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PubMed1989

Crusted scabies: a case report and review of the literature.

Crusted (Norwegian) scabies, a highly contagious variant of classical scabies, has traditionally been associated with mentally retarded and physically debilitated patients. Recent reports have increasingly linked scabies with immunosuppression, as in acquired immunodeficiency syndrome (AIDS) and in transplant recipients. Lesions may mimic those of a wide variety of skin diseases. The patient presented is a 41-year old male with signs of systemic illness and atypical dermatitis. This case illustrates the pitfalls in recognition of crusted scabies and the importance of rapid diagnosis. Diagnostic technique and treatment are briefly reviewed.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[Statistical studies on scabies at Division of Dermatology, Urakawa Red Cross Hospital].

Scabies is a relatively common skin disease caused by the itch mite Sarcoptes scabiei var. hominis. Because of its strong contagious capacity, social problems especially as sexual transmission or massive infection in school children arise quite frequently. Since we have experienced many scabies patients in our outpatient clinic of Urakawa Red Cross Hospital, statistical analysis was attempted on patients from April 1976 to March 1987, in order to contribute to prevention and control of the disease. Results have been obtained as follows: (1) The total number of scabies patients was 496 that is 1.96% of the total number of new outpatients seen in this period. (2) Sex ratio was 1.33 (male): 1 (female), slightly higher in male. (3) As to the age distribution, the highest peak was 3rd decade of life. (4) Compared with previous reports, the ratio of children and elders was remarkably high. (5) Massive infection was observed in one nursing home and one hospital. (6) As to the seasonal distribution, the number of patients was high from October to March, and the highest peak was November. (7) We compared three kinds of scabies and discussed about the useful effect of gamma-BHC in the cure and prevention of the disease, comparing with crotamiton and benzyl benzoate.

Adolescent↗

PubMed1989

Scabies, lice, and fungal infections.

Scabies and pediculosis capitis are frequent and often unrecognized causes of multiple streptococcal and staphylococcal pyodermas. Permethrin 1 per cent creme rinse (NIX) for head lice, and permethrin 5 per cent topical cream for scabies are new, highly effective, safe, and cosmetically elegant treatments which have shown superiority over older remedies. In populations in which pediculosis and scabies have resisted traditional lindane therapy, patients promptly responded to these permethrin products. Scabies in nursing homes is a persistent and expanding problem which demands a high level of diagnostic suspicion and an integrated approach to management. For fungal infections, several new broad-spectrum oral and topical agents have been introduced. Their successful use is enhanced by appropriate diagnostic tests which can be performed in the office setting. Recommendations and references are given to assist the physician in diagnosis and choice of therapy.

Antifungal Agents↗

PubMed1986

[Biological behavior of Sarcoptes scabiei var. suis in swine epidermis. A scanning electron microscopy study in hyperkeratotic (or Norwegian) scabies of swine].

The behaviour of Sarcoptes scabiei var. suis has been studied in hyperkeratotic scabies of pigs (fig. 1). The scanning electron microscope enabled us to observe the outer surface of the eggs in the burrow and even within the cut body of the fertilized female mite (fig. 2). Early events during hatching of the eggs and the first steps of the newborn larva (fig. 3) are shown. The presence of crystals containing calcium and phosphate is shown to occur in places where huge amounts of faecal material are collected (fig. 4). Although some of these aspects have not been published previously we observed many similarities in behavior between Sarcoptes scabiei var. hominis and suis in their respective hosts affected with hyperkeratotic scabies. As to the therapeutic aspect of scabies in humans, carefully selected drugs currently used in the systemic treatment of scabies in pigs would be worth a trial in patients difficult to treat.

Animals↗

PubMed1987

Scabies in urban Bangladesh.

As a part of a larger project on hygiene education and diarrhoeal diseases we followed 766 children less than 6 years of age from October 1984 to September 1985 in Dhaka, Bangladesh. The aims were to estimate the annual risk of infestation with scabies in children, to describe its involvement of other family members, and to determine some of the familial and individual risk factors for apparent infestation by scabies. During this period 589 (77%) children appeared to have been infected with scabies, and 125 (16%) children were infested for more than 6 months. Of the factors examined, direct and indirect indicators of decreased wealth and incorrect hygiene practices correlated with higher rates of apparent infestation, although scabies rates remained high at all socioeconomic levels.

Bangladesh↗

PubMed1985

Norwegian scabies in Australian Aborigines.

Norwegian scabies is a rare, but distinctive, variant of scabies. The infestation by the parasite is massive, and the lesions consist of hyperkeratotic plaques affecting the skin of the whole body. Predisposition to this form of scabies occurs in association with a variety of conditions. Three cases of Norwegian scabies, which occurred in full-blood Australian Aborigines, and were managed in the Royal Darwin Hospital, are reported.

Adult↗

PubMed1983

Atypical crusted "Norwegian" scabies: report of nosocomial transmission in a community hospital and an approach to control.

During August, 1981, a person with an unrecognized case of atypical Norwegian scabies was admitted to a community hospital in Chariton, Iowa. Twenty cases of symptomatic scabies were reported among hospital staff; mites were recovered from four. Subsequent evaluation confirmed scabies transmission to family and friends of this patient before hospitalization; twelve cases of symptomatic scabies, three of them slide positive, were identified in this group. The patient was treated sequentially with 1 percent lindane lotion, 10 percent crotamiton lotion, and 6 percent sulfur ointment to successfully eradicate the infestation. Secondary cases in the hospital and community were treated with 10 percent crotamiton which also was used to prophylactically treat exposed contacts. Control measures and patient management are presented.

Administration, Topical↗

PubMed1983

Ivermectin for the control of swine scabies: relative values of prefarrowing treatment of sows and weaning treatment of pigs.

Ivermectin given in a single subcutaneous dose (300 micrograms/kg of body weight) was tested for activity against swine scabies (Sarcoptes scabiei). Efficacy was determined by recoveries of mites from ear scrapings and by observations of clinical signs. Treatment of infected sows 8 to 37 days before farrowing eliminated scabies from the sows and prevented its transmission to their offspring. Pigs farrowed by ivermectin-treated sows remained noninfected throughout the study regardless of whether they were treated with ivermectin at weaning. Placebo-treated sows remained infected and transmitted scabies to their offspring. Ivermectin treatment of pigs at weaning eliminated the infection, whereas placebo treatment did not. The placebo-treated pigs remained infected while in the nursery, but ivermectin treatment eliminated the infection when they were moved to the growing and finishing floor at 12 weeks of age. It appears that an effective control program for swine scabies using ivermectin could be based on a single treatment of the sows before farrowing. Any infection (epizootic) appearing in growing pigs could be controlled by a single treatment of all in-contact pigs.

Animals↗

PubMed1978

Norwegian scabies. A new complication of immunosuppressive therapy.

The second reported case of Norwegian scabies in an immunosuppressed patient is presented. This uncommon fulminant form of scabies is difficult to diagnose and may give rise to numerous secondary cases of routine scabies. Because of the current widespread use of immunosuppressive medication, it is believed that an increasing number of cases of Norwegian scabies will be seen and that an increased awareness on the part of clinicians will be necessary in order to diagnose such cases early in their course before numerous hospital personnel are infested.

Azathioprine↗

PubMed1993

Scabies therapy--1993.

The addition of permethrin as a scabicide with low toxicity adds significantly to our therapeutic options for typical and special forms of scabies. Detailed specific management suggestions, as well as a scabies instruction sheet, are included. The management of crusted (Norwegian) scabies and scabies in human immunodeficiency virus-acquired immune deficiency syndrome (HIV/AIDS) is more difficult and may require, particularly in those intensely immunosuppressed, repeated treatment with scabicides and sometimes sequential use of several agents. Tolerance (resistance) to lindane was suggested in Central America but also in South America, Haiti, Egypt, and in clusters in the United States.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Scabies in infants and small children.

Scabies in infants and young children manifests as a pruritic, often generalized eruption with frequent involvement of the face, scalp, palms, and soles, in contrast to the intertriginous localization of lesions in older patients. The most common presenting lesions are papules, vesiculopustules, and nodules. Secondary eczematization and impetiginization are common, but burrows are difficult to find. The diagnosis of scabies should be confirmed by mineral oil scraping. Permethrin 5% cream (Elimite; Herbert, Irvine, CA) is now considered to be the treatment of choice for infants and small children with scabies because of its high efficacy and low risk of side effects. Concomitant treatment of other family members and caretakers is imperative, as is cleansing of articles of contact. Postscabietic nodules may persist for a few months after clearance of the mites. Animal scabies may also cause pruritic papules and vesicles in young children, but the eruption clears spontaneously; the infested animal should be treated.

Administration, Cutaneous↗

PubMed1975

Scabies and other skin diseases in pre-school children in Ujamaa villages in Tanzania.

A survey of skin diseases was carried out in pre-school children in five Ujamaa villages in Rufiji district and 532 children (5.3% of the total population) were screened. The results showed that scabies was the commonest skin problem affecting 31% of the children. Primary pyoderma and fungal infections were relatively less common and accounted for 7.0 and 2.4% respectively. Staphylococcus aureus, Group A beta haemolytic streptococci and Corynebacterium diphteriae were the commonest pathogeneic bacteria isolated from both infected scabies and primary pyoderma. Tinea capitis was similarly the commonest fungal infection and Microsporium audouinii was the main pathogen. The high prevalence of scabies was attributed to poor hygiene, overcrowding with intimate personal contact. The low prevalence of pyoderma was due to the fact that we did not include secondarily infected scabies and eczema amongst the cases of pyoderma.

Child↗

PubMed1976

[Epidemiological and immunological study of human scabies].

The scabies epidemy being observed since 1965, had developed from persistent endemic centres and pursues continuous the cyclic course of the scabies humanis in periods of 15 to 20 years. The intracutaneous tests with antigens of Notoedres alepis show a cross antigenity with the antigens of Sarcoptes scabiei and a sensibility of patients suffering from scabies. These tests have a diagnostical value. The antigens of Notoedres alepis are free of antigens from human epidermis.--The results support the theory of immunity for the interpretation of the cyclic course of the scabies, whereas wars and social and hygienic nuisances only have a modifying influence, and promiscuity, Sarcoptotoxicity of environment and others have no deciding importance.

Acari↗

PubMed1998

[Causes of spread and return of scabies in health care institutes; literature analysis of 44 epidemics].

OBJECTIVE: To determine the risk factors that contribute to the transmission and return of scabies in health care institutions. DESIGN: Literature analysis. SETTING: Public Health Care Service Midden-Kennemerland. Heemskerk, the Netherlands. METHODS: Search of Medline over the years 1976-1996 yielded 34 reports of 44 outbreaks. The contents were qualitatively examined on factors possibly contributing to the transmission and return of scabies in health care institutions. RESULTS: Six such factors that contribute to the transmission and return of scabies in health care institutions were found: (a) among residents in health care institutions a considerable number are, once infested, at risk of developing crusted scabies, (b) many people are exposed through close contact, (c) the generally long diagnostic delay, (d) insufficient survey of the epidemiological problem, (e) treatment failures and (f) incomplete post-intervention monitoring.

Disease Outbreaks↗

PubMed1998

[Scabies crustosa and AIDS].

We report crusted (Norwegian) scabies in two patients with AIDS. Undiagnosed crusted scabies gives rise to outbreak of scabies in persons in close contact with the patients and in personnel and patients at the institutions. The described cases emphasize the importance of being aware of crusted scabies in patients suffering from AIDS.

AIDS-Related Opportunistic Infections↗

PubMed1992

Identification of a protein-binding sequence involved in expression of an esterase gene from Streptomyces scabies.

Expression of an esterase gene from Streptomyces scabies is regulated by zinc in both Streptomyces scabies and Streptomyces lividans. A specific protein-binding site was identified on an esterase promoter fragment by using an S-30 extract from S. scabies. The location of the protein-binding site was determined by gel shift assays of promoter deletion fragments and by DNase I footprinting analysis. The protein-binding site maps from nucleotides -59 to -81 relative to the start of transcription. An esterase gene construct cloned and expressed in S. lividans was used to assess the importance of the protein-binding site. Deletion of the 23-bp protein-binding site resulted in a 10-fold decrease in esterase production when cells were grown in zinc-inducing conditions. The protein-binding site may represent a region involved in positive regulation of the S. scabies esterase gene.

Amino Acid Sequence↗

PubMedDate not supplied

Comparison of the efficacy of topical 1% lindane vs 5% permethrin in scabies: a randomized, double-blind study.

BACKGROUND: Permethrin, a pyrethroid insecticide, is not yet available in Iran and may be a useful substitute for the control of scabies in Iran. AIM: To compare the efficacy of topical lindane with topical permethrin in the treatment of scabies in a population in Iran. METHODS: In a double-blind, randomized study, all consecutive patients with scabies were randomized into two groups. One group and their family contacts received 1% lindane cream, and the other group and their family contacts were treated with topical 5% permethrin cream. Subsequently, patients were followed up at 2- and 4-week post-treatment. RESULTS: Of the 99 patients enrolled in the study, 47 patients received 1% lindane cream, and 52 patients were treated topically with 5% permethrin cream. Permethrin provided an improvement rate of 84.6% after two weeks, whereas lindane was effective only in 48.9% of patients. CONCLUSION: Permethrin (5%) cream was found to be significantly more effective in the treatment of scabies in comparison with lindane in this study, and it seems that it could be an alternative treatment.

Administration, Topical↗

PubMed2004

The scourge of sarcoptes: oral ivermectin for scabies.

OBJECTIVE: To review the use of the oral antiparasitic ivermectin in the treatment of scabies, with an emphasis on its use in the elderly and in long-term care settings. DATA SOURCE: A MEDLINE/PUBMED search was conducted to identify pertinent studies, case reports, letters, and reviews in the English language. All articles published from 1980 to October 2003 were reviewed. Additional references were obtained from the bibliographies of these articles. STUDY SELECTION: All studies evaluating ivermectin in the context of scabies mite infestation. DATA SYNTHESIS: The semisynthetic macrocyclic lactone ivermectin has been available since the early 1980s as a broad-spectrum antiparasitic agent in animals and humans. This agent, which works by suppressing motor nerve conduction leading to parasite paralysis and death, was first used in ectoparasitic diseases (i.e., those caused by lice and mites) shortly after commercial introduction. A large body of literature, mainly uncontrolled case reports and series, has since evolved. However, these reports and results of the small number of placebo- and/or active-controlled studies have demonstrated the favorable response of both classic and crusted scabies to single- and multiple-dose oral ivermectin. Adverse reactions to the drug are uncommon, with the exception of a transient, new onset, or mild increase in existing pruritus soon after drug ingestion, which is thought to be a hypersensitivity reaction to dead mites and/or their products. CONCLUSION: Oral ivermectin may prove to be a time- and labor-saving alternative to topical scabicide treatments, especially in the institutional setting where labor shortages make the management of scabies outbreaks a true challenge. However, the use of this agent does not change the need to decontaminate the environment (clothing, bedding, bed clothes, and, in selected cases, floors and walls) in order to truncate an outbreak and prevent reinfestation.

Journal Article↗