Gebelik ve laktasyon döneminde scabies ve ebelik yaklaşımı

Yıl 2024, , 80 - 96, 30.04.2024

Resmiye Özdilek , Suzi Özdemir , Nursena Duran

https://doi.org/10.59244/ktokusbd.1409750

Öz

İnsan uyuzu olarak bilinen scabies dünyanın en yaygın hastalıklarından biridir. Yoğun kaşıntı ve genellikle yaygın papüler veya ekzematöz lezyonlarla karakterize olan scabiesin daha çok insandan insana cilt teması ile bulaştığı bilinmektedir. Uyuz tanısı genellikle klinik muayene ve hasta öyküsüne dayalı olarak konulmaktadır. Gebelikte uyuz prevalansı sistematik olarak araştırılmamış olmasına rağmen, gözlem çalışmalarının sonuçları, gebelikte gelişen tüm cilt hastalıklarının %2-6’sını oluşturduğunu göstermektedir. Gebelikte uyuz tedavisi seçenekleri sınırlı olup belirli bir standart bulunmamaktadır. Uyuzdan etkilenen hastanın tedavi yönetimi, akarların farmakolojik bir yöntemle yok edilmesini, uyuzun diğer bireylere yayılmasını önleme stratejilerini ve uyuzla ilişkili komplikasyonların, yani ilişkili kaşıntının gözetimini ve tedavisini içermektedir. Permethrin %5 krem (kanıt düzeyi III, Kategori B), gebelikte tercih edilen bir tedavi yöntemidir. Plasentayı geçebilmesine rağmen, permetrin sadece küçük miktarlarda emildiği ve hızla metabolize olduğu için fetal maruziyet riski minimumdur. Oral ivermektin ile ilişkili risk düşük olsa da gebelikte kullanımla ilgili veriler sınırlıdır. Malathion kullanımı gebe kadınlarda çalışılmamış olup hayvan çalışmaları sonucunda teratojenik etki saptanmamıştır. Topikal kükürt ve %25 benzil benzoat losyon ikinci basamak tedavilerdir. Travmatize cilt üzerine uygulandığında maternal nörotoksisite ve aplastik anemi riski nedeniyle Lindane gebelikte kullanılmamalıdır. Laktasyon dönemi ise anne ve bebeğin yakın temasta olduğu bağlanma sürecinin de parçasını oluşturan bir dönemdir. Uyuzla enfekte olan emziren kadınların, anne sütüyle beslenmeyi sürdürmeye ve bebeğe uyuz bulaşma riskini sınırlamaya izin veren etkili bir tedavi almadıkları sürece, sütlerini sağmaları gerekmektedir. Emzirme döneminde uyuz tedavisinde kullanılan ilaçların güvenliğine ilişkin veriler sınırlıdır. Potansiyel yan etkileri nedeniyle emzirme döneminde Lindane’dan kaçınılmalıdır. Uyuzun tedavisinde toksisitenin çok düşük olduğu düşünülen Permethrin, emziren annelerde de güvenle kullanılmıştır. Bu bağlamda uyuzun gebelik ve laktasyon dönemindeki tedavi ve bakımını kapsayan ebelik yaklaşımlarını inceleyen araştırmalara ihtiyaç vardır.

Anahtar Kelimeler

Scabies, Gebelik, Laktasyon, Ebelik bakımı

Kaynakça

• Abduljalil Alsaad, R. K. (2020). Epidemiology and Zoonoses of Seven-Year Disease- Scabies. La Prensa Medica Argentina, 106(2). https://doi.org/10.47275/0032-745x-182
• Al-Dabbagh, J., Younis, R., & Ismail, N. (2023). The current available diagnostic tools and treatments of scabies and scabies variants: An updated narrative review. Medicine, 102(21), e33805. https://doi.org/10.1097/MD.0000000000033805
• Alsyali, Z., Alaithan, A., Almubarak, K., Alibrahim, H., Almansour, A., Albalawi, T., Daimi, S.R., & Mohiuddin, S.S. (2019). A Comprehensive Review Study on Scabies and its Associated Impact on Psycho-Social Health of an Individual. International Journal of Contemporary Research and Review, 10(02), 20700–20707. https://doi.org/10.15520/ijcrr.v10i02.674
• Anderson, K. L., & Strowd, L. C. (2017). Epidemiology, diagnosis, and treatment of scabies in a dermatology office. Journal of the American Board of Family Medicine, 30(1), 78–84. https://doi.org/10.3122/jabfm.2017.01.160190
• Arora, P., Rudnicka, L., Sar-Pomian, M., Wollina, U., Jafferany, M., Lotti, T., Sadoughifar R., Sitkowski Z., & Goldust, M. (2020). Scabies: A comprehensive review and current perspectives. Dermatologic Therapy, 33(4), 1–12. https://doi.org/10.1111/dth.13746
• Bernigaud, C., Fischer, K., & Chosidow, O. (2020). The management of scabies in the 21st century: Past, advances and potentials. Acta Dermato-Venereologica, 100(100-year theme Cutaneous and genital infections), 225–234. https://doi.org/10.2340/00015555-3468
• Bernigaud, C., Samarawickrama, G. R., Jones, M. K., Gasser, R. B., & Fischer, K. (2019). The Challenge of Developing a Single-Dose Treatment for Scabies. Trends in Parasitology, 35(11), 931–943. https://doi.org/10.1016/j.pt.2019.08.002
• Bhaumik, H., Sanyal, S., & Suchiang, D. (2019). Better Sight and Clarity of Vision through Yoga. AYUHOM, 6, 74–79. https://doi.org/10.4103/AYUHOM.AYUHOM
• Chaccour, C., Hammann, F., & Rabinovich, N. R. (2017). Ivermectin to reduce malaria transmission I. Pharmacokinetic and pharmacodynamic considerations regarding efficacy and safety. Malaria Journal, 16(1), 1–16. https://doi.org/10.1186/s12936-017-1801-4
• Chandler, D. J., & Fuller, L. C. (2019). A Review of Scabies: An Infestation More than Skin Deep. Dermatology, 235(2), 79–80. https://doi.org/10.1159/000495290
• Chosidow, O., & Hay, R. J. (2019). Control of scabies and secondary impetigo: optimising treatment effectiveness in endemic settings. The Lancet Infectious Diseases, 19(5), 454–456. https://doi.org/10.1016/S1473-3099(19)30068-4
• Cohen, P. R. (2020). Classic and Non-classic (Surrepticius) Scabies: Diagnostic and Treatment Considerations. Cureus, 12(3). https://doi.org/10.7759/cureus.7419
• Daim, S. U. R., Ashraf, M. F., Ashraf, A., Zubair, R., & Ahmed, R. U. (2023). Breaking the Bubble: Bullous scabies – A case report. IDCases, 32(April), e01762. https://doi.org/10.1016/j.idcr.2023.e01762
• Dhingra, S. (2014). Management of scabies in pregnancy and lactation. Healthcare Interventions Journal, 2, 17–20. Retrieved from https://www.researchgate.net/publication/264420910_Management_of_scabies_in_pregnancy_and_lactation
• Dowler, J., & Wilson, A. (2020). Acute post-streptococcal glomerulonephritis in Central Australia. Australian Journal of Rural Health, 28(1), 74–80. https://doi.org/10.1111/ajr.12568
• El-Moamly, A. A. (2021). Scabies as a part of the World Health Organization roadmap for neglected tropical diseases 2021–2030: what we know and what we need to do for global control. Tropical Medicine and Health, 49(1). https://doi.org/10.1186/s41182-021-00348-6
• Engelman, D, Yoshizumi, J., Hay, R. J., Osti, M., Micali, G., Norton, S., Walton D., Boralevi, C., Bernigaud, A. C., Bowen, A. Y., Chang, O., Chosidow, D., Estrada-Chavez, H., Feldmeimer, N., Ishii F., Lacarrubba, F., Mahe A., Maurer, M. M. A., Mahdi, M. M. A., Murdoch, M.E., Pariser, D., Nair, P.A., Rehmus, W., Romani, L., Tilakaratne, D., Tuicakau, M., Walker,S. E., Wanat, K.A., Whitfeld,M. J., Yotsu, R., Steer, A. C., & Fuller, L. C. (2020). The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. British Journal of Dermatology, 183(5), 808–820. https://doi.org/10.1111/bjd.18943
• Engelman, D., Cantey, P. T., Marks, M., Solomon, A. W., Chang, A. Y., Chosidow, O., Enbiale W., Engels D., Hay R. J., Hendrickx D., Hotez P. J., Kaldor J. M., Kama M., Mackenzie C. D., McCarthy J. S., Martin D. L., Mengistu B., Maurer T., Negussu N., Romani, L., Sokana, O., Whitfeld, M. J., Fuller, L. C., & Steer, A. C. (2019). The public health control of scabies: priorities for research and action. The Lancet, 394(10192), 81–92. https://doi.org/10.1016/S0140-6736(19)31136-5
• Engelman D., Marks, M., Steer, A. C., Beshah, A., Biswas, G., Chosidow, Luc E. Coffeng, Dofitas, B. L., Enbiale, W., Fallah, M., Gasimov, E., Hopkins, A., Jacobson, J., Kaldor, J.M., Ly, F., , Mackenzie, C. D., McVernon, J., Parnaby, M., Rainima-Qaniuci, M., Sokana, O., Sankara, D., Yotsu, R., Yajim, A., & Cantey, P. T. (2021). A framework for scabies control. PLoS Neglected Tropical Diseases, 15(9). https://doi.org/10.1371/journal.pntd.0009661
• FitzGerald, D., Grainger, R.J., & Reid, A. (2014). Interventions for preventing the spread of infestation in close contacts of people with scabies. Cochrane Database of Systematic Reviews. Issue 2. https://doi.org/10.1002/14651858.CD009943.pub2.
• GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1545–1602. https://doi.org/10.1016/S0140-6736(16)31678-6
• Gopinath, H., & Karthikeyan, K. (2020). Genital scabies: Haven of an unwelcome guest. Indian Journal of Sexually Transmitted Diseases and AIDS, 41(1), 10–16. https://doi.org/10.4103/ijstd.IJSTD_69_17
• Gunning, K., Kiraly, B., & Pippitt, K. (2019). Lice and Scabies: Treatment Update. American Family Physician, 99(10), 635–642.
• Hengge, U. R., Currie, B. J., Jäger, G., Lupi, O., & Schwartz, R. A. (2006). Scabies: a ubiquitous neglected skin disease. Lancet Infectious Diseases, 6(12), 769–779. https://doi.org/10.1016/S1473-3099(06)70654-5
• Hill, T. A., & Cohen, B. (2017). Scabies in babies. Pediatric Dermatology, 34(6), 690–694. https://doi.org/10.1111/pde.13255.
• Karacam, Z. & Eroglu, K. (2019). Nursing and Midwifery: Similarities and Differences in Tasks, Authorities and Responsibilities. Lokman Hekim Journal, 9 (2): 211-227 https://doi.org/10.31020/mutftd.524807.
• Kennedy, D., Hurst, V., Konradsdottir, E., & Einarson, A. (2005). Pregnancy outcome following exposure to permethrin and use of teratogen information. American Journal of Perinatology, 22(2), 87–90. https://doi.org/10.1055/s-2005-837736
• Khalil, S., Abbas, O., Kibbi, A. G., & Kurban, M. (2017). Scabies in the age of increasing drug resistance. PLoS Neglected Tropical Diseases, 11(11), 1–10. https://doi.org/10.1371/journal.pntd.0005920
• Khan, R. M. A., Muzammil, A., Siddiqi, S., Qasim, S. M., & Nadeem, A. (2022). Scabies Surrepticius (Bullous Scabies) Presenting as Bullous Impetigo in a Child. Journal of the College of Physicians and Surgeons Pakistan, 32(3), 380–382. https://doi.org/10.29271/jcpsp.2022.03.380
• Kim, H. S., Hashimoto, T., Fischer, K., Bernigaud, C., Chosidow, O., & Yosipovitch, G. (2021). Scabies itch: an update on neuroimmune interactions and novel targets. Journal of the European Academy of Dermatology and Venereology, 35(9), 1765–1776. https://doi.org/10.1111/jdv.17334
• Koc, H. A., & Unlu Açıkel, S. (2023). Scabies: Clinical Signs, Diagnosis and Current Treatment. Archives of Current Medical Research, 4(January), 62–69. https://doi.org/10.47482/acmr.1244299
• Leung, A. K. C., Lam, J. M., & Leong, K. F. (2020). Scabies: A Neglected Global Disease. Current Pediatric Reviews, 16(1), 33–42. https://doi.org/10.2174/1573396315666190717114131
• Li, F. Z., Jia, M., Chen, K. J., Ye, Q., & Fang, S. (2021). Bullous Scabies: Clinical, Dermoscopic, and Pathologic Characteristics of Ten Patients. American Journal of Tropical Medicine and Hygiene, 105(6), 1798–1802. https://doi.org/10.4269/ajtmh.21-0516
• Lobo, Y., & Wheller, L. (2021). A narrative review of the roles of topical permethrin and oral ivermectin in the management of infantile scabies. Australasian Journal of Dermatology, 62(3), 267–277. https://doi.org/10.1111/ajd.13654
• Luwito, J., Indah Lestari, D., Putri Yulius, C., & Putri Liviansyah, M. (2022). Management of Scabies Cases with Secondary Infection in Children through Family Medicine Approach. Science Midwifery, 10(5), 4007–4013. https://doi.org/10.35335/midwifery.v10i5.933
• Lynar, S., Currie, B.J., & Baird, R. (2017). Scabies and mortality. The Lancet Infectious Diseases, 17(12), 1234. https://doi.org/10.1016/S1473-3099(17)30636-9
• Manjhi, M., Yadav, P., Mohan, S., Sonthalia, S., Ramesh, V., & Kashyap, V. (2020). A comparative study of topical tacrolimus and topical triamcinolone acetonide in nodular scabies. Dermatologic Therapy, 33(6), 1–8. https://doi.org/10.1111/dth.13954
• Micali, G., Lacarrubba, F., Verzì, A. E., Chosidow, O., & Schwartz, R. A. (2016). Scabies: Advances in Noninvasive Diagnosis. PLoS Neglected Tropical Diseases, 10(6), 1–10. https://doi.org/10.1371/journal.pntd.0004691
• Mitchell, E., Bell, S., Thean, L. J., Sahukhan, A., Kama, M., Koroivueti, A., Kaldor, J., Steer, A., & Romani, L. (2020). Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study. PLoS Neglected Tropical Diseases, 14(12), e0008825. https://doi.org/10.1371/journal.pntd.0008825
• Mounsey, K. E., Bernigaud, C., Chosidow, O., & McCarthy, J. S. (2016). Prospects for Moxidectin as a New Oral Treatment for Human Scabies. PLoS Neglected Tropical Diseases, 10(3), 4–11. https://doi.org/10.1371/journal.pntd.0004389
• Müllegger, R. R., Häring, N. S., & Glatz, M. (2016). Skin infections in pregnancy. Clinics in Dermatology, 34(3), 368–377. https://doi.org/10.1016/j.clindermatol.2016.02.009
• Murase, J. E., Heller, M. M., & Butler, D. C. (2014). Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy. Journal of the American Academy of Dermatology, 70(3), 401.e1-401.e14. https://doi.org/10.1016/j.jaad.2013.09.010
• Mytton, O. T., McGready, R., Lee, S. J., Roberts, C. H., Ashley, E. A., Carrara, V. I., Thwai, K. L., Jay, M. P., Wiangambun, T., Singhasivanon, P., & Nosten, F. (2007). Safety of benzyl benzoate lotion and permethrin in pregnancy: A retrospective matched cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 114(5), 582–587. https://doi.org/10.1111/j.1471-0528.2007.01290.x
• Nolan, K., Kamrath, J., & Levitt, J. (2012). Lindane toxicity: A comprehensive review of the medical literature. Pediatric Dermatology, 29(2), 141–146. https://doi.org/10.1111/j.1525-1470.2011.01519.x
• Ogbuokiri, J. E., Ozumba, B. C., & Okonkwo, P. O. (1993). Ivermectin levels in human breast milk. Eur J Clin Pharmacol, 45(1), 389–390. https://doi.org/10.1590/1806-9282.20220770
• Ogbuokiri, J. E., Ozumba, B. C., & Okonkwo, P. O. (1994). Ivermectin levels in human breast milk. European Journal of Clinical Pharmacology, 46(1), 89–90. https://doi.org/10.1007/BF00195923
• Park, J. H., Kim, C. W., & Kim, S. S. (2012). The diagnostic accuracy of dermoscopy for scabies. Annals of Dermatology, 24(2), 194–199. https://doi.org/10.5021/ad.2012.24.2.194
• Patel, V. M., Lambert, W. C., & Schwartz, R. A. (2016). Safety of Topical Medications for Scabies and Lice in Pregnancy. Indian Journal of Dermatology, 61(6), 583–587. https://doi.org/10.4103/0019-5154.193659
• Porto, I. (2003). Antiparasitic drugs and lactation: Focus on anthelmintics, scabicides, and pediculicides. Journal of Human Lactation, 19(4), 421–425. https://doi.org/10.1177/0890334403258133
• Richards, R. N. (2021). Scabies: Diagnostic and Therapeutic Update. Journal of Cutaneous Medicine and Surgery, 25(1), 95–101. https://doi.org/10.1177/1203475420960446
• Romani, L., Steer, A. C., Whitfeld, M. J., & Kaldor, J. M. (2015). Prevalence of scabies and impetigo worldwide: A systematic review. The Lancet Infectious Diseases, 15(8), 960–967. https://doi.org/10.1016/S1473-3099(15)00132-2
• Rosumeck, S., Nast, A., & Dressler, C. (2018). Ivermectin and permethrin for treating scabies. Cochrane Database of Systematic Reviews, 2018(4). https://doi.org/10.1002/14651858.CD012994
• Rouaz, K., Chiclana-Rodríguez, B., Nardi-Ricart, A., Suñé-Pou, M., Mercadé-Frutos, D., Suñé-Negre, J. M., Pérez-Lozano, P., & García-Montoya, E. (2021). Excipients in the paediatric population: A review. Pharmaceutics, 13(3), 1–44. https://doi.org/10.3390/pharmaceutics13030387
• Salavastru, C. M., Chosidow, O., Boffa, M. J., Janier, M., & Tiplica, G. S. (2017). European guideline for the management of scabies. Journal of the European Academy of Dermatology and Venereology, 31(8), 1248–1253. https://doi.org/10.1111/jdv.14351
• Sunderkötter, C., Wohlrab, J., & Hamm, H. (2021). Epidemiologie, Diagnostik und Therapie der Skabies. Deutsches Arzteblatt International, 118(41), 695–704. https://doi.org/10.3238/arztebl.m2021.0296
• Strong, M., & Johnstone, P. W. (2007). Interventions for treating scabies. Cochrane Database of Systematic Reviews, (3). https://doi.org/10.1002/14651858.CD000320.pub2
• Swe, P. M., Christian, L. D., Lu, H. C., Sriprakash, K. S., & Fischer, K. (2017). Complement inhibition by Sarcoptes scabiei protects Streptococcus pyogenes - An in vitro study to unravel the molecular mechanisms behind the poorly understood predilection of S. pyogenes to infect mite-induced skin lesions. PLoS Neglected Tropical Diseases, 11(3), 1–20. https://doi.org/10.1371/journal.pntd.0005437
• Talaga-Ćwiertnia, K. (2021). Sarcoptes infestation. What is already known, and what is new about scabies at the beginning of the third decade of the 21st century? Pathogens, 10(7). https://doi.org/10.3390/pathogens10070868
• Thomas, C., Coates, S. J., Engelman, D., Chosidow, O., & Chang, A. Y. (2020). Ectoparasites: Scabies. Journal of the American Academy of Dermatology, 82(3), 533–548. https://doi.org/10.1016/j.jaad.2019.05.109
• Thompson, R., Westbury, S., & Slape, D. (2021). Paediatrics: How to manage scabies. Drugs in Context, 10, 1–13. https://doi.org/10.7573/DIC.2020-12-3
• Thornley, S., King, R., Marshall, R., Oakley, A., Sundborn, G., Harrower, J., Reynolds, E., Arbuckle, M., & Johnson, R. J. (2020). How strong is the relationship between scabies and acute rheumatic fever? An analysis of neighbourhood factors. Journal of Paediatrics and Child Health, 56(4), 600–606. https://doi.org/10.1111/jpc.14697
• Vasanwala, F. F., Ong, C. Y., Aw, C. W. D., & How, C. H. (2019). Management of scabies. Singapore Med J 2019;, 60(6), 281–285. https://doi.org/10.11622/smedj.2019058
• Ward, R. M., Bates, B. A., Benitz, W. E., Burchfield, D. J., Ring, J. C., Walls, R. P., & Walson, P. D. (2001). The transfer of drugs and other chemicals into human milk. Pediatrics, 108(3), 776–789. https://doi.org/10.1542/peds.108.3.776
• Weill, A., Bernigaud, C., Mokni, M., Gil, S., Elefant, E., & Chosidow, O. (2021). Scabies-infested pregnant women: A critical therapeutic challenge. PLoS Neglected Tropical Diseases, 15(1), 1–6. https://doi.org/10.1371/journal.pntd.0008929
• Welch, E., Romani, L., & Whitfeld, M. J. (2021). Recent advances in understanding and treating scabies. Faculty Reviews, 10(28). https://doi.org/10.12703/r/10-28
• WHO. (2020). World Health Oorganization Informal Consultation on a Framework for Scabies Control Meeting report. https://iris.who.int/bitstream/handle/10665/333154/9789240008069-eng.pdf.
• Workowski, K.A., Bachmann, L.H., Chan, P.A., Johnston, C.M., Muzny, C.A., Park, I., Reno, H., Zenilman, J.M.,& Bolan, G.A. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. US Department of Health and Human Services/Centers for Disease Control and Prevention, MMWR (Vol.70). https://doi.org/10.1001/jama.2022.1246