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PubMed1999

Crusted (Norwegian) scabies induced by use of topical corticosteroids and treated successfully with ivermectin.

Crusted scabies is mainly observed in children with immunosuppression or mental illness. Treatment is very difficult, and relapse is frequent after topical scabicidal therapy. We describe a case of crusted scabies, induced by long-term application of a topical corticosteroid, relapsing after topical treatment and dramatically improved by ivermectin. We suggest that ivermectin is a safe and effective alternative therapy for the treatment of severe Sarcoptes scabiei infestation in children unresponsive to conventional treatment.

Administration, Topical↗
PubMed1990

The "nuisance" sexually transmitted diseases: molluscum contagiosum, scabies, and crab lice.

Although molluscum contagiosum, scabies, and infestation by crab lice do not carry the requirements of partner notification or other long-term consequences, they are among the most commonly reported sexually transmitted disease. Molluscum contagiosum is a benign viral infection of the skin epidermal layer, most often transmitted by intimate skin-to-skin contact. The lesions often resolve spontaneously over time, but patient discomfort or social reasons may require destructive removal of the lesions. Scabies is caused by the Sarcoptes scabiei mite. The victims continually itch, especially at night, and often seek over-the-counter topical remedies before seeing a clinician. Once a correct diagnosis is made, successful resolution of this disease and its itching can be achieved. Head and pubic lice account for most of the more than three million cases of louse infestation treated in the United States each year. Symptoms of infestation generally include itching that leads to scratching, erythema, irritation, and inflammation. A careful diagnosis followed by disinfection, symptomatic treatment, and psychologic support should result in a complete cure with no long-term effects.

Animals↗
PubMed1978

Scabies in children.

We are in the midst of a pandemic of scabies. Classic scabies is seen less frequently in the current cycle. The infestation frequently occurs in special forms, the differential diagnosis of which includes nearly every pruritic dermatosis. The cause of the current pandemic is not clear but there is evidence that immunologic factors, particularly delayed hypersensitivity, play a principal role. The diagnosis should be made with certainty, preferably by identifying the mite prior to instituting therapy. The modern scabicides are highly effective. A recent re-evaluation of the risk-benefit relationships of lindane has led to altered therapeutic routines.

Adolescent↗
PubMed2006

Scabies.

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.

Adult↗
PubMed1984

An epidemic of scabies with unusual features and treatment resistance in a nursing home.

An epidemic of scabies affecting elderly patients on one ward of a nursing home is described. The outbreak was characterized by a high degree of contagion and treatment resistance among patients suffering from malignant diseases and receiving immunosuppressive therapy. The clinical picture was unusual, with papules surmounted by scabies burrows and a high percentage of persistent nodular lesions. The origin of the outbreak was probably a patient with an exfoliative psoriasis, treated with an aromatic retinoid and potent topical corticosteroids. In view of the high recurrence rate, follow-up may be advisable especially in elderly patients.

Aged↗
PubMed1988

Staphylococcus aureus colonization of burrows in erythrodermic Norwegian scabies. A case study of iatrogenic contagion.

Scanning electron microscopy demonstrated extensive bacterial colonization of scabies burrows honeycombing the stratum corneum of an elderly woman with erythroderma. Cultures of scybala revealed hemolytic Staphylococcus aureus, possibly responsible for the erythroderma. Epidemiologic data revealed a trail of scabies through two nursing homes and one hospital during the 2-year period that physicians believed she had a drug-induced erythroderma.

Aged↗
PubMed1988

Cheyletiellosis and scabies.

Cheyletiellosis and scabies can cause pruritus in dogs and cats. Cheyletiellosis is variably pruritic, whereas scabies is usually intensely pruritic. Hypersensitivity reactions are described in both of these parasitic dermatoses and probably contribute to the development of lesions and pruritus. Both parasites are readily eradicated with insecticides.

Animals↗
PubMed1992

Management of an outbreak of Norwegian scabies.

An outbreak of Norwegian scabies in a 170-bed acute care hospital was controlled through an organized plan for delivering treatment to those affected: four patients, 50 staff members, and 14 family members of staff members. Health departments in two counties were notified and found four additional cases in the long-term care facility at which the index patient lived. Contact isolation was used for the index patient and any other patients with nosocomial scabies. Staff members infested with Sarcoptes scabiei were released from work until they had been treated with lindane. Staff members who had been in contact with infested persons and staff members' families were treated prophylactically with lindane. This aggressive treatment plan resulted in rapid resolution of the outbreak.

Cross Infection↗
PubMed1985

Pseudouremic pruritus: a scabies epidemic in a dialysis unit.

A scabies epidemic was studied in a university hospital dialysis unit. Itching in patients was initially attributed to uremic pruritus, and diagnosis of the epidemic was delayed until cases occurred among the staff. Sixteen cases (seven patients and nine staff) were identified by survey questionnaire and dermatologic examination. Application of 1% lindane lotion (Kwell, Reed and Carnrick, Piscataway, NJ) to all patients dialyzed in the unit and the entire staff eradicated the epidemic. A dialysis unit-associated nosocomial scabies epidemic has not been reported before and may mimic uremic pruritus in dialysis patients.

Antiparasitic Agents↗
PubMed1997

Evaluation of the therapeutic and protective efficacy of doramectin against psoroptic scabies in cattle.

Three studies were conducted to evaluate the therapeutic and protective efficacy of doramectin when given by injection at a dose of 200 micrograms/kg against induced Psoroptes otis infestations of cattle. The first study investigated therapeutic efficacy. Mite infestations were established on 15 test animals held in stanchions by transfer of material from infested donor calves. Test animals were then allotted on the basis of mite counts to a treatment group (10 animals) which received doramectin and a control group (5 animals) which received saline. Skin scrapings were collected for mite counts on the day before treatment and on days 7, 14, 21 and 28 after treatment. Efficacy assessed on the basis of the proportion of animals cured by day 28 was 100%. The second study was designed to determine the duration of protective efficacy. Forty-eight scabies-free heifers were allotted to a treated group of 32 which received doramectin, and a control group of 16 which remained untreated. These treatment groups were each divided into eight subgroups. Commencing on treatment day and continuing at weekly intervals for 7 weeks, a subgroup of animals from each treatment was placed in stanchions and challenged by transfer of material from infested donor calves. Skin scrapings for mite counts were collected 7 and 14 days later. Infestations were successfully established on all untreated control calves. Doramectin prevented the establishment of infestation for three weeks and significantly (P < 0.05) reduced infestation levels for an additional two weeks. The third study established the duration of residual protection conferred by doramectin and ivermectin under contact transmission. Ninety-six scabies-free heifers were divided into two equal treatment groups. Animals in one group received doramectin and animals in the other group received ivermectin at its recommended dose of 200 micrograms/kg by subcutaneous injection. Each treatment group was then divided into eight subgroups of six animals. Commencing on treatment day and continuing at weekly intervals for 7 weeks a subgroup of animals from each treatment was exposed to purposely infested seeder animals for one week. Three animals from each treatment subgroup were then placed in individual stanchions in which grooming was prevented and the other three were placed together in a pen where normal grooming behavior was permitted. Skin scrapings for mite counts were collected at weekly intervals for up to 4 weeks. Doramectin provided complete protection against infestation for five weeks compared to four weeks for ivermectin. These periods were not influenced by grooming behavior.

Animals↗
PubMed1990

Scabies infestation: the effect of intervention by public health education.

The objectives of this study were to determine the prevalence of scabies in an infested village; to educate the residents on self-treatment and prevention by the use of 5% monosulfiram soap; to evaluate the short term effectiveness of this intervention by determining, 2 weeks later, the compliance to self-treatment and prevention; and to determine the prevalence rate on the second visit. In 59 households (96.7% of the village) containing 313 persons, an educational session was held and a leaflet distributed on the use and availability of the soap. Thirteen persons (4.2%) from eight households (13.6%) had scabies. After 2 weeks, 7 persons (2.2%) (2 persisting and 5 new cases) from 5 households (8.5%) were infested. Thus a cure rate of 85% was obtained though the prevalence rate showed no statistically significant difference. Among the under 15 year olds, the numbers infected decreased from 10 to 3 while among the over 15 years olds, the numbers infected increased from 3 to 4, neither reading significance at the 5% level.

Adolescent↗
PubMed2006

A scabies outbreak in a further education college in Gloucestershire.

Scabies outbreaks in England have been reported in hospitals, long-stay wards, acquired immune deficiency syndrome (AIDS) units and residential homes for the elderly. This paper describes the control of an outbreak in a further education college for persons with learning disabilities. In March 2004, four confirmed cases of scabies were reported among a subset of 108 students and 41 staff members. Staff had considerable physical contact with the students who were housed in five groups of homes, individual homes and support centres. Mass prophylaxis was offered to all staff and students, through 39 general practice surgeries. Challenges overcome were: ensuring complete case ascertainment, accessing of up-to-date information about students and staff, achieving a coordinated approach to treatment, securing informed consent and media management. No further outbreaks have been reported. The college has revised its information request form for new students.

Disease Outbreaks↗
PubMed2002

CD30 antigen expression in cutaneous inflammatory infiltrates of scabies: a dynamic immunophenotypic pattern that should be distinguished from lymphomatoid papulosis.

BACKGROUND: Expression of CD30 antigen is a distinct marker of lymphocyte activation that was originally described in the Reed-Sternberg cells of Hodgkin's disease. The observation of CD30+ cells has been considered a diagnostic feature of cutaneous CD30 lymphoid proliferations. However, CD30 expression has also been reported in some cutaneous benign inflammatory infiltrates. METHODS: Eleven skin biopsies from patients with scabies were double-blindly and retrospectively analysed. A panel of histopathological parameters and immunophenotypic expression of CD4, CD8, CD30 and S-100 antigens was studied. CD30 and S-100 antigens expression were related to clinical features. RESULTS: Large CD30+ cells were demonstrated in eight (8/11) biopsies, corresponding to patients with long-standing lesions (3 months or longer). However, no expression of the CD30 antigen was observed in all biopsy specimens (3/11) corresponding to early lesions (2 months or less). The presence of S-100 positive cells in the papillary dermis was an almost constant feature. CONCLUSIONS: CD30+ large cells seem to be a common feature in long-standing infiltrates of scabies. CD30 expression in scattered cells of a cutaneous lymphoid infiltrate cannot be assessed as a strong diagnostic argument of neoplastic cutaneous CD30+ lymphoid proliferation (lymphomatoid papulosis/cutaneous CD30+ lymphoma). Therefore, the possibility that large atypical CD30+ cells may be also present in several benign inflammatory diseases should be always considered.

Adult↗
PubMed1999

Crusted scabies in two immunocompromised children: successful treatment with oral ivermectin.

Two immunodeficient children, aged 4 and 12 years, with crusted scabies were successfully treated with a single oral dose of ivermectin (200 micrograms/kg). One child had been diagnosed in infancy with an undefined congenital T cell immunodeficiency and the other with chronic mucocutaneous candidiasis. Both had failed to respond to conventional topical therapy. In view of the excellent therapeutic response and absence of side-effects, ivermectin should be considered in the treatment of recalcitrant crusted scabies in children.

Administration, Oral↗
PubMed2002

Factors supporting sustainability of a community-based scabies control program.

Scabies remains a major problem in Aboriginal communities within the Northern Territory of Australia. Secondary skin infection with Group A streptococcus (GAS) is very common and post-streptococcal disease rates remain high. Treating families in isolation will have only limited success, as reinfection frequently occurs as a result of the high levels of movement between households and communities. We describe the results of a successful community intervention to reduce scabies and GAS skin infection in one of the largest Aboriginal communities in the Northern Territory, 15 months post-intervention, and we discuss factors that have led to the success and sustainability of the program.

Adult↗
PubMedDate not supplied

Topical ivermectin: a new successful treatment for scabies.

Ivermectin is the only one of the avermectins that has been widely used in humans, since it is recommended as the treatment of choice for onchocerciasis, a filariasis that produces "river blindness," a parasitic endemic infestation in countries of West Equatorial Africa and in some areas of Central and South America. Also, ivermectin has been used for treating human endo- and ectoparasites with effective results and with almost no side effects. To study the efficacy of ivermectin for scabies, which is very common in Colombia, a trial with this drug that could be easily administered, with fast application and high efficacy, was undertaken. For this purpose, six complete families with active scabies, consisting of 12 adults and 20 children ranging in age from 1 to 10 years, were treated with 1% ivermectin in a solution of propylene glycol applied topically to the affected skin. The dose employed was 400 microg/kg, repeated once the following week. All patients were cured, tolerated the medication well, and there were no side effects or signs of recurrence 2, 4, or 6 weeks after therapy. In addition to its efficacy, easy administration, and lack of side effects, ivermectin is a low-cost medication.

Administration, Cutaneous↗
PubMed2003

Bullous scabies.

Bullous scabies is a rare presentation usually occurring in patients who are elderly. Clinical, histologic, and immunofluorescent findings mimic bullous pemphigoid. We report a case of bullous scabies in a 4-year-old boy and review the literature.

Blister↗