An extraordinary outbreak of scabies in Turkey

Abstract

IU/L) levels were observed (Fig. 1d). Based on the patient's clinical course, in which no treatments other than the scabies treatment were introduced, the improvement of his skin symptoms and reductions in his serum TARC and IgE levels were considered to have been due to the scabies treatment. There are two common subtypes of scabies: classic and crusted scabies. 1,5 The skin manifestations of classic scabies include burrows and erythematous papules/nodules. Severe and persistent pruritus is a hallmark of scabies. 6 Hashimoto et al. 6 reported that Th2 immunity predominates in human ordinary scabies lesions and is accompanied by the massive infiltration of interleukin (IL)-31 (+) M2 macrophages and epidermal expression of thymic stromal lymphopoietin and periostin (TSLP). Eosinophils are one of the first cell types attracted to tissue sites affected by localized allergic inflammation, and they secrete Th2-inducing cytokines (IL-4 and IL-13), which affect resident dendritic cells (DCs), enhancing DC activation and promoting a Th2-inducing phenotype. 7,8 In our case, a histological examination revealed the massive infiltration of eosinophils and indicated that Th2 immunity was involved in upregulating the patient's serum TARC levels. Interestingly, his serum TARC levels decreased more markedly than his serum IgE levels after treatment. Serum TARC levels might reflect treatment efficacy more closely than serum IgE levels and, hence, could be considered as a potential biomarker. Further, as scabies is frequently misdiagnosed as AD or PN and treated with topical corticosteroids, which masks the condition, elevated serum TARC levels could further delay diagnosis. Thus, clinicians must consider scabies when examining patients with pruritic nodules who exhibit elevated serum TARC levels, and the serum TARC level might be a useful marker of the efficacy of treatments for scabies. Acknowledgement The patients in this manuscript have given written informed consent to publication of their case details.

Multicenter study evaluating the impact of COVID ‐19 outbreak on dermatology outpatients in Turkey

“…The significant increase in the frequency of scabies is not surprising because of the ongoing scabies outbreak in Turkey that has been documented and reported recently. 21 The increasing rates of patients with scabies and urticaria during the pandemic have also been reported in other studies from Turkey. 10,11 During the period corresponding to the lockdown in Italy; dermatitis, infections including scabies, herpes zoster, psoriasis and urticaria were reported as the most common diagnoses, similar to our results.…”

“…The high frequency of pityriasis rosea in this season might also have affected this result. The significant increase in the frequency of scabies is not surprising because of the ongoing scabies outbreak in Turkey that has been documented and reported recently 21 . The increasing rates of patients with scabies and urticaria during the pandemic have also been reported in other studies from Turkey 10,11 .…”

A Neglected Disease: Scabies a Retrospective Study On Children

“…It is noteworthy that the patients who received treatment with sulfur ointments to younger ages from 2013 to 2018 (11). No difference was observed in the distribution of scabies prevalence according to different ages from 2014 to 2019 in a recent multicentre study conducted in distinct regions of Turkey (12). In our study, the incidence of scabies was 1%, consistent with the rate in the years mentioned above.…”

“…In the literature, there were both female and male dominance observed in various studies investigating scabies (10)(11)(12). The population and geographical differences in the studies may explain the contradictory results.…”

Impact of Coronavirus in a Dermatology Outpatient Clinic: A Single-Center Retrospective Study

“…There was an increase in parasitic infections, with cases of scabies. The number of scabies cases has increased recently, especially with the rise in the number of immigrants fleeing the Syrian civil war (17). This result may be expected, with the increase in the time that families spend together at home.…”