Diagnosis and Treatment of Scabies

Chouela, Edgardo; Abeldaño, Alejandra; Pellerano, Graciela; Hernández, María Inés

doi:10.2165/00128071-200203010-00002

Cited by 81 publications

(53 citation statements)

References 36 publications

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“…Dermatologists, in general, did not consider scabicide soaps alone as appropriate treatment for scabies. [26][27][28] Thus, it is evident that the selected products used for self-medicated scabies are not adequate, as reported in 1995 by Mahe et al 29 Contrary to Heukelbach et al, who did not observe mystification or stigmatization in scabies patients in a slum, in Fortaleza, 2 this study shows a high frequency of negative feelings related to diagnosis of scabies. This stigmatization depends on the population's socioeconomic context, and was described in other studies.…”

Section: Discussionmentioning

confidence: 67%

Percepção da doença e automedicação em pacientes com escabiose

Kovács

Brito

2006

An. Bras. Dermatol.

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FUNDAMENTOS: A situação de alta prevalência da escabiose, associada ao baixo grau de autodiagnóstico e à estigmatização dos parasitados, contribui para a automedicação. OBJETIVOS: Verificar a percepção dos pacientes com escabiose em relação à doença, às possibilidades diagnósticas consideradas, à automedicação realizada e os sentimentos diante do conhecimento do diagnóstico. MÉTODOS: Em estudo prospectivo de série de casos, foram entrevistados 65 pacientes com diagnóstico clínico de escabiose atendidos no ambulatório de Dermatologia do Hospital das Clínicas da Universidade Federal de Pernambuco, em Recife, Brasil. RESULTADOS: Apenas 47,7% deles acreditavam que seus sintomas fossem devidos à escabiose, e 86% achavam que esses poderiam ser devidos a outras enfermidades, como infecções, picada de insetos e alergia a contactantes. Como automedicação, observada em 55,4% dos pacientes, os produtos mais utilizados foram os sabões e as plantas. O diagnóstico da escabiose levou a sentimentos negativos em 56,7% dos casos. CONCLUSÕES: O estudo evidenciou ser baixo o grau de suspeição de escabiose entre os infestados. A automedicação foi utilizada em mais da metade dos pacientes, geralmente com produtos inadequados para o tratamento da parasitose. É freqüente o diagnóstico da escabiose levar a sentimentos negativos, indicando a importância da atenção integral ao paciente.

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Section: Discussionmentioning

confidence: 67%

Percepção da doença e automedicação em pacientes com escabiose

Kovács

Brito

2006

An. Bras. Dermatol.

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“…Using the present tape method, we could observe the striated structure with a dark or weak red color and fine gray granule-like constitution on the body of some moving mites, although such structure with red or gray color was not observed by incident light microscope (5), epiluminescence microscope (7) or by the standard method (8). The use of 10% potassium hydrochloride onto the scraped skin on the slide by the standard method (2) may have erased the red or gray color.…”

Section: Discussionmentioning

confidence: 91%

Simple Method of Detecting Sarcoptes Scabiei Var Hominis Mites among Bedridden Elderly Patients Suffering from Severe Scabies Infestation Using an Adhesive-Tape

Katsumata

2006

Intern. Med.

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Object Scabies infestation is very common among bedridden elderly patients. The standard method of diagnosis for scabies by scraping the skin requires some skill. Therefore, dermatologists employ this method. However, dermatologists are usually not present in most long-term nursing units. Thus, we tried to catch mites using a strong transparent adhesive tape commercially available for packing use as an alternative method for the diagnosis of severe scabies infestation. Methods After firmly applying the adhesive side of the tape onto an appropriate skin lesion of patients, the tape was pulled off and transferred directly onto a slide for microscopy, affixing the adhered separated part of the corneal skin. Patients When a massive outbreak of scabies infestation occurred in May 2004 at the nursing unit of K hospital with thirty-one bedridden elderly patients, we tried to detect scabies mite using an adhesive tape. Results We could detect mites from six patients using this tape method. The diagnosis was confirmed by the standard scraping method. By the tape method we could observe some mites moving around and also could see a striated structure with dark red or weak red color or gray color granule-like constitution on the body of some mites. We found mites only on the skin of the fingers and toes where the skin of a patient is thin. Recently, massive scabies infestation in elderly long-term residents has been reported elsewhere. This tape method is simple and useful for diagnosis of severe scabies infestation in long-term nursing units.

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“…Treatment can be unsuccessful because of misdiagnosis, poor application of topical treatments, inadequate dosing, and drug resistance. 3 Eczema herpeticum, also known as Kaposi varicelliform eruption, is a rare skin complication of atopic dermatitis that often results from taking immunosuppressive agents to treat the primary skin condition. Eczema herpeticum, which is typically a challenging diagnostic dilemma for nondermatologists, is characterized by cutaneous pain with new skin lesions.…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of Eczema Herpeticum With Septic Shock Due to Methicillin-Resistant Staphylococcus aureus

Tupe

Weiler

Verceles

et al. 2016

American Journal of Critical Care

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A 62-year-old woman treated with several courses of corticosteroids for an undifferentiated rash came to the emergency department with progressively worsening cutaneous signs and symptoms and generalized weakness. She had scabies, and despite treatment continued to decompensate. Repeat skin biopsies revealed disseminated herpes simplex virus infection, and results of blood cultures were consistent with infection by methicillin-resistant Staphylococcus aureus. Despite antiviral and antimicrobial therapy, sepsis and multiorgan failure developed, and the patient died. This case illustrates the complications of the rare entity eczema herpeticum, which occurs most often in immunocompromised patients and is associated with a high mortality. Maintaining a high index of suspicion for this disease in decompensating patients with an unidentified rash is essential to avoid catastrophic outcomes. (American Journal of Critical Care. 2016;25:379-382 M any life-threatening diseases initially have seemingly innocuous dermatological findings, and subtle abnormalities may only be evident to an astute clinician considering a broad range of potential diagnoses. Although chronic skin conditions, such as atopic dermatitis, are common and are relatively benign, severe complications can occur. For example, eczema herpeticum is a cutaneous dissemination of herpes simplex virus (HSV) in patients with a chronic skin condition, most commonly atopic dermatitis. Because of the rare occurrence and difficult diagnosis, the true incidence and prevalence of eczema herpeticum are unknown, although the condition is thought to affect 3% to 6% of patients with atopic dermatitis.1 Even though eczema herpeticum is exceedingly rare, 6% to 10% of immunocompetent hosts and up to 50% of immunocompromised patients can die of the viremia, multiorgan involvement, and bacterial superinfection potentially associated with it. highlights an important condition to consider in both critical care and primary care assessment of a patient with an undiagnosed rash.A 62-year-old woman with a history of mild mental retardation, diabetes, hypertension, and hypothyroidism who was living in a group home came to the emergency department with a rash and generalized weakness. She had intermittently experienced a pruritic, generalized rash for approximately 1 year before she came to the hospital. Her caregivers at the group home had taken her to the primary care doctor for the workup of this rash throughout the year. The results of an outpatient skin biopsy were consistent with a drug eruption, thus prompting her primary care physician to have her stop taking hydrochlorothiazide and sitagliptin. Despite this step, the rash did not resolve.The patient had an empiric trial of prednisone, which resulted in temporary resolution of the rash.However, whenever prednisone was discontinued, the rash would promptly reappear. The patient received repeated short courses of steroids (< 7 days each) throughout the year. Despite the prednisone therapy, during the week before she ca...

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Diagnosis and Treatment of Scabies

Cited by 81 publications

References 36 publications

Percepção da doença e automedicação em pacientes com escabiose

Percepção da doença e automedicação em pacientes com escabiose

Simple Method of Detecting Sarcoptes Scabiei Var Hominis Mites among Bedridden Elderly Patients Suffering from Severe Scabies Infestation Using an Adhesive-Tape

A Fatal Case of Eczema Herpeticum With Septic Shock Due to Methicillin-Resistant Staphylococcus aureus

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