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The adoption of babies from third-world countries with endemic scabies by European and North American families is an ever increasing phenomenon. A brazilian baby was presented with papulopustules on both cheeks and an itchy, papular rash that developed four weeks upon arrival in Germany. Meanwhile the adoptive mother had contracted scabies.
Crusted (Norwegian) scabies occurred in a patient with adult T-cell leukemia. It was not noted at the time of hospital admission. Scabies should be included among the opportunistic pathogens in immunocompromised hosts.
A typical case of norwegian scabies is reported in a patient with diabetes and chronic lymphoid leukaemia under immunosuppressive therapy. Clinical differential diagnosis, diagnosis procedures, and frequent development of an epidemic of common scabies in contacts are emphasized.
Scabies can be easily mistaken for dermatitis herpetiformis because the two conditions have features in common, namely, pruritic papules, vesicles, and crusted erosions in the sacral and gluteal regions. In five patients with scabies who were initially judged clinically to have dermatitis herpetiformis, histological examination was decisive in the eventual correct diagnosis.
A patient who was infested with scabies subsequently developed recurrent herpes genitalis. Scratching the scabetic lesions resulted in self-inoculation with herpes on the lower abdomen and chin. Inoculation herpes is one of the most common complications of HSV-2 infection. The infection can be divided into primary, latent, shedding and recurrent stages. Pruritic lesions such as scabies complicate the management in herpes.
Cell infiltrates in the dermis of biopsy specimens from skin lesions of seven patients with scabies were characterized by receptors for sheep erythrocytes (T-lymphocytes), Fc C3b (macrophages and B-lymphocytes) and C3d receptors (B-lymphocytes) using hemadsorption to cryostat sections in closed chamber. T-lymphocytes were also identified using an indirect immunofluorescence technique with rabbit anti-T-lymphocyte serum. All sections showed perivascular mononuclear cell infiltrates in the dermis as judged by sections stained by hematoxylin and eosin. T-lymphocytes were the predominant cells in the infiltrates. Fewer macrophages and very few B-lymphocytes were detected. Cell-mediated immune response may be of importance in the pathogenesis of scabies.
An epidemiological analysis was carried out of more than 11 thousand cases of scabies reported in 1961-1979 in the district of Karviná, Czechoslovakia. The paper presents analyses of the incidence of scabies in different age groups of patients divided according to sex and occupation and the results of the epidemiological investigations in family foci. A special attention is paid to the problems of spread of infection in the human population, including the detection of the source and mode of transmission in patients with microscopically confirmed diagnosis. The results obtained serve as a basis for the proposed practical control measures.
The authors studied seric IgE levels in 79 patients with scabies: 48 p. 100 had significant elevated concentration of IgE (greater than 300 U. I./ml) (p less than 0,001). This is the fact of scabies infestation and is not the result of internal parasitic infestation, associated illnesses or atopic disease. There is a statistically significant correlation between high IgE levels and degree of extension (p less than 0,1) and, overall, eczematization (or) and superinfection (p less than 0,001).
The in vitro addition of mice or human unparasited scale extracts to the serum of 8 patients with scabies and 5 healthy controls did not significantly modify the fixation of 125I-C1q as compared to control tubes (serum with physiological saline). These results suggest that antigens or substances derived from the scabies mite are not involved in the immune complexes present in the serum of the parasited patients.
A fit, normally intelligent young man developed Norwegian scabies after prolonged treatment with large quantities of clobetasol propionate ointment. The development of this overwhelming infestation from the normal eruption of scabies may be related to the local immunosuppressive effect of this potent topical steroid.
An outbreak of Norwegian scabies in a surgical ward of a teaching hospital was reported. The source of infestation was an elderly diabetic. The epidemic involved 28 of 32 medical personnel in the ward and 3 family contacts. All infected individuals were given a two-course treatment with hexachlorcyclohexane gel. Control of the outbreak was achieved by strict handwashing after patient contact, application of gowns and gloves for contact with skin lesions and the treatment of infected persons. Norwegian scabies in institutions is on the rise, vigilance for its occurrence is needed.
An outbreak of scabies was detected in autumn 1992 at a school for children with learning disabilities. Because of the scale of the outbreak all the children at the school, and their contacts, were treated on one 'mass treatment day'. Scabies is still widely misunderstood and carries a social stigma, which makes investigation and control more difficult than it would otherwise be.
Scabies is one of the most important prevalent contagious disease caused by itch mite "Sarcoptes scabiei." Many effective scabiecides have been suggested and tried. They differ in their side effects since they are applied on diseased skin sometimes all over the body. In this paper, sixteen parasitologically proved human scabies were successfully treated by 5% sulfur precipitate and 2.5% permethrin. Application of sulfur for one week or 2 applications of permethrin followed by a third one a week later proved to be safe and effective. The one week course of sulfur and the third application of permethrin acts against any emerging immature stages of the mite.
In a double-blind study, 38 adults with scabies were treated with the scabicide Tenutex (a proprietary aqueous emulsion containing 0.5% DDT, 2% disulfiram and 22.5% benzyl benzoate) and 42 patients were treated with a similar emulsion lacking DDT. The treatment consisted of a single whole-body (except for the head) application which was washed off after 24 hours. When examined 3 weeks later, both groups were completely cured. Thereafter, a further 35 patients took part in an open trial with the DDT-free Tenutex emulsion and all patients were cured, irrespective of whether the treatments were administered by skilled personnel or by themselves at home. It is concluded that for the treatment of scabies in Sweden, the most commonly used preparation, Tenutex, can be replaced, without risk of loss of efficacy, by an emulsion containing 2% disulfiram and 22.5% benzyl benzoate, i.e. Tenutex without DDT.
Scabies is a skin infestation of a mite which is spread by skin-to-skin contact and causes an intense generalized intractable pruritus. This case presentation demonstrates how scabies can be mistaken for other skin conditions, and the importance of proper diagnosis, treatment, and followup.
In order to contribute to a better knowledge of the pediculosis capitis and scabies during March-December 1995, 1122 primary schoolchildren under 14 years of age in the city-port of Antofagasta in northern Chile (20 degrees South lat.), were examined. A total of 285 (25.4%) were found to be infested with Pediculus humanus capitis and only 20 (1.8%) with Sarcoptes scabiei. In general the rates of infestation to both ectoparasitic diseases were higher in groups of younger schoolchildren, also higher in women than in men and in those groups with high indexes of crowding and ignorance of the transmission mechanism of pediculosis capitis and scabies.
Letterer-Siwe's disease was diagnosed from clinical appearance and initial assessment of a skin biopsy in a child with a 2-month history of skin rash. Fine erythematous papules were scattered on the trunk. The biopsy showed epidermal thickening and an inflammatory infiltrate chiefly in the upper layers of the dermis; deeper in the dermis the infiltrate was perivascular and periappendicular, histiocytes predominating in some areas and lymphocytes in others. A diagnosis of scabies was made after burrows were demonstrated on palms and soles and the mite of scabies was isolated from them.
Scabies is a highly contagious disease of the skin caused by an ectoparasite arthropod called Sarcoptes scabiei var hominis. It has a world-wide distribution and affects all ages with no specific gender predisposition. Scabies is of public health interest because certain environment factors such as overcrowding, poor hygiene, delayed treatment of primary cases and lack of public enlightenment are conducive to its spread. However, prompt and adequate therapy is rewarding and prevents spread.