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Uzun S, Durdu M, Yürekli A, Mülayim MK, Akyol M, Velipaşaoğlu S, Harman M, Taylan-Özkan A, Şavk E, Demir-Dora D, Dönmez L, Gazi U, Aktaş H, Aktürk AŞ, Demir G, Göktay F, Gürel MS, Gürok NG, Karadağ AS, Küçük ÖS, Turan Ç, Ozden MG, Ural ZK, Zorbozan O, Mumcuoğlu KY. Clinical practice guidelines for the diagnosis and treatment of scabies. Int J Dermatol 2024. [PMID: 38922701 DOI: 10.1111/ijd.17327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.
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Affiliation(s)
- Soner Uzun
- Department of Dermatology and Venereology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Murat Durdu
- Department of Dermatology, Adana Dr. Turgut Noyan Application and Research Center, Başkent University Faculty of Medicine, Adana, Turkey
| | - Aslan Yürekli
- Training and Research Hospital Dermatology Department, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mehmet K Mülayim
- Faculty of Medicine, Department of Dermatology and Venereology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Melih Akyol
- Department of Dermatology and Venereology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Sevtap Velipaşaoğlu
- Department of Social Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mehmet Harman
- Department of Dermatology and Venereology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Ayşegül Taylan-Özkan
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - Ekin Şavk
- Department of Dermatology and Venereology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Devrim Demir-Dora
- Department of Medical Pharmacology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Levent Dönmez
- Department of Public Health, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Umut Gazi
- Department of Medical Microbiology and Clinical Microbiology, Near East University, Nicosia, Cyprus
| | - Habibullah Aktaş
- Department of Dermatology and Venereology, Karabük University Faculty of Medicine, Karabük, Turkey
| | - Aysun Ş Aktürk
- Department of Dermatology and Venereology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Gülay Demir
- Vocational School of Health Services, Sivas Cumhuriyet University, Sivas, Turkey
| | - Fatih Göktay
- Private Dermatology and Venereology Clinic, İstanbul, Turkey
| | - Mehmet S Gürel
- Department of Dermatology and Venereology, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Neşe G Gürok
- University of Health Sciences Fethi Sekin City Hospital, Dermatology and Venereology Clinic, Elazığ, Turkey
| | - Ayşe S Karadağ
- Private Dermatology and Venereology Clinic, İstanbul, Turkey
| | - Özlem S Küçük
- Department of Dermatology and Venereology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Çağrı Turan
- Department of Dermatology and Venereology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Müge G Ozden
- Department of Dermatology, Ondokuz Mayıs University Medical Faculty, Samsun, Turkey
| | - Zeynep K Ural
- Department of Dermatology and Venereology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Orçun Zorbozan
- Department of Medical Parasitology, Bakırcay University Faculty of Medicine, İzmir, Turkey
| | - Kosta Y Mumcuoğlu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, the Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Vázquez-Prieto S, Vaamonde A, Paniagua E. Study of the Use of Permethrin 5% Cream in Galicia (Spain) between 2018 and 2021. Infect Dis Rep 2023; 15:222-230. [PMID: 37102983 PMCID: PMC10138315 DOI: 10.3390/idr15020023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Drug utilization studies can provide direct insights into how a drug is used in real-world conditions and can give a rough estimate of the proportion of the study population treated with it. In the present work, we examined the consumption of permethrin 5% cream in the four provinces of Galicia (a Spanish autonomous community) and described the seasonal variability and the annual evolution of its consumption between 2018 and 2021. A descriptive, cross-sectional, and retrospective study of the consumption of this drug, expressed in defined daily dose per 1000 inhabitants per day (DID), was carried out. The results obtained revealed differences between the amounts consumed in the four Galician provinces (p < 0.001). No specific geographical pattern was observed; however, the results suggested a marked seasonality and a slightly increasing global trend in the consumption of permethrin 5% cream throughout the study period. Since the only authorized indication of this drug in the study area is the treatment of scabies, this work may give an idea of the epidemiological situation of the disease in Galicia and serve to establish public health strategies against this parasitosis.
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Affiliation(s)
- Severo Vázquez-Prieto
- Universidad de Los Lagos, Osorno, Chile
- Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - Antonio Vaamonde
- Departamento de Estadística e Investigación Operativa, Universidad de Vigo, 36310 Vigo, Spain
| | - Esperanza Paniagua
- Laboratorio de Parasitología, Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain
- Instituto de Investigación en Análisis Químicos y Biológicos (IAQBUS), Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. [Translated article] Epidemic Scabies: New Treatment Challenges in an Ancient Disease. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T132-T140. [PMID: 36462668 DOI: 10.1016/j.ad.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
Scabies which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications, such as spinosad or, especially, moxidectin, offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - A Boada
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. Epidemic Scabies: New Treatment Challenges in an Ancient Disease. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:132-140. [PMID: 35963332 DOI: 10.1016/j.ad.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
Scabies, which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications -such as spinosad or, especially, moxidectin- offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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