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PubMed1977

Role of sociocultural and environmental factors in the cause of scabies.

A house-to-house survey for scabies was done in a semiurban area with a population of 1727 from 273 families in 253 households, to study the sociocultural and environmental factors in families with scabies. It was found that sleeping habits, overcrowding for sleeping space and sharing of clothes, towel, etc, were significantly associated with scabies. There was no significant correlation between the size of family and the number of persons infected with scabies per family. The prevalence of scabies within the families was almost the same either with good hygiene, satisfactory hygiene or unsatisfactory hygiene. The factors significantly associated with the disease were observed to be more frequent among Christian families than among Hindus and were thought to be responsible for higher prevalence of the disease within the Christian families.

Attitude to Health↗
PubMed1985

Serum IgE antibodies to the scabies mite.

Porcine scabies mites, Sarcoptes scabiei var. suis are more readily available in sufficient quantities than are human scabies mites. Circulating IgE antibodies specific to porcine scabies mites were found in 6 (30%) of 20 scabies patients with an RAST score of at least 2. Seven patients had elevated serum total IgE levels. Correlation between the RAST values, the duration of pruritus, and the IgE levels was not found. The results do not prove the existence of antibodies specific to porcine scabies mites but strongly support this assumption.

Adolescent↗
PubMed1981

Antigens Common to Scabies and House dust Mites.

Twenty-five antigens were demonstrated in a crude Dermatophagoides farinae (DF) extract by means of crossed immunoelectrophoresis (CIE), using a rabbit anti-DF serum. With the same antiserum, four antigens were demonstrated in a scabies mite preparations, indicating an immunological relationship between these scabies antigens and some of the DF antigens. In tandem CIE experiments the DF antigens were found to be partly identical to three of the scabies antigens. No IgE activity against any of these scabies antigens was evident in pooled sera from patients with house dust mite allergy by crossed radioimmunoelectrophoresis. However, one such patient had IgE antibodies to a DF antigen and a partial identical scabies antigen.

Animals↗
PubMed2006

Treatment of scabies with 5% permethrin cream: results of a German multicenter study.

BACKGROUND: Until recently, no prescription drug containing permethrin for the therapy of scabies was available on the German market.Therefore, a 5% permethrin cream formulation (InfectoScab 5%) was tested in a single-arm multi-center study including adults and children from 3 months of age with proven scabies. PATIENTS AND METHODS: On day 0, patients were treated once with permethrin cream in the study center. Control examinations including dermatoscopy were performed on day 14+/-2 and on day 28+/-3. Patients who were not considered cured or who had contact to individuals with untreated scabies received one further treatment with permethrin cream on day 14+/-2. Itching and local tolerability of the cream were documented in patients' diaries. Side effects were assessed by history, skin inspection and evaluation of patients' notes. RESULTS: 106 patients in 13 centers were enrolled in the study. Their mean age was 29.2 years (range, 141 days to 71.9 years); 34% of them were children or adolescents. 78.3% of patients were either severely (3 body sites) or very severely (4-5 sites) affected. The cure rate on day 28+/-3 was 95.1% (95% confidence interval, 91.0-99.3%). Pruritus declined markedly and continuously. In general, the cream was well tolerated; side effects were almost invariably mild. CONCLUSIONS: Our results support the efficacy and safety of 5% permethrin cream in adults, children and infants suffering from scabies. These results have contributed to the approval of InfectoScab 5% in Germany for the treatment of scabies in October 2004.

Administration, Topical↗
PubMed1964

TYROSINASE INHERITANCE IN STREPTOMYCES SCABIES. I. GENETIC RECOMBINATION.

Gregory, Kenneth F. (Ontario Agricultural College, Guelph, Ontario, Canada), and Jay C. C. Huang. Tyrosinase inheritance in Streptomyces scabies. I. Genetic recombination. J. Bacteriol. 87:1281-1286. 1964.-Mutants derived from Streptomyces scabies strain A26 recombined with other derivatives of A26, but not with nine other strains of S. scabies nor with eight strains of other streptomycetes. Most of the spore progeny of heterogenomic mycelia formed from complementary diauxotrophic strains of S. scabies A26 were capable of forming tyrosinase (tye(+)), provided either of the parents was tye(+). About 99.8% of these spores carried the nutritional markers of either one or the other of the two parents. All recombinant classes between nutritional and streptomycin susceptibility markers were like-wise predominantly tye(+). We suggest that the tye(+) characteristic is carried in a small genetic unit, which is unlinked to most other genes and capable of replicating faster than the rest of the S. scabies genome.

Canada↗
PubMed2001

Successful treatment of scabies with oral ivermectin in Nigeria.

Currently, several topical scabicides are available but there is yet no oral or parenteral drug which has been established for the treatment of scabies in Nigeria. Ivermectin which is a modified avermectin, known to be an ectoparasiticidal agent in animals, has been used in adults for systemic parasitosis. In Nigeria, 25% benzyl benzoate is being extensively used for the treatment of scabies in adults. It is effective and readily available. The present study was carried out to evaluate the efficacy and safety of ivermectin in the treatment of patients with scabies at the skin clinic of the University of Nigeria Teaching Hospital, Enugu. Fifty-eight patients with scabies were recruited for the study; 13 (22.4%) were children aged between 5-14 years. Oral ivermectin was given in a single dose of 200 [microg/kg body weight to 29 patients. The remaining 29 patients had to apply 25% benzyl benzoate emulsion. All patients received a full physical and dermatological examination prior to onset of treatment and weekly for 4 weeks. Skin scrapings were taken to confirm the diagnosis of scabies. There was a 93% resolution of pruritus with ivermectin and 48% with benzyl benzoate. No side effects were observed with ivermectin. Our results show that oral ivermectin is a promising, effective and safe alternative in both children and adults of Nigeria when compared to 25% benzyl benzoate topical application.

Administration, Oral↗
PubMed2005

Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989-90.

BACKGROUND: Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989-90, for which permission to publish was only recently obtained. METHODS: A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. RESULTS: Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067). Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8) and moving beyond the room (but within the ward) (OR = 4.1; 95% CI: 1.4, 12.5) were significantly associated with infection, while types of room (Western or Japanese) and sleeping arrangement (on beds or futons laid directly on the floor) appeared not to be risk factors. CONCLUSION: Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help improve control practices.

Aged↗
PubMedDate not supplied

[Outbreak of scabies at a home for the elderly in the province of Huesca].

BACKGROUND: Individuals residing in institutionalized living facilities are currently a high-risk group as regards scabies outbreaks. This study is aimed at analyzing the characteristics of one of these outbreaks, which occurred at a senior citizen living facility located in the municipality of Barbastro (Huesca) through the Huesca Provincial Epidemiological Monitoring Division. METHODS: Following the initial notification of cases, a specific scabies prevention protocol was set out. An epidemiological investigation was conducted, proceeding to an active search for cases among all of the individuals residing or working at the facility in question. The information gathered on the cases and contacts by means of a validated survey was included in a database using Epiinfo 6.0. The attack rate and the relative risk of those residing in each area of the center were estimated, taking as a reference that having the lowest attack rate. RESULTS: A total of nineteen (18 and 1 respectively) cases of scabies were detected among the 104 residents and 20 workers employed at the facility. The source of the outbreak could not be specifically determined, although at least two of the first cases had begun to show some symptoms six months prior to their detection. The average delay in diagnosis was 53 days. This outbreak had a greater effect on the males in the assisted living quarters (TA = 77%; RR = 18.5, C195% = 2.7-128.7). The only employee affected was the person in charge of this area, who had not employed the universal personal protection measures during his caregiving tasks. CONCLUSIONS: This is a scabies outbreak at a senior citizen living facility, probably due to the delay in diagnosing the first cases and the failure on the part of one caregiver to have employed the personal protection measures. A specific scabies-prevention protocol having been implemented was fundamental for the control of this outbreak.

Aged↗
PubMed2000

Scabies and head-lice infestations in different environmental conditions of Lower Silesia, Poland.

A comparison of external parasitic infestations among inhabitants of Legnica, Wałbrzych, and Wrocław districts, in the Lower Silesia region of Poland showed a direct relationship between the high incidence of scabies and low standard ecological indices, as well as social economic setting of the communities. In the years 1990-1997, the highest mean incidences of scabies per 100,000 people (80 and 46) were noted, respectively, in the Legnica and Wałbrzych districts, compared to only 7.9 in the Wrocław district. Infestation was correlated with percentages of the population with higher education (4.8; 4.2, 10.1, respectively) and the number of patients per physician (795, 632, 288, respectively), and the percentages of degraded land/and land threatened by degradation (10/37, 5/16, 0.7/10, respectively), forest stands damaged by gases and particulates (99.4, 99.4, 58.8, respectively), and air pollution emission indices in the towns of Legnica and Wałbrzych (30 and 21 tons/km2) and Wrocław (16). Scabies infestation was highest in children and teenagers (0-19) and was gender-associated (in all age groups, women were more often infested than men). A decreasing rate of scabies infestation, especially from the mid-1990s, was noted for both scabies and pediculosis in Wałbrzych district; in the 0-19-yr-old inhabitants, it varied from 0.75% in 1994 to 0.41% in 1996.

Adolescent↗
PubMed2004

[Nosocomial infection of scabies in national hospitals and sanatoria in Japan].

The aim of this study was to investigate cases of nosocomial infection of scabies in the national hospitals in Japan. Questionnaires sent to 183 hospitals and sanatoria were returned by 93. Fifty-three cases in 24 institutions of nosocomial infection were reported in the past 5 years. No nosocomial infection was reported from 7 sanatoria for Hansen's diseases where the patients were relatively older and had higher ADL scores. It took 7.5 weeks on the average to eliminate nosocomial infection and more than 8 weeks were required to control them in the hospitals where more than 10 cases had occurred. Benzyl benzoate, gamma benzene hexachloride, and Pyrethroids, which were not approved as drugs for the treatment of scabies in Japan, were used in the all institutions where nosocomial infection occurred except for one institution. Problems to be solved were as follows; (1) delay of diagnosis and treatment, (2) lack of nursing staff, (3) difficulties of complete isolation due to lack of spaces, inability of patients to understand the need for isolation and also the psychological instability of the isolated patients, (4) recurrence due to the use of ineffective drugs, (5) insufficient information about the prevalence of scabies in the previous institutions, (6) misdiagnosis of non-scabies patients with itchy skin rash as the scabies, (7) inconsisitent care due to poor evaluation of skin lesions.

Aged↗
PubMedDate not supplied

[Crusted (Norwegian) scabies in Dakar (Senegal)].

Between January 1993 and June 1997, 30 patients with crusted scabies were seen at the dermatological clinic in Dakar (Senegal). Seventeen of these patients were male and 13 were female. Six were children aged 5 to 15 years and 24 were adults aged 18 to 70 years. Diagnosis of crusted scabies was straightforward because this condition, which was rare in Dakar before 1990, has become much more common and is now familiar to Senegalese dermatologists. The infection presented as an extensive scaly or crusted eruption with symmetrical lesions affecting the hands, feet, knees, elbows and ears in particular. Scalp involvement was reported in 25 patients. Erythrodermia was present in 4 cases and pachyonychia in 4 cases. Twenty-seven of the 30 patients had moderate or severe pruritus, whereas an absence of pruritus is regarded as a classical characteristic of crusted scabies. Diagnosis was readily confirmed by examination of hyperkeratotic material under the microscope: numerous mites and eggs were present. The two most common etiological factors were auto-immune diseases (6 cases, 4 of whom were receiving no steroid or other immunosuppressive treatment at the time of onset of crusted scabies) and malnutrition (5 of the 6 children in the study). The other associated conditions identified were: physical debilitation (4 cases), HIV infection (3), mental disability-Down's syndrome (3) and long term use of topical steroids for artificial depigmentation (2). Two patients were immunocompetent and 5 patients died shortly after diagnosis, before any underlying conditions could be identified. Seven patients were cured with benzyl benzoate. Seven others, all adults, received a single oral dose of ivermectin (200 mg/kg) and topical kerolytic drugs. Ivermectin was ineffective in 1 case, and an improvement was observed in another case, although a complete cure was achieved only after a second dose. The other patients were all cured and showed no signs of scabies one month after ivermectin treatment. A recurrence was observed in 3 patients a few months later however, suggesting that these patients were reinfected. No side effects were reported in any of the patients treated with ivermectin.

Adolescent↗
PubMed2001

[Scabies in a dalysis unit. Mystery and prejudice].

BACKGROUND: Pruritus is one of the most common symptoms of uremia. The etiology of uremic pruritus is steel incompletely known. Scabies may be a cause of itching in these patients. METHODS: Retrospective analysis of beginning and developing of a scabies outbreak in a Dialysis Unit with 160 patients. RESULTS: Sixteen cases of scabies were observed in the Dialysis Unit from April 1998 and January 1999: in 6 of them the scarification was positive. In 10 the scarification was negative, but itching disappeared after treatment with benzyl benzoate 20%. Many courses were necessary (max 6). Prophylaxis (treatment with benzyl benzoate 20% for 3 days and lingery cleaning) was applied to approximately 400 people. No cases were observed among health care workers of the Dialysis Unit. CONCLUSIONS: In a Dialysis Unit the diagnosis of scabies is difficult because the patients often have generalized itching; moreover some of them are affected by neuropathy that may make the infestation of scabies more difficult to identify. The most important factor to limitate the outbreak seems to be the prophylaxis of people who take care of patients (health-care workers, family members and car-drivers). It seems also necessary to repeat the treatments many times. The most exposed patients seemed to be those with diminished independence, diabetes and malnutrition.

Cross Infection↗
PubMed2002

Ivermectin: new indication. Oral treatment of scabies: simple and effective.

(1) Ivermectin is the first oral drug to be licensed in France for the treatment of scabies. (2) In common scabies, three small trials suggest that ivermectin is about as effective as topical preparations. (3) Several cohort studies have shown that ivermectin can control outbreaks of scabies (especially in institutions) and also in endemic areas. (4) There are no clinical trial data on ivermectin in crusted scabies. Case series suggest that combining ivermectin with topical treatments may increase efficacy. (5) Ivermectin seems to have few, mostly mild short-term side effects in adults. There are no reports of ivermectin treatment in infants weighing less than 15 kg or in breast-feeding infants. Data on about 400 pregnant women treated with ivermectin are reassuring. (6) In a small cohort of elderly patients, ivermectin used after topical preparations coincided with excess mortality 6 months later. Subsequent studies were reassuring, but all adverse events (including death) in elderly patients treated with ivermectin must none the less be notified. (7) In practice, oral ivermectin is effective against scabies and is thus an alternative to topical treatments. Its single-dose administration facilitates treatment, especially during outbreaks.

Administration, Oral↗
PubMed2003

A comparative study between 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride gel in the treatment of scabies in children.

BACKGROUND: Scabies is a common contagious skin disease in children. Treatment of scabies in infants and children is the subject of worldwide concern because of risk and benefit of the variety of scabicides. OBJECTIVE: To compare the efficacy of 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride gel for the treatment of scabies in children. METHOD: A randomized investigator blind study was conducted to compare the efficacy of 10 per cent sulfur ointment and 0.3 per cent gamma benzene hexachloride (GBH) for the treatment of scabies in children at Queen Sirikit National Institute of Child Health from December 1999 to May 2000. Diagnosis was made by the clinical signs of excoriated papules in the classic distribution with nocturnal pruritus and family history of similar symptoms. Diagnosis for all patients was confirmed by positive skin scrapings for eggs, larva, mites or fecal pellets by light microscopy. Patients were followed-up at intervals of 2 and 4 weeks. RESULTS: One hundred children with an age range from 6 months to 13 years were randomized into 2 groups, 10 per cent sulfur group (50 cases) and 0.3 per cent GBH (50 cases). Age, sex, history of contact cases and clinical manifestations were not statistically different between the two groups. After 4 weeks of treatment, there were no statistical differences between the two groups in patients assessed cured (92% vs 94%), clinical cure (92% vs 91%) and parasitic cure (83% vs 84%). The adverse effect of foul odor in the sulfur group was more common than in the GBH group (p < 0.05). CONCLUSION: 10 per cent sulfur ointment is as safe and efficacious as 0.3 per cent GBH for the treatment of scabies in children.

Administration, Topical↗
PubMed2004

[Successful treatment of Norwegian scabies with ivermectin in a patient with recessive dystrophic epidermolysis bullosa].

A 14 year-old female born from consanguineous healthy parents was admitted to our institute for the presence of a generalized bullous eruption started at birth. The bullae were asymmetrically distributed all over the cutaneous surface and, over time, evolved into erosions that resolved with scarring areas. On the basis of the clinical picture and the ultrastructural and antigenic studies, a diagnosis of recessive dystrophic epidermolysis bullosa was made. In the following months, the patient began to complain a severe pruritus and the bullae and erosions were accompanied with diffuse erythematous patches and plaques covered by thick scale-crusts situated mostly on the arms. Microscopic examination of the scales revealed the presence of many mites and ova. Since the conventional topical therapies for scabies were uneffective, the patient was treated with a single dose (200 mcg/hg) of ivermectin. Although there was an initial improvement, scabies recurred within 2 months from discontinuation of the therapy. Finally, a further single administration of ivermectin at the same dosage led to the complete and permanent resolution of scabies. The association of recessive dystrophic epidermolysis bullosa and norwegian scabies has been already reported in literature. The case presented suggests that ivermectin represents an effective drug for severe forms of scabies occurring in patients affected by other dermatoses that prevent the use of topical treatments.

Adolescent↗
PubMed2005

Norwegian scabies in Peru: the impact of human T cell lymphotropic virus type I infection.

Isolates cases and groups of patients co-infected with human T cell lymphotropic virus type I (HTLV-I) and Norwegian scabies have been previously reported. Peru is considered to be endemic for HTLV-I. Between June 1999 and December 2000, 23 patients with Norwegian scabies were enrolled in this study after written informed consent was obtained. Antibodies against HTLV-I were detected by an enzyme-linked immunosorbent assay and confirmatory Western blot. Patients ranged in age from 3 months to 84 years; 15 (65.2%) were female. Infection with HTLV-I was found in 16 (69.6%) patients. Comorbid features included corticosteroid therapy (8.6%), malnutrition (8.6%), and Down's syndrome (4.3%). Among those who consented to be tested for human immunodeficiency virus (n = 13, 56.5%), no one had a positive result. The three patients that reported one or more prior episodes of Norwegian scabies were infected with HTLV-I and two of these HTLV-I-positive patients died. Infection with HTLV-I is an important co-factor related to Norwegian scabies in Peru. In our setting, the evaluation for HTLV-I in all Norwegian scabies cases is highly recommended, especially when no other risk factors are apparent.

Adolescent↗
PubMed2006

[Norwegian scabies, a rare diagnosis in Tunisia].

UNLABELLED: Norwegian scabies is a particular form of scabies, rarely reported in Tunisia. It habitually occurs in immunocompromised hosts, with prolonged immunosuppressive therapy, congenital immune disease, HIV-1 infection or neoplasm. We report an observation of norwegian scabies, occuring in a woman with prolounged systemic corticosteroid therapy. OBSERVATION: A 65-year-old woman, with a long history of obstructive bronchoneumopathy and bronchiectasis, treated with systemic corticosteroids for 5 years, was referred with a mild pruriginous and scaly erythroderma. This dermatosis developed within 5 months, with fever and impairing of health. Skin parasitological exams showed a massive infestation by sarcoptes. Histologic findings revealed multiple sarcoptes scabiei and eggs in the stratum corneum. The patient was treated with benzyl benzoate during 48 hours. She died rapidly with acute respiratory distress. DISCUSSION: basing on this observation of norwegian scabies occuring in an old immunocompromised woman, we put the accent on this particular form of scabies, often misappreciated, and incite to practice skin and nail parasitological exams in case of mild pruriginous, chronic scaly erythroderma. developing in immunocompromised patients.

Benzoates↗
PubMed1991

[Pyrethrin and pyrethroid (permethrin) in the treatment of scabies and pediculosis].

The history and development of pyrethrum, the natural pyrethrins and synthetic pyrethroids and their insecticidal properties, chemical structure and toxic and allergic side-effects are reported. Permethrin is stressed as a photostable insecticide that is very effective against a large variety of insects and mites with low mammalian toxicity and virtually no allergic side-effects. Only 10-20 min after application, permethrin (1% cream rinse or 0.5% in ethanol) proved to be safe, reliable and cosmetically acceptable in the treatment of infestations with head lice and the prevention of reinfestations, and also in failures with lindane owing to the development of tolerance in the lice. The same was true of 5% permethrin cream (2.5% in children below 5 years of age) used in the treatment of scabies. Permethrin is absorbed percutaneously in only small amounts, is metabolized rapidly in the skin and excreted in the urine. A single "head to toe" application is ideal for eradication programmes allowing lice to be targetted and the prevalence of secondary bacterial infections decreased at the same time. Benzyl benzoate has an irritant potential, and lindane has been reported to exert CNS toxicity in a few anecdotal cases, in particular in small children or after repeated applications in patients with scabies crustosa, and permethrin was distinctly superior to both of these. This is documented by the results obtained in the treatment of 48 children and 56 adults suffering from scabies. Permethrin is recommended in scabies therapy in premature infants, small children, patients with seizures and neurological complications, in treatment failures with lindane entailing the need to repeat the therapy, in scabies crustosa and in pregnant women and nursing mothers.

Adolescent↗