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Nguyen HTG, Le HLH, Nguyen HV, Le HM, Vu HL, Inaoka PT, Tetsuo O, Ly QT, Espinoza JL. Exploring Blood Cell Count-Derived Ratios as Practical Diagnostic Tools for Scabies in Vulnerable Populations. J Pers Med 2024; 14:373. [PMID: 38673000 PMCID: PMC11050978 DOI: 10.3390/jpm14040373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/15/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Scabies is a neglected tropical disease and represents a considerable global burden. Although consensus diagnostic criteria for scabies have been recently published, diagnosing scabies infestation remains challenging in clinical practice. We investigated the diagnostic utility of complete blood cell count (CBC) and CBC-derived ratios obtained at diagnosis in a set of 167 patients who are Vietnamese with confirmed scabies. These parameters were compared with those of patients with dermatophytosis (N = 800) and urticaria (N = 2023), two diseases frequent in Vietnam, which can present with similar skin manifestations to scabies and tend to pose a diagnostic challenge in vulnerable populations. Our analysis revealed that white blood cell, monocyte, and eosinophil counts were significantly higher among patients with scabies than the other two diseases. Similarly, the monocyte-to-lymphocyte ratio (MLR) and eosinophil-to-lymphocyte ratio (ELR) were significantly higher among patients with scabies. The optimal cut-off values to distinguish scabies from dermatophytosis and urticaria were 0.094 for ELR (sensitivity: 74.85%, specificity: 70.7%) and 0.295 for MLR (sensitivity: 52.69%, specificity: 73.54%). CBC, ELR, and MLR are low-cost and easily calculated parameters that may be helpful for the diagnosis of scabies.
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Affiliation(s)
- Hoang Thao Giang Nguyen
- Faculty of Health Sciences, Kanazawa University, Kanazawa 920-0942, Ishikawa, Japan; (H.T.G.N.); (P.T.I.)
| | - Ha Long Hai Le
- Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi 100000, Vietnam
- Faculty of Medical Technology, Hanoi Medical University, Hanoi 116001, Vietnam;
| | - Hoang Viet Nguyen
- Faculty of Medical Technology, Hanoi Medical University, Hanoi 116001, Vietnam;
| | - Huyen My Le
- Department of Biochemistry, Hematology and Immunology, National Hospital of Dermatology and Venereology, Hanoi 100000, Vietnam
| | - Huy Luong Vu
- Department of Laser and Skin Care, National Hospital of Dermatology and Venereology, Hanoi 116001, Vietnam
| | - Pleiades T. Inaoka
- Faculty of Health Sciences, Kanazawa University, Kanazawa 920-0942, Ishikawa, Japan; (H.T.G.N.); (P.T.I.)
| | - Ota Tetsuo
- Faculty of Health Sciences, Kanazawa University, Kanazawa 920-0942, Ishikawa, Japan; (H.T.G.N.); (P.T.I.)
| | - Quoc Trung Ly
- Soctrang Hospital for Women and Children, Soc Trang 950000, Vietnam;
| | - J. Luis Espinoza
- Faculty of Health Sciences, Kanazawa University, Kanazawa 920-0942, Ishikawa, Japan; (H.T.G.N.); (P.T.I.)
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Alberfkani MI, Mero WMS. The Incidence of Scabies and Head Lice and Their Associated Risk Factors among Displaced People in Cham Mishko Camp, Zakho City, Duhok Province, Iraq. Pol J Microbiol 2021; 69:463-469. [PMID: 33574874 PMCID: PMC7812363 DOI: 10.33073/pjm-2020-050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/04/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022] Open
Abstract
This study was conducted to estimate the incidence and the effects of associated risk factors of scabies and head lice on displaced people in Cham Mishko camp, Zakho city, Duhok Province, Iraq. The study included 1300 internally displaced people (IDPs) who visited the dermatology clinic and health care center in Cham Mishko camp from January 2018 to December 2019. Participants' bio-information was collected on special questionnaire form after receiving permission from the camp's health authorities and verbal consent from the participants. Monthly weather data were collected from Duhok Directorate of Meteorology and Seismology. The total rate of ectoparasites was 81.2% (45% for scabies and 36.2% for head lice). Ages from 1-10, 21-30, and 31-40 years showed the highest rates with scabies (48.1%, 46.7% and 46.1%, respectively), while the highest rates of head pediculosis were at ages from 1-10 and 11-20 years (40% and 36.6%, respectively). Scabies rate was slightly higher in males than females (46.6% vs. 43.4%), while the rate of head pediculosis was significantly higher in females than males (58.2% vs. 13.9%). Families with more than ten people showed the highest rates of scabies and head pediculosis (49.5% and 74.5%). Scabies was more common in cold months than in summer while head pediculosis was more common in hot months. The number of scabies and head pediculosis cases increased by 123 and 85 cases, respectively, in 2019. It is inferred that the effects of scabies and head pediculosis in IDPs will be considerable, with a higher carriage rate than other studies in Iraq.
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Affiliation(s)
| | - Wijdan M S Mero
- Department of Biology, Faculty of Science University of Zakho, Zakho, Duhok, Iraq
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Tai DBG, Abu Saleh O, Miest R. Genital nodular scabies. IDCases 2020; 22:e00947. [PMID: 32963963 PMCID: PMC7490806 DOI: 10.1016/j.idcr.2020.e00947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022] Open
Abstract
Nodular scabies is a less common manifestation of scabies. It is characterized by firm, erythematous, pruritic nodules, often involving the genitalia. Diagnosis can be made clinically, and first-line treatment is topical permethrin or oral ivermectin.
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Gopinath H, Karthikeyan K. Genital scabies: Haven of an unwelcome guest. Indian J Sex Transm Dis AIDS 2020; 41:10-16. [PMID: 33062975 PMCID: PMC7529175 DOI: 10.4103/ijstd.ijstd_69_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/10/2018] [Accepted: 12/30/2019] [Indexed: 11/04/2022] Open
Abstract
The itch mite Sarcoptes scabiei var. hominis has been a menace to humanity for ages. Diagnosing scabies can be a challenge in view of the varied presentations of the disease. The male genitalia are an important area of predilection of the mite. Examination of this often overlooked area is essential as it may reveal both characteristic and atypical manifestations of scabies. Genital involvement also attains special relevance in view of the possible sexual transmission of the mite. In addition to the morbidity caused by itching, patients may have to deal with myths, stigma, and embarrassment.
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Affiliation(s)
- Hima Gopinath
- Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Niedringhaus KD, Brown JD, Sweeley KM, Yabsley MJ. A review of sarcoptic mange in North American wildlife. Int J Parasitol Parasites Wildl 2019; 9:285-297. [PMID: 31304085 PMCID: PMC6599944 DOI: 10.1016/j.ijppaw.2019.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 01/27/2023]
Abstract
The "itch mite" or "mange mite", Sarcoptes scabiei, causes scabies in humans and sarcoptic mange in domestic and free-ranging animals. This mite has a wide host range due to its ability to adapt to new hosts and has been spread across the globe presumably through human expansion. While disease caused by S. scabiei has been very well-studied in humans and domestic animals, there are still numerous gaps in our understanding of this pathogen in free-ranging wildlife. The literature on sarcoptic mange in North American wildlife is particularly limited, which may be due to the relatively limited number of clinically-affected species and lack of severe population impacts seen in other continents. This review article provides a summary of the current knowledge of mange in wildlife, with a focus on the most common clinically-affected species in North America including red foxes (Vulpes vulpes), gray wolves (Canis lupus), coyotes (Canis latrans), and American black bears (Ursus americanus).
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Affiliation(s)
- Kevin D. Niedringhaus
- Southeastern Cooperative Wildlife Disease Study, 589 D.W. Brooks Drive, Wildlife Health Building, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | - Justin D. Brown
- Department of Veterinary and Biomedical Sciences, 115 Henning Building, Pennsylvania State University, University Park, PA, 16802, USA
| | - Kellyn M. Sweeley
- College of Veterinary Medicine, 501 D.W. Brooks Drive, University of Georgia, Athens, GA, 30602, USA
| | - Michael J. Yabsley
- Southeastern Cooperative Wildlife Disease Study, 589 D.W. Brooks Drive, Wildlife Health Building, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
- Warnell School of Forestry and Natural Resources, 180 E Green Street, University of Georgia, Athens, GA, 30602, USA
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Arnaud A, Chosidow O, Détrez M, Bitar D, Huber F, Foulet F, Le Strat Y, Vandentorren S. Prevalences of scabies and pediculosis corporis among homeless people in the Paris region: results from two randomized cross‐sectional surveys (HYTPEAC study). Br J Dermatol 2015; 174:104-12. [DOI: 10.1111/bjd.14226] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 11/28/2022]
Affiliation(s)
- A. Arnaud
- Observatoire du Samusocial de Paris 35 Avenue Courteline 75012 Paris France
- French Institute for Public Health Surveillance Saint‐Maurice France
| | - O. Chosidow
- Department of Dermatology AP‐HP Hôpital Henri Mondor Créteil France
- Université Paris‐Est Créteil Val de Marne (UPEC) Créteil France
- CIC INSERM 1430 and EA EpiDermE (Epidemiology in Dermatology and Evaluation of Therapeutics) Créteil France
| | - M.‐A. Détrez
- Observatoire du Samusocial de Paris 35 Avenue Courteline 75012 Paris France
| | - D. Bitar
- French Institute for Public Health Surveillance Saint‐Maurice France
| | - F. Huber
- Observatoire du Samusocial de Paris 35 Avenue Courteline 75012 Paris France
| | - F. Foulet
- Department of Dermatology AP‐HP Hôpital Henri Mondor Créteil France
| | - Y. Le Strat
- French Institute for Public Health Surveillance Saint‐Maurice France
| | - S. Vandentorren
- Observatoire du Samusocial de Paris 35 Avenue Courteline 75012 Paris France
- French Institute for Public Health Surveillance Saint‐Maurice France
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Abstract
PURPOSE OF REVIEW Features of endemic scabies are specific in resource-poor and underprivileged communities, with implications for control measures on the community level. In this review, these special aspects are addressed. RECENT FINDINGS Scabies is endemic in many resource-poor communities, with a prevalence of 20% and higher. Transmission is influenced by social attitudes, migration, access to healthcare services, housing conditions, hygiene conditions, and crowding. Endemic scabies occurs with severe infestations, complications, and sequels, mainly in children. Sleep loss as a result of scabies-related itching is common. Complications include secondary infections by group A streptococci and acute poststreptococcal glomerulonephritis. Shame, restriction of leisure activities, and stigmatization are common. Treatment of scabies includes a variety of topical compounds, but control on the community level is not an easy task. As ivermectin kills a variety of other parasites, this oral drug is increasingly used for mass treatment. Intervention should address socioemotional aspects using an integrated approach with professionals from different areas, and the community. SUMMARY Scabies is a neglected disease and needs to be perceived as an important public health problem causing morbidity in many resource-poor communities. Future work on epidemiology, clinical aspects, transmission dynamics, socioeconomic aspects, and sustainable control in resource-poor communities is needed.
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Foo CW, Florell SR, Bowen AR. Polarizable elements in scabies infestation: a clue to diagnosis. J Cutan Pathol 2012; 40:6-10. [DOI: 10.1111/cup.12035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 09/25/2012] [Accepted: 09/27/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Chong Wee Foo
- Department of Dermatology; University of Utah; Salt Lake City; UT; USA
| | - Scott R. Florell
- Department of Dermatology; University of Utah; Salt Lake City; UT; USA
| | - Anneli R. Bowen
- Department of Dermatology; University of Utah; Salt Lake City; UT; USA
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Abstract
Scabies is an ectoparasite caused by the mite Sarcoptes scabiei var hominis, an obligate human parasite. There are about 300 million cases of scabies in the world each year. Common predisposing factors are overcrowding, immigration, poor hygiene, poor nutritional status, homelessness, dementia, and sexual contact. Direct skin-to-skin contact between 15 and 20 minutes is needed to transfer the mites from one person to another. The diagnosis suspected with a clinical history of itch, worse at night, affecting other family members, clinical distribution, and appearance. Definite diagnosis relies on microscopic identification of the mites, eggs, or fecal pellets with 10% potassium hydroxide, ink enhancement, tetracycline fluorescence tests, or mineral oil; other methods include: epiluminescence light microscopy and S. scabiei DNA. The most commonly used treatment modalities are permethrin and ivermectin. Persistence of symptoms for 2-6 weeks after successful treatment is common. Most recurrences are because of reinfection from untreated contacts.
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Affiliation(s)
- Maria I Hicks
- Geisinger Dermatology, Danville, Pennsylvania 17822, USA.
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Lepe Jiménez JA, Otero Guerra L, Blanco Galán MA, Aznar Martín J, Vázquez Valdés F. [Update on the epidemiology, diagnosis and treatment of sexually-transmitted infections]. Enferm Infecc Microbiol Clin 2008; 26 Suppl 13:25-31. [PMID: 19100164 DOI: 10.1157/13128777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In the last decade, cases of sexually-transmitted infections (STIs) have progressively increased in Europe. The reasons for this increase are unclear, but may involve changes in social behavior, migration and international travel, coupled with the emergence of risk groups that have not been taken into sufficient consideration to date. The routine use of molecular diagnostic techniques for many of these infections has solved many problems of sensitivity and the suitability of samples for microbiological diagnosis: non-invasive samples can be used, which has undoubtedly contributed to the increase in the number of cases. Moreover, molecular methods have also been introduced for antibiotic and antiviral susceptibility testing, as well as for molecular characterization of clinical isolates. All of these factors, together with the approval of the vaccine against the human papillomavirus, have changed the landscape of STIs across Europe.
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The epidemiology of scabies in an impoverished community in rural Brazil: presence and severity of disease are associated with poor living conditions and illiteracy. J Am Acad Dermatol 2008; 60:436-43. [PMID: 19064303 DOI: 10.1016/j.jaad.2008.11.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 10/27/2008] [Accepted: 11/05/2008] [Indexed: 11/21/2022]
Abstract
BACKGROUND We sought to study the epidemiology of scabies and to identify risk factors of severe disease in an impoverished rural community in northeast Brazil. METHODS The study was designed as a repeated cross-sectional study based on two door-to-door surveys. One survey was carried out in the rainy season, the other in the dry season. The inhabitants of the community were examined for the presence of scabies and demographic, socioeconomic, and behavioral risk factors were assessed. Risk factors were analyzed using bivariate and multivariate regression analysis. RESULTS The overall prevalence was 9.8% with no significant variation between seasons and the incidence was estimated to be 196/1000 person-years. The highest prevalence (18.2%) was observed in children younger than 4 years. Risk factors in the bivariate analysis were young age, presence of many children in the household, illiteracy, low family income, poor housing, sharing clothes and towels, and irregular use of shower. Age younger than 15 years, illiteracy, sharing of clothes, and living in the community for more than 6 months remained significant independent risk factors in multivariate regression analysis. LIMITATIONS We used a clinical case definition; specificity and sensitivity were not verified. Men were underrepresented in the study population. CONCLUSIONS In this impoverished community scabies is an important health problem characterized by continuous transmission throughout the year. The parasitic skin disease is embedded in a complex web of causation characterized by poor living conditions and a low level of education.
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Arlian LG, Fall N, Morgan MS. In vivo evidence that Sarcoptes scabiei (Acari: Sarcoptidae) is the source of molecules that modulate splenic gene expression. JOURNAL OF MEDICAL ENTOMOLOGY 2007; 44:1054-1063. [PMID: 18047206 DOI: 10.1603/0022-2585(2007)44[1054:ivetss]2.0.co;2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The clinical signs of a Sarcoptes scabiei (De Geer) (Acari: Sarcoptidae) infestation are initially delayed, which suggests that the mites can depress the immune/inflammatory response. The purpose of this study was to investigate the modulatory properties of scabies mites in vivo at the gene expression level in a secondary lymphoid organ that is involved in initiating an immune response to the parasite. We found that substances from scabies mites influenced the expression of mRNA for molecules that participate in the sequestering of lymphocytes in the periarteriolar lymphoid sheath, primary follicle, and marginal zone of the spleen. Mice exposed to live scabies mites exhibited decreased mRNA expression for the adhesion molecules intercellular adhesion molecule (ICAM)-1, ICAM-2 and L-selectin; the cytokines tumor necrosis factor (TNF)alpha and CCL5; and the receptors for several other cytokines including TNF and interferon gamma. In addition, exposure to live mites or vaccination with a scabies extract resulted in reduced expression of mRNA for B7-2, CD40, CD4, CD8, and CD45, thereby potentially reducing the physical interactions between B cells and T-helper (Th)2 helper cells, between Th1 and Tc cells, and between T-helper cells and antigen-presenting cells, thus depressing their function in response to thymus-dependent antigen. Live scabies mites also depressed expression of toll-like receptors 2, 4, and 6. In conclusion, our results indicate that live mites produce substances that can down-regulate expression of adhesion molecules, cytokines, chemokines, chemokine receptors, and lymphocyte surface molecules involved in leukocyte sequestering and the interaction of B and T cells during activation of an immune response in the spleen.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, Dayton, OH 45435, USA.
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Vorou R, Remoudaki HD, Maltezou HC. Nosocomial scabies. J Hosp Infect 2007; 65:9-14. [PMID: 17141368 DOI: 10.1016/j.jhin.2006.08.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Accepted: 08/29/2006] [Indexed: 11/25/2022]
Abstract
Scabies is a parasitic dermatosis with a worldwide distribution. This infestation affects millions of people annually and may cause large nosocomial outbreaks with considerable morbidity among patients and healthcare workers. Immunocompromised or elderly institutionalized patients admitted with unrecognized crusted scabies are the main source of nosocomial transmission. Factors that facilitate the development of hospital-acquired scabies and nosocomial epidemics are: poor knowledge of scabies epidemiology, unfamiliarity of healthcare workers with atypical presentations, long incubation period, diagnostic delay and incomplete monitoring. Within hospitals, containment of an outbreak relies on the strict implementation of appropriate infection control measures and treatment administration to contacts. It is associated with a considerable working and economic burden.
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Affiliation(s)
- R Vorou
- Department of Epidemiological Surveillance, Hellenic Centre for Disease Control and Prevention, Athens, Greece
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15
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Abstract
Sexually transmitted infections are an important aspect of clinical care for adolescents. Recognition of common STI syndromes allows more efficient diagnosis and treatment. Prevention of infections by counseling, provision of condoms, periodic screening of at-risk teens, and treatment of partners all contribute to the sexual health of adolescent patients.
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Affiliation(s)
- J Dennis Fortenberry
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis IN, USA
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