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A case of scabies infestation in a ten-week-old infant is described. Infestation in a neonate presents a clinical picture quite different from that found in older children and adults. Therapeutic options can be limited in infants. Current concepts and treatment modalities are discussed.
Scabies is a mite infestation caused by Sarcoptes scabiei. Varieties of this organism can produce disease on 40 different species of animal, including humans. The organisms mature, burrow, and lay eggs. The newly hatched larvae mature and mate on the skin, causing itching and excoriated papules on humans, and mange, with crusts and oozing, on hair-bearing animals. Treatment with the gamma isomer of hexachlorobenzene or with pyrethrins is effective. Care must be taken that all infected or exposed individuals are treated. The role of fomites in the transmission of the disease is not clear. Most cases seem to be transmitted by close personal contact.
For the first time in Soviet and foreign literature the authors describe a girl suffering from hypoparathyrosis developing Norwegian scabies. Since all family members have contracted condition, a conclusion on its high contagiosity is made.
The authors are reporting a new case of widespread scabies in a baby. They take this opportunity to emphasize on the atypical erythematous and excoriated papular rash which sometimes may be vesicular and hyper-keratotic. This widespread eruption may mimic generalised dermatitis, pustular psoriasis and even histiocytosis X. They also underline importancy of longlasting ointment with fluorinated steroid being responsible for this widespread eruption.
Treatment for scabies is usually initiated by general practitioners; most consider lindane (gamma benzene hexachloride) the treatment of choice. Lindane is also widely used as an agricultural and industrial pesticide, and as a result the toxic profile of this insecticide is well understood. Evidence is accumulating that lindane can be toxic to the central nervous system and may be associated with aplastic anaemia. Preparations containing lindane continue to be sold over the counter and may represent a hazard to poorly informed patients. This literature review suggests that general practitioners should prescribe scabicides with increased caution for certain at-risk groups, and give adequate warnings regarding potential toxicity.
We describe an unusual vesicular eruption occurring secondary to scabies in an elderly patient receiving high-dose prednisone therapy.
The clinical efficacy and transdermal absorption of permethrin, a new synthetic insecticide was investigated in ten scabies patients. All patients were successfully treated with one application of a cream, containing 5% permethrin. Apart from mild postscabies dermatitis no side-effects were observed. The mean weight of cream used per patient was 25 g (range 21-32; mean content of permethrin 1250 mg). The degree of permethrin absorption was assessed indirectly by determination of conjugated and unconjugated cis- and trans-CVA (a metabolite of permethrin) excretion in urine using two dimensional gas chromatography mass spectrometry. It was found that during the first 48 hours the mean estimated absorption was 6 mg (range 3-11), which is approximately 0.5% of the total dose.
In the third part of article (first was published in Wiad. Parazytol. 32, 3-10 and second in Wiad. Parazytol. 33, 3-7, 1987) the authors quote fragments of the work of L. J. Columella (books: VI and VII) concerning scabies of domestic animals. The paper is provided with a wide, vet.-parasitological comment.
Hereford heifer calves were experimentally infested with Psoroptes ovis. Histologic examination of skin specimens was conducted at weekly intervals before and after treatment with ivermectin on postinfestation week 7. Electron microscopy revealed numerous degranulating mast cells in the skin of infested but not in control calves. many active, as well as degenerate, neutrophils were in the scab on infested calves. Microscopic epidermal ulcers developed on infested calves when live mites were present but not after treatment. Numbers of dermal neutrophils and plasma cells decreased and numbers of circulating neutrophils increased 1 week after treatment. Numbers of dermal eosinophils and mast cells in calves with eosinophilia increased for several weeks after treatment. Statistical analysis indicated significant correlations (P less than 0.05) among numbers of dermal inflammatory cells, hemogram values, and changes in dermal thickness. Seemingly, mite-induced epidermal damage was the key pathogenic event in psoroptic scabies in calves. Mast cell degranulation contributed to the pathogenesis of the dermatitis, and neutropenia was caused by sustained, poorly compensated efflux of neutrophils into the scab through mite-induced breaks in the epidermis.
An infant of 10 months, suffering from scabies, has developed multiple involvements of the nail plates on the hands and feet, with detachment of some of them. A diagnostic error has promoted the dissemination of the process. The patient has been etiologically cured by a 10% water/soap suspension of benzyl-benzoate.
Tokelau children have been examined for scabies infestation in three groups--those living in their home atolls--those living in New Zealand in 1972-73, and those living in New Zealand in 1975. There was less infestation in Tokelau than in New Zealand. In 1975 the rate of infestation in New Zealand had increased since 1972. The manifestation of the mite in children in New Zealand varied from the classical descriptions, in that the mite itself, and its burrows, were seldom found, and the skin lesions were more often seen on the body than on the wrists and hands. A treatment regime which was found satisfactory is described. It was found essential to treat the entire family at the same time.
Two cases with an atypical form of Norwegian (or crusted) scabies are presented. It is suggested that a systemic (first case) or a local (second case) alteration of the immune system paved the way for the development of this atypical presentation.
The infestation of a 3-month-old child with Sarcoptes scabiei by way of infested nipples during the breast-feeding period led initially to facial papules and later to generalized dermatitis. Scabies mites were not detected on the face; studies on ten infested babies in India supported this findings. Thus, direct antiscabies treatment to the face is not necessary in babies.
The behaviour of Sarcoptes scabiei var. hominis has been studied in the skin of 2 patients with hyperkeratotic scabies. After examination under the scanning electron microscope, the skin specimens can be reprocessed for light microscopic examination. Original aspects and the dynamics of the burrowing parasite are presented, namely its penetration into the epidermis, the elimination of digestive residues and the maturation of the parasite's eggs.
Psoroptic scabies of cattle causes substantial economic losses. An eradication program begun in 1905 virtually eradicated the disease by 1950. Complacency was followed by a resurgence of the disease, particularly in the 1970s, when more than 1,000 outbreaks were reported. Program effectiveness was reduced when the disease was often not detected or reported for several months after herds became infested. Further spread was enhanced by infested cattle moving undetected through market channels.
The risks of incidents and accidents--especially systemic ones--complicating topical scabies treatment in infants are reviewed. After a short review concerning insecticides (sulphur, benzyl-benzoate, DDT, Lindane, Crotamiton) and the use of several drugs proposed for infants, the authors insist on the choice of the drug and the therapeutic protocol, that are as important as the drug itself. Directions for use should be strict, in order to avoid automedication and overdosage. There is no study concerning the comparative evaluation of risks and efficacy of each drug.
Scabies and pediculosis pubis are ectoparasitic infestations often transmitted by sexual contact. The distinctive clinical features that characterize these infestations are described, along with laboratory diagnosis. Entomologic, epidemiologic, and pathogenetic essentials are also considered, and safe and effective methods of treatment are presented for the clinician.
A liquid concentrate formulation of amitraz (Mitaban: Upjohn) was used to topically treat 181 dogs with scabies, at an active drug level of 250 ppm, or 10.6 ml of concentrate in 2 gal water. After the dogs were clipped and bathed, the diluted medication was applied and allowed to dry on the animal. All treated dogs were clinically improved and 97.8% cured after a single treatment; 3 dogs required 2 treatments and 1 dog 3 treatments. Otodectes cynotis and Cheyletiella yasguri in several dogs were also cleared after 1 treatment. Mild, transient sedation occurred in 12.4% of treated dogs, with transient vomiting, increased appetite and diarrhea in less than 1%.