Scabies: Clinical Signs, Diagnosis and Current Treatment

Yıl 2023, Cilt: 4 Sayı: 2, 62 - 69, 31.05.2023

Huriye Aybüke Koç , Sezin Ünlü Açıkel

https://doi.org/10.47482/acmr.1244299

Cited By: 2

Öz

Scabies is a parasitic disease caused by Sarcoptes scabiei var hominis. It can spread through indirect contact with contaminated objects as well as direct skin-to-skin contact. Widespread itching that gets worse at night can be present along with a variety of lesions, including papules, vesicles, nodules and excoriations. Mites, eggs, or faeces should be visualised using an additional tool for a definitive diagnosis. Only the patient's history and physical examination are used to diagnose clinical scabies or suspected clinical scabies. It is included in the differential diagnosis with other itchy skin diseases. Although other topical treatments like benzyl benzoate, sulphur, and lindane are available, permethrin is still the top option. Oral ivermectin is used as an efficient, secure, and affordable treatment for scabies in many countries despite not having FDA approval for this use. Current search for treatment continues, and there are studies on moxidectin and isoxazoline derivative drugs. Application errors, skipping treatment repetitions, inadequate environmental cleaning, not receiving treatment from the patient's relatives, and not providing the patient with the necessary precautions in writing are all reasons why treatments fail. It is known that good results can be obtained in the treatment of scabies, which continues to be a global public health problem, if physicians have sufficient knowledge and can manage their patients appropriately. By summarising the information that is currently available, this review aims to provide an update on the clinical characteristics, diagnosis, treatment, and management of scabies.

Anahtar Kelimeler

scabies, treatment, diagnosis

Kaynakça

• Lluch Galcerá J, Carrascosa Carrillo J, Boada García A. Epidemic Scabies: New Treatment Challenges in an Ancient Disease. Actas Dermosifiliogr 2022.
• Widaty S, Miranda E, Cornain EF, Rizky LA. Scabies: update on treatment and efforts for prevention and control in highly endemic settings. J Infect Dev Ctries. 2022;16(2):244–51.
• Arlian LG, Morgan MS. A review of Sarcoptes scabiei: Past, present and future. Parasites and Vectors. 2017;10(1):1–22.
• Currie BJ, McCarthy JS. Permethrin and Ivermectin for Scabies. N Engl J Med. 2010;362(8):717–25.
• Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: Scabies. J Am Acad Dermatol [Internet]. 2020;82(3):533–48.
• Salavastru CM, Chosidow O, Boffa MJ, Janier M, Tiplica GS. European guideline for the management of scabies. J Eur Acad Dermatology Venereol. 2017;31(8):1248–53.
• Arora P, Rudnicka L, Sar-Pomian M, Wollina U, Jafferany M, Lotti T, et al. Scabies: A comprehensive review and current perspectives. Vol. 33, Dermatologic Therapy. 2020.
• Sunderkötter C, Wohlrab J, Hamm H. Epidemiologie, Diagnostik und Therapie der Skabies. Dtsch Arztebl Int. 2021;118(41):695–704.
• Leung AKC, Lam JM, Leong KF. Scabies: A Neglected Global Disease. Curr Pediatr Rev. 2019;16(1):33–42.
• Chosidow O, Ph D. Scabies. new Engl J o f Med. 2006.
• Wolf R, Davidovici B. Treatment of scabies and pediculosis: Facts and controversies. Clin Dermatol [Internet]. 2010;28(5):511–8.
• Romani L, Steer AC, Whitfeld MJ, Kaldor JM. Prevalence of scabies and impetigo worldwide: A systematic review. Lancet Infect Dis [Internet]. 2015;15(8):960–7.
• Sunderkötter C, Feldmeier H, Fölster-Holst R, Geisel B, Klinke-Rehbein S, Nast A, et al. S1-Leitlinie zur Diagnostik und Therapie der Skabies – Kurzfassung. JDDG - J Ger Soc Dermatology. 2016;14(11):1160–71.
• Karthikeyan K. Treatment of scabies: Newer perspectives. Postgrad Med J. 2005;81(951):7–11. 15. Wendel K RA. Scabies and pediculosis pubis: An update of treatment regimens and general review. Clin Infect Dis. 2002;35(SUPPL. 2):146–5.
• Chosidow O. Scabies and pediculosis. Lancet. 2000;355:819–26. Şimşek E, Keskin A, Dağcıoğlu BF. Common and Frequently Overlooked Disease Scabies: Case Report. Ankara Med J. 2019;19(1).
• Li FZ, Chen S. Diagnostic accuracy of dermoscopy for scabies. Korean J Parasitol. 2020;58(6):669–74.
• Ueda T, Katsura Y, Sasaki A, Minagawa D, Amoh Y, Shirai K. Gray-edged line sign of scabies burrow. J Dermatol. 2021;48(2):190–8.
• Mang R, Kremer A, Lehmann P, Assmann T. Videodermoscopic clues for scabies diagnosis and assessment of therapeutic efficacy. JDDG - J Ger Soc Dermatology. 2020;18(9):1022–4.
• Engelman D, Yoshizumi J, Hay RJ, Osti M, Micali G, Norton S, et al. The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies. Vol. 183, British Journal of Dermatology. 2020. 808–820 p. Micali G, Lacarrubba F, Verzì AE, Chosidow O, Schwartz RA. Scabies: Advances in Noninvasive Diagnosis. PLoS Negl Trop Dis. 2016;10(6):1–10.
• Barrabeig I, Gassiot M, Gómez-de-Carvallo M MM, Molinero E, Parron I et al. Protocol de prevenció i control de l’escabiosi (sarna). Barcelona. In: Agència de Salut Pública de Catalunya. 2019.
• Bernigaud C, Fernando DD, Lu H, Taylor S, Hartel G, Chosidow O, et al. How to eliminate scabies parasites from fomites: A high-throughput ex vivo experimental study. J Am Acad Dermatol. 2020;83(1):241–5.
• Chandler DJ, Fuller LC. A Review of Scabies: An Infestation More than Skin Deep. Dermatology. 2019;235(2):79–80.
• Sunderkötter C, Aebischer A, Neufeld M, Löser C, Kreuter A, Bialek R, et al. Increase of scabies in Germany and development of resistant mites? Evidence and consequences. JDDG - J Ger Soc Dermatology. 2019;17(1):15–23.
• Morgado-carrasco D, Piquero-casals J. Atención Primaria. 2022;54.
• Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018;2018(4).
• Mytton OT, McGready R, Lee SJ, Roberts CH, Ashley EA, Carrara VI, et al. Safety of benzyl benzoate lotion and permethrin in pregnancy: A retrospective matched cohort study. BJOG An Int J Obstet Gynaecol. 2007;114(5):582–7.
• Singalavanija S, Limpongsanurak W SS. A comparative study between 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride gel in the treatment of scabies in children. J Med Assoc Thai. 86(3):531.
• Cohen CMWCNBCGBBA. Chapter 178: Scabies, Other Mites, and Pediculosis. In: Fitzpatrick’s Dermatology, 9e. 2019. p. 3274–86.
• Jittamala P, Monteiro W, Smit MR, Pedrique B, Specht S, Chaccour CJ, et al. A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication? PLoS Negl Trop Dis. 2021;15(3):1–22.
• Weill A, Bernigaud C, Mokni M, Gil S, Elefant E, Chosidow O. Scabies-infested pregnant women: A critical therapeutic challenge. PLoS Negl Trop Dis [Internet]. 2021;15(1):1–6.
• Ross TC, Alam M, Ross S, Merk HF, Bickers DR. Pharmacotherapy of ectoparasitic infections. Drugs. 2001;61(8):1067–88.
• Paasch U, Haustein UF. Management of endemic outbreaks of scabies with allethrin, permethrin, and ivermectin. Int J Dermatol. 2000;39(6):463–70.
• Cubela V YS. Clinical experience with crotamiton cream and lotion in treatment of infants with scabies. Br J Clin Pr. 32(8):229–31.
• WE W. The gamma isomer of hexachlorocyclohexane in the treatment of scabies. J Invest Dermatol. 10(5):363–6.
• Rasmussen JE. The problem of lindane. J Am Acad Dermatol. 1981;5(5):507–16.
• Rauch AE, Kowalsky SF, Leser TS et al. Gamma benzene hexachloride (Kwell) induced aplastic anemia. Arch Intern Med. 1990;150:2393–5.
• Laing R, Gillan V, Devaney E. Ivermectin – Old Drug, New Tricks? Trends Parasitol. 2017;33(6):463–72.
• Daye M, Temiz SA, Kılınç F. A case of nodular scabies with atypical course. Dermatol Ther. 2020;33(3).
• Davis JS, McGloughlin S, Tong SYC, Walton SF, Currie BJ. A Novel Clinical Grading Scale to Guide the Management of Crusted Scabies. PLoS Negl Trop Dis. 2013;7(9):1–6.
• Centers for Disease Control and Prevention. Medications. [Internet]. 2018. Available from: https://www.cdc.gov/parasites/scabies/health_professionals/meds.html
• Bernigaud C, Fang F, Fischer K, Lespine A, Aho LS, Dreau D, et al. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model. PLoS Negl Trop Dis. 2016;10(10):1–18.
• U.S. Food & Drug Administration. Moxidectin [package insert] [Internet]. 2018 [cited 2019 Jan 16]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210867lbl.pdf.
• Cotreau MM, Warren S, Ryan JL, Fleckenstein L, Vanapalli SR, Brown KR, et al. The antiparasitic moxidectin: Safety, tolerability, and pharmacokinetics in humans. J Clin Pharmacol. 2003;43(10):1108–15.
• Bernigaud C, Fang F, Fischer K, Lespine A, Aho LS, Mullins AJ, et al. Efficacy and pharmacokinetics evaluation of a single oral dose of afoxolaner against sarcoptes scabiei in the porcine scabies model for human infestation. Antimicrob Agents Chemother. 2018;62(9).
• U.S. Food & Drug Administration. Fact sheet for pet owners and veterinarians about 712 potential adverse events associated with isoxazoline flea and tick products [Internet]. 2018 [cited 2018 Dec 30]. Available from: https://www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/713 ucm6209%0A714 40.htm
• Liu X, Walton S, Mounsey K. Vaccine against scabies: Necessity and possibility. Parasitology. 2014;141(6):725–32.
• Riley T V., Carson CF, Hammer KA. Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties. Clin Microbiol Rev. 2006;19(1):50–62.
• Castillo AL, Osi MO, Ramos JDA, De Francia JL, Dujunco MU, Quilala PF. Efficacy and safety of Tinospora cordifolia lotion in Sarcoptes scabiei var hominis-infected pediatric patients: A single blind, randomized controlled trial. J Pharmacol Pharmacother. 2013;4(1):39–46.
• Luo B, Liao F, Hu Y, Liu X, He Y, Wu L, et al. Acaricidal activity of extracts from ligularia virgaurea against the sarcoptes scabiei mite in vitro. Exp Ther Med. 2015;10(1):247–50.
• Aussy A, Houivet E, Hébert V, Colas-Cailleux H, Laaengh N, Richard C, et al. Risk factors for treatment failure in scabies: a cohort study. Br J Dermatol. 2019;180(4):888–93.
• Lehmann P, Kremer A, Assmann T, Mang R. 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(November 2022):e01678.
• Ertugrul G AH. Comparison of sulfur ointment and permethrin treatments in scabies. Dermatol Ther. 35(12):15897.
• Pasay C, Arlian L, Morgan M, Vyszenski-Moher D, Rose A, Holt D, et al. High-resolution melt analysis for the detection of a mutation associated with permethrin resistance in a population of scabies mites. Med Vet Entomol. 2008;22(1):82–8.
• Andriantsoanirina V, Izri A, Botterel F, Foulet F, Chosidow O, Durand R. Molecular survey of knockdown resistance to pyrethroids in human scabies mites. Clin Microbiol Infect. 2014;20(2):2013–5.
• Mounsey KE, Pasay CJ, Arlian LG, Morgan MS, Holt DC, Currie BJ, et al. Increased transcription of Glutathione S-transferases in acaricide exposed scabies mites. Parasites and Vectors. 2010;3(1):1–9.
• Atif M, Smith JJ, Estrada-Mondragon A, Xiao X, Salim AA, Capon RJ, et al. GluClR-mediated inhibitory postsynaptic currents reveal targets for ivermectin and potential mechanisms of ivermectin resistance. PLoS Pathog. 2019;15(1):1–21.
• Arlian LG, Morgan MS, Paul CC. Evidence that scabies mites (Acari: Sarcoptidae) influence production of interleukin-10 and the function of T-regulatory cells (Tr1) in humans. J Med Entomol. 2006;43(2):283–7.
• Musalek M KE. Psychiatrische und parasitologische Aspekte des Dermatozooenwahns. Wien Klin Wochenschr. 1989;101:153–60.