Scabies

Abstract

Scabies is a neglected parasitic disease that is a major public health problem in many resource-poor regions. It causes substantial morbidity from secondary infections and post-infective complications such as acute post-streptococcal glomerulonephritis. Disease control requires treatment of the affected individual and all people they have been in contact with, but is often hampered by inappropriate or delayed diagnosis, poor treatment compliance, and improper use of topical compounds such as permethrin, lindane, or benzyl benzoate. In addition to concerns over toxicity with such compounds, parasite resistance seems to be increasing. Oral ivermectin is an alternative that has been used successfully in community control programmes. Plant derivatives such as turmeric, neem, and tea tree oil are also promising future treatments. The disease is strongly associated with poverty and overcrowding, and the associated stigma can ostracise affected individuals. Treatment of scabies in poor countries needs to integrate drug treatment programmes with efforts to improve the socioeconomic conditions and education programmes to reduce stigma. We expect the future to bring more sensitive and specific clinical and laboratory-based diagnostic methods, as well as new therapeutic strategies.

Transmission of scabies in a rural community

“…In a recent seminar in The Lancet [1], we pointed out discrepancies between industrialized and developing countries in the clinical features and epidemiological characteristics of scabies. We concluded that 320 years after the identification of the causative organism, Sarcoptes scabiei, the factors contributing to a high incidence of scabies in vulnerable population groups remain enigmatic.…”

Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers

“…The larvae subsequently hatch within 3 days, emerge from the skin, and then burrow again to mature. The host typically mounts an immune response against the mite, which accounts for the pruritus [9,10]. In naive hosts, symptoms can take 2-6 weeks to occur, whereas in non-naive patients, symptoms typically occur within 12-72 h [11].…”

“…Scabies typically presents with erythematous papules or nodules with linear burrows in flexural areas, finger and toe web spaces, and in the groin [9] (Fig. 3).…”

Infections in Residents of Nursing Homes

“…Crusted scabies are frequently found in immunocompromized patients, such as patients infected with HIV, patients receiving immunosuppressive therapy, individuals with mental retardation, and institutionalized elderly people. Within nursing homes, residents with unrecognized crusted scabies often constitute a source for spread of scabies to other residents and staff members [7].…”