela Di Cesare
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
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RF - Resistance to Permethrin in Scabies Treatment: Does It Really Exist? ACTAS DERMO-SIFILIOGRAFICAS 2022; 114:433-434. [PMID: 36567030 DOI: 10.1016/j.ad.2022.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/09/2022] [Accepted: 05/08/2022] [Indexed: 12/24/2022] Open
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Scanni G. Facilitations in the Clinical Diagnosis of Human Scabies through the Use of Ultraviolet Light (UV-Scab Scanning): A Case-Series Study. Trop Med Infect Dis 2022; 7:tropicalmed7120422. [PMID: 36548678 PMCID: PMC9785351 DOI: 10.3390/tropicalmed7120422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/13/2022] [Accepted: 11/19/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To confirm the suspicion of scabies, dermatologists have one pathognomonic sign, "the tunnel" through which Sarcoptes scabiei digs into the epidermis. Light microscopy is considered the most reliable procedure, but it is time-consuming and operator-dependent. Recently, dermoscopy has greatly improved the chances of recognizing mite in situ, but it is still linked to the examiner's experience and to the magnification capability of the device used. METHODS This article, based on a case-series study, describes a novel diagnostic path, which uses an ultraviolet LED source at 365 nm and a digital camera for the evaluation of lesions that raise the suspicion of scabies. RESULTS The gallery emits a naked-eye-visible wavy bluish-white linear luminescence, better than that of any standard lighting. UVA light is also able to identify Sarcoptes scabiei as a white or green point-shaped area. This sign can only be appreciated by enlarging its picture to full frame on a common PC monitor. CONCLUSIONS Ultraviolet light (365 nm) seems to offer help in the diagnosis of scabies because it saves time compared with light microscopy and because it does not require contact with the patient's skin, as in dermoscopy. Although examiner experience remains an important factor, it is easily compensated by procedural simplicity, the cost of the devices and, especially, by the clarity of the results, even in non-specific lesions.
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Affiliation(s)
- Gaetano Scanni
- Dermatology Unit, Department of Prevention ASL, 70123 Bari, Italy;
- Osservatorio Per lo Studio e la Prevenzione Delle Parassitosi ed Infezioni Nelle Collettività (OPIC), Via Lungomare Starita n.6, 70132 Bari, Italy
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Kokilananthan S, Bulugahapitiya VP, Manawadu H, Gangabadage CS. Sesquiterpenes and monoterpenes from different varieties of guava leaf essential oils and their antioxidant potential. Heliyon 2022; 8:e12104. [PMID: 36568663 PMCID: PMC9768318 DOI: 10.1016/j.heliyon.2022.e12104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/05/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Despite that Sri Lanka is a biodiversity hotspot with numerous guava varieties (Psidium guajava L.), no adequate scientific research has been reported on leaf essential oil (EO) composition based on varieties and its pharmacological properties, namely antioxidant properties. Therefore, this study focused to evaluate the chemical compositions and antioxidative capacity of EOs isolated from leaves of seven guava varieties grown in Sri Lanka, including apple-guava (P. pomiferum , PGA), common-guava (P. guaja v a , PGCG), two wild-guava; cultivar of P. guajava (PGG) and a cultivar of P. guineense (PGE), two introduced varieties of P. guajava (PGK and PGP), and one introduced variety of P. guineense (PGC). The EOs were isolated using hydro-distillation and the chemical compositions were analyzed using Gas Chromatography-Mass Spectrometry (GC-MS) technique, and the compounds that showed greater than 90% matching value were considered for characterization. The yields of EOs ranged from 0.02-0.26% (w/w) where PGE produced the greatest amount. About sixty-eight chemical compounds were identified from seven varieties and Sesquiterpenes were found to be the most abundant in the PGCG, PGG, PGE, and PGA varieties, whereas monoterpenes were found to be the most abundant in PGK, PGP, and PGC varieties. The sesquiterpenes, Nerolidol (70.0-7.9%), (-)-Globulol (21.0-7.0%), and Caryophyllene (20.4-1.4%) and monoterpenes, D-Limonene (30.3-14.1 %) were found as the major compounds of all studied guava varieties. Twenty-eight compounds were identified for the first time in guava EOs, including Cadinadiene-1,4, Benzylacetaldehyde, and Epiglobulol. The antioxidant efficacy of EOs varied from 329.56 ± 2.01 to 85.70 ± 2.01 μL Trolox Eq/L, where PGE showed the highest antioxidative potential. Ultimately, the chemical constituents and antioxidant capacity of isolated EOs varied with the variety, with EO from PGE leaves exerting an amazing antioxidant capacity compared to the others and being rich in Nerolidol. The findings of this study fill the gap in the literature on chemical constituents in the EO of guava leaves, and also it will open the avenue to discover novel potential compounds with outstanding pharmacological activities from guava leaves.
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Ertugrul G, Aktas H. Comparison of sulfur ointment and permethrin treatments in scabies. Dermatol Ther 2022; 35:e15897. [PMID: 36193643 DOI: 10.1111/dth.15897] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 09/15/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022]
Abstract
Scabies is a contagious, parasitic skin disease that adversely affects the quality of life and, can cause systemic complications if it is not properly treated. Sulfur ointment and permethrin cream are among the most used topical agents in the treatment of scabies. In this study, we aimed to compare the efficacy of sulfur ointment and permethrin cream in the treatment of scabies. In this single-center study, patients who were diagnosed with scabies in the dermatology outpatient clinics of Karabuk University Training and Research Hospital between April, 2021 and September, 2021 were investigated retrospectively. Age, gender, date of diagnosis, topical agent used for scabies treatment, and response to the treatment at the control examination in the second week were recorded. The patients were divided into two groups those receiving 5% permethrin cream or 10% sulfur ointment, and the treatment efficacy of both agents was compared. This study showed that 10% sulfur ointment was significantly more effective in treating scabies than 5% permethrin cream (p < 0.001). Moreover, younger patients with scabies responded better to both treatments. 10% Sulfur ointment can be considered a safe and effective topical option in the treatment of scabies. The resistance to 5% permethrin cream, which is the most commonly used agent for scabies, can be a concern as an unexpected low success rate was obtained in this study.
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Affiliation(s)
- Goksen Ertugrul
- Department of Dermatology, Karabuk University, Faculty of Medicine, Karabuk, Turkey
| | - Habibullah Aktas
- Department of Dermatology, Karabuk University, Faculty of Medicine, Karabuk, Turkey
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50
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Cebeci F, Turgut Erdemir VA, Gürel MS, Akdeniz N, Aslan Kayıran M. Crusted scabies in a child with down syndrome. J Cosmet Dermatol 2022; 21:6466-6467. [PMID: 35599632 DOI: 10.1111/jocd.15105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/09/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Filiz Cebeci
- Dermatology Department, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Kadıköy/İstanbul, Turkey
| | - Vefa Aslı Turgut Erdemir
- Dermatology Department, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Kadıköy/İstanbul, Turkey
| | - Mehmet Salih Gürel
- Dermatology Department, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Kadıköy/İstanbul, Turkey
| | - Necmettin Akdeniz
- Dermatology Department, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Kadıköy/İstanbul, Turkey
| | - Melek Aslan Kayıran
- Dermatology Department, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Kadıköy/İstanbul, Turkey
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