Scabies outbreak in Turkey in 2018-2019

Clinical practice guidelines for the diagnosis and treatment of scabies

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.

Increased Scabies Incidence at the Beginning of the 21st Century: What Do Reports from Europe and the World Show?

Reports from various countries have described increasing numbers of scabies cases, especially in the past two decades. The epidemiological data for various world regions showed prevalence estimates ranging from 0.2% to 71%, with the highest prevalence in the Pacific region and Latin America. Therefore, geographically, scabies occurs more commonly in the developing world, tropical climates, and in areas with a lack of access to water. According to results from specific regions of the world, the greatest burdens from scabies were recorded for East Asia, Southeast Asia, Oceania, tropical Latin America, and South Asia. Among countries with the highest rates, the top 10 were Indonesia, China, Timor-Leste, Vanuatu, Fiji, Cambodia, Laos, Myanmar, Vietnam, and the Seychelles. From Europe, available data shows an increasing trend in scabies infestation, particularly evident among populations with associated contributing factors, such as those who travel frequently, refugees, asylum seekers, those who regularly lack drinking water and appropriate hygiene and are of a younger age, etc. This increase in observed cases in the last 10–20 years has been evidenced by research conducted in Germany, France, Norway, and Croatia, among other countries. In addition, increased scabies transmission was also recorded during the COVID-19 pandemic and may have been the result of increased sexual intercourse during that time. Despite all the available treatment options, scabies commonly goes unrecognized and is therefore not treated accordingly. This trend calls for a prompt and synergistic reaction from all healthcare professionals, governmental institutions, and non-governmental organizations, especially in settings where population migration is common and where living standards are low. Furthermore, the proper education of whole populations and accessible healthcare are cornerstones of outbreak prevention. Accurate national data and proper disease reporting should be a goal for every country worldwide when developing strategic plans for preventing and controlling the community spread of scabies.

Skabies insidansında artış: üçüncü basamak, retrospektif, tek merkez çalışması

Amaç: Son yıllarda bölgemizde gözlemlediğimiz skabies olgularındaki artışı ve skabies hastalarının demografik özelliklerini araştırmayı amaçladık. Gereç ve Yöntemler: Elazığ Fethi Sekin Şehir Hastanesi Dermatoloji Kliniğine Ocak 2019 ve Aralık 2021 tarihleri arasında başvuran ve skabies tanısı alan tüm hastalar retrospektif olarak değerlendirildi. Yaş, cinsiyet, vatandaşlık ve başvuru tarihleri hastane veri tabanından anonimleştirilerek elde edildi. Bulgular: 2019-2021 yılları arasında dermatoloji polikliniğine başvuran toplam 191.925 hastanın 2.898’ine skabies tanısı kondu. Bu üç yılda gözlenen skabies hasta sıklıklarının istatistiksel olarak anlamlı artış gösterdiği gözlendi (χ2:296.158 ; p:0.000