Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei var hominis. It has high prevalence in many tropical countries where crowded people live in resource‐poor settings. The rash is distributed differently in adults and children. Adults manifest lesions primarily on the interdigital web spaces of the hands, flexor aspects of the wrists, dorsal feet, axillae, elbows, waist, buttocks, and genitalia. Palms (along with soles and head) are commonly involved in infants and very young children but typically absent in older age groups. Here, we report 25 older children and adult patients with scabies including involvement of the palms. If patients are left untreated for long periods of time in hot tropical climates, scabies may produce severe infestation with involvement of palms in older children and adults. We should acknowledge palms as potential body sites whose involvement warrants early and aggressive treatment in scabies.
Background: Recalcitrant dermatophytosis has become a menace in recent times. The perception of the hosts or patients regarding the disease gives a real-life picture of the deep-rooted host-factors and the way to overcome the socio-economic and cultural milieu that becomes a hindrance in preventing the relapse and recurrence of this infection. Aims: This qualitative study was conducted to assess the perception regarding the patients’ understanding of causation and prevention of dermatophytosis, role of personal hygiene, and healthcare seeking behavior, and consequently, exploring the socio-economic and cultural milieu that contributes to the menace of recalcitrant dermatophytosis. Materials and Methods: Two focus group discussions (FGDs) consisting 12 patients with recalcitrant dermatophytosis, who speak the vernacular, were conducted with the help of a predetermined FGD-guide. Both FGD sessions were recorded, transcribed, and translated into English. These verbatims were thematically analyzed and emerging themes were identified with illustrative quotations. Free listing and pile sorted data obtained were analyzed by Visual Anthropac version 1.0 software for Smith's salience value, cognitive mapping with two-dimensional scaling and hierarchical cluster analysis. Results: Washing of clothes with soap antiseptics and drying the clothes under the sun prevents diseases, whereas, not changing undergarments for prolonged periods of time, bathing in ponds using mustard oil spreads the disease, furthermore, staying in wet clothes, working for more than five hours under sun, playing outdoors, household jobs cause tinea, etc. were the most common reported perceptions. Overall, five themes emerged after pile sorting the data, namely, ignorance about the disease, understanding of the predisposing factors of the disease, prevention, role of personal and traditional belief, and care-seeking behavior. Conclusions: There is a dire need to address the myths or traditional beliefs, which are not supported by scientific evidence. Expense of the treatment of dermatophytosis calls for price control of the commonly prescribed antifungals. Poor socio-economic conditions and professional responsibilities hinder people from implementing the preventive measures in spite of their knowledge.
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Background: Leprosy is a disease having tremendous social implications due to ostracization. Despite continuous efforts made so far to eliminate leprosy, stigma/misbeliefs/adverse attitude toward leprosy still prevails among common people. Community perceptions and attitudes towards leprosy patients are critical and unique indicator of how society stereotypes leprosy. Aims: The qualitative study was conducted to explore the perceptions of leprosy patients towards leprosy. Materials and Methods: Two focused group discussions (FGDs) with 19 newly-diagnosed leprosy patients who can speak vernacular were conducted with help of a predetermined FGD-guide between April and June 2019 in the dermatology out-patient department of the tertiary-care center. Both FGD sessions were recorded, transcribed, and translated into English. These verbatims were thematically analyzed and emerging themes were identified with illustrative quotations. Free list and pile sort data obtained were analyzed by Visual Anthropac version 1.0 software for Smith's salience value Cognitive mapping with two-dimensional scaling and hierarchical cluster analysis. Results: Small size of wound, not giving importance, failure to realize, bad luck and scared of being isolated etc., were the most common reported perceptions. Overall, five themes emerged after pile sorting, namely ignorance about the disease, stigma and economic burden, positive perception after diagnosis, treatment-related suggestions, and myths and frequently asked questions. Conclusion: The study concludes that more IEC campaigns are required to abolish the stigma; and ASHA workers/front-line workers can play a pivotal role. The program (NLEP) can also utilize the role of satisfied cured-patient as peer-educator to improve the attitude of society towards this disease.
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