Skabiyeste Tedavi Başarısızlığı ve Nüksün Belirleyicileri: 332 Olgunun Tek Merkezli Retrospektif Analizi

Öz

Amaç: Bu çalışmada, skabiyeste tedavi başarısızlığının temel belirleyicilerinin belirlenmesi ve özellikle hane içi tedavi uyumu ile temas yönetiminin klinik sonuçlar üzerindeki etkisinin değerlendirilmesi amaçlandı.
Materyal ve metod: Ocak 2023 - Ekim 2025 tarihleri arasında dermatoloji polikliniğinde klinik ve/veya dermoskopik olarak skabies tanısı alan toplam 332 hasta retrospektif olarak incelendi. Demografik özellikler, temas öyküsü, hane içi tedavi durumu ve tedavi başarısızlığı ile ilişkili faktörler değerlendirildi. Tedavi başarısızlığı nedenleri sınıflandırıldı ve hane içi tedavi durumu ile başarısızlık tipleri arasındaki ilişki ki-kare testi ile analiz edildi.
Bulgular: Hastaların %78,9’u erişkin, %55,4’ü erkekti. Tedavi başarısızlığının en sık nedeni hane içi tedavinin eksik veya hiç uygulanmaması (%58,4) olup, bunu klinik olarak şüpheli permetrin tedavi yanıtsızlığı (%16,9), yeniden bulaş (%12,7) ve hatalı veya yetersiz tedavi (%12,0) izledi. Hane içi tedavi durumu ile tedavi başarısızlığı tipleri arasında istatistiksel olarak anlamlı ilişki saptandı (χ²=222,8; p<0,001).
Sonuç: Skabiyeste tedavi başarısızlığı, farmakolojik dirençten ziyade yetersiz eş zamanlı hane içi tedavi ve devam eden hane içi bulaş ile ilişkilidir. Hane içi temas yönetiminin standardize edilmesi ve hasta uyumunun artırılması, tedavi başarısızlığının azaltılmasında temel stratejilerdir.

Anahtar Kelimeler

• Skabiyez
• Permetrin
• Tedavi Başarısızlığı
• Epidemiyoloji

Etik Beyan

Ethical approval was obtained from the Mersin City Training and Research Hospital Clinical Research Ethics Committee (approval no: 2025/61, date: December 24, 2025).

Determinants of Treatment Failure and Recurrence in Scabies: A Single-Center Retrospective Study of 332 Cases

Öz

Background: This study aimed to identify the main determinants of treatment failure in scabies, with particular emphasis on the role of household treatment compliance and contact management.
Materials and Methods: Between January 2023 and October 2025, a total of 332 patients diagnosed with scabies clinically and/or dermoscopically in a dermatology outpatient clinic were retrospectively analyzed. Demographic characteristics, contact history, household treatment status, and factors associated with treatment failure were evaluated. The causes of treatment failure were classified, and the association between household treatment status and failure types was analyzed using the chi-square test.
Results: Of the patients, 78.9% were adults and 55.4% were male. The most frequent cause of treatment failure was incomplete or absent household treatment (58.4%), followed by clinically suspected permethrin non-response (16.9%), reinfestation (12.7%), and incorrect or insufficient treatment (12.0%). A statistically significant association was observed between household treatment status and the distribution of treatment failure types (χ²=222.8; p<0.001).
Conclusions: Treatment failure in scabies is primarily associated with inadequate simultaneous household treatment and ongoing intra-household transmission rather than pharmacological resistance. Standardization of household contact management and improvement of patient adherence represent key strategies for reducing treatment failure.

Anahtar Kelimeler

• Scabies
• Permethrin
• Treatment Failure
• Epidemiolog

Etik Beyan

Ethical approval was obtained from the Mersin City Training and Research Hospital Clinical Research Ethics Committee (approval no: 2025/61, date: December 24, 2025).

Kaynakça

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