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Lause M, Libson K, Korman AM, Colburn N, Day S, Greer M, Hardgrow M, Malcolm K, Mcginnis M, Seely E, Smyer J, Trinidad J. Crusted scabies at a tertiary care center: Case series and cautionary tale. JAAD Case Rep 2023; 41:17-21. [PMID: 37842148 PMCID: PMC10568219 DOI: 10.1016/j.jdcr.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- Michael Lause
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Karissa Libson
- Ohio State University College of Medicine, Columbus, Ohio
| | - Abraham M. Korman
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Nora Colburn
- Department of Infectious Disease, Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Shandra Day
- Department of Infectious Disease, Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Marek Greer
- Occupational Health and Wellness, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Michele Hardgrow
- Occupational Health and Wellness, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kimberly Malcolm
- Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Marcy Mcginnis
- Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Elizabeth Seely
- Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Justin Smyer
- Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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2
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Skayem C, Majda A, Gary C, Hemery F, Mahé E, Caux F, Dupin N, Senet P, Greder-Belan A, Hillion B, Meni C, Saiag P, Bellaud G, Bleibtreu A, Lariven S, Bollens D, Descamps V, Molina JM, Bouchaud O, Vittecoq D, Do-Pham G, Foulet F, Botterel F, Chosidow O, Bernigaud C. Severe Scabies: A French Multi-centre Study Involving 95 Patients with Crusted and Profuse Disease and Review of the Literature. Acta Derm Venereol 2023; 103:adv00878. [PMID: 36861856 PMCID: PMC9993169 DOI: 10.2340/actadv.v103.5351] [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: 11/21/2022] [Accepted: 02/01/2023] [Indexed: 03/03/2023] Open
Abstract
The aim of this multi-centre French retrospective study was to identify severe, i.e. crusted and profuse, scabies patients. Records were retrieved from 22 Dermatology or Infectious Diseases departments in the Ile-de-France from January 2009 to January 2015 to characterize epidemiology, demography, diagnosis, contributing factors, treatment features, and outcomes in severe scabies. A total of 95 inpatients (57 crusted and 38 profuse) were included. A higher number of cases was observed among elderly patients (>75 years), mostly living in institutions. Thirteen patients (13.6%) reported a history of previously treated scabies. Sixty-three patients (66.3%) had been seen by a previous practitioner for the current episode (up to 8 previous visits). Initial misdiagnosis (e.g. eczema, prurigo, drug-related eruptions, psoriasis) was documented in 41 patients (43.1%). Fifty-eight patients (61%) had already received 1 or more previous treatments for their current episode. Forty percent received corticosteroids or acitretin for an initial diagnosis of eczema or psoriasis. Median time from the onset of symptoms to the diagnosis of severe scabies was 3 months (range 0.3-22). Itch was present in all patients at diagnosis. Most patients (n=84, 88.4%) had comorbidities. Diagnostic and therapeutic approaches varied. Complications occurred in 11.5% of cases. To date, there is no consensus for diagnosis and treatment, and future standardization of is required for optimal management.
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Affiliation(s)
- Charbel Skayem
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France.
| | - Askour Majda
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Charlotte Gary
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Francois Hemery
- Service d'Information Médicale, DSIGHM, APHP, Hôpital Henri-Mondor, Créteil, France
| | - Emmanuel Mahé
- Dermatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Frederic Caux
- Dermatology Department, APHP, Hôpital Avicenne, Bobigny, France
| | - Nicolas Dupin
- Dermatology Department, APHP, Hôpital Cochin, Pavillon Tarnier, Paris, France
| | - Patricia Senet
- Dermatology Department, APHP, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Alix Greder-Belan
- Service de Médecine Interne et Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier de Versailles, Hôpital Mignot, Le Chesnay, France
| | - Brigitte Hillion
- Dermatology Department, Centre Hospitalier Marne la Vallée, Jossigny, France
| | - Cecile Meni
- Dermatology Department, APHP, Hôpital Necker-Enfants malades, Paris, France
| | - Philippe Saiag
- Dermatology Department, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Guillaume Bellaud
- Infectious Diseases Department, APHP, Hôpital Tenon, Hôpitaux Universitaires Paris-Est, Paris, France
| | - Alexandre Bleibtreu
- Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Sylvie Lariven
- Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Diane Bollens
- Infectious Diseases Department, APHP, Hôpital Saint-Antoine, Paris, France
| | - Vincent Descamps
- Dermatology Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
| | - Jean-Michel Molina
- Infectious Diseases Department, APHP, Hôpital Saint-Louis, Paris, France
| | - Olivier Bouchaud
- Infectious Diseases Department, APHP, Hôpital Avicenne, Bobigny, France
| | - Daniel Vittecoq
- Infectious Diseases Department, APHP, CHU Bicêtre, Le Kremlin Bicêtre, France
| | - Gia Do-Pham
- Service de Médecine Interne, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Francoise Foulet
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Francoise Botterel
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - Olivier Chosidow
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
| | - Charlotte Bernigaud
- Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France.
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Abstract
Crusted scabies causes extensive hyperkeratotic skin lesions, crusting, and scaling and is common in elderly and institutionalized patients. We present a case of crusted scabies in a patient with encephalopathy and diffuse exfoliative erythroderma. After extensive workup, the patient’s condition was attributed to hypereosinophilic syndrome due to crusted scabies. Skin condition, mental status, and eosinophilia improved with high-dose steroids in conjunction with topical permethrin and oral ivermectin.
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Affiliation(s)
- Asis Shrestha
- Internal Medicine, Rochester Regional Health, Rochester, USA
| | - Edward Bischof
- Internal Medicine, Bassett Medical Center, Cooperstown, USA
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4
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Poortinga S, Paul C, Kunz J, Altengarten J, Hornung T, Bieber T. [Misdiagnosis of refractory hand and foot eczema in patient with crusted scabies under iatrogenic immunosuppression]. MMW Fortschr Med 2020; 162:51-53. [PMID: 32189258 DOI: 10.1007/s15006-020-0265-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Sietske Poortinga
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland.
| | - Cornelia Paul
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland
| | - Julia Kunz
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland
| | - Julia Altengarten
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland
| | - Thorsten Hornung
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland
| | - Thomas Bieber
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, D-53127, Bonn, Deutschland
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5
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Aukerman W, Curfman K, Urias D, Shayesteh K. Norwegian Scabies management after prolonged disease course: A case report. Int J Surg Case Rep 2019; 61:180-183. [PMID: 31376739 PMCID: PMC6677688 DOI: 10.1016/j.ijscr.2019.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction Scabies is a well – known, commonly recognized, and frequently diagnosed pathology especially in children, close quarters, living facilities, and immunocompromised patients. An accelerated severe infestation of traditional scabies with limited treatment options is known as the rare entity of Norwegian or Crusted Scabies. Case presentation We present the history, clinical manifestations, medical treatments and surgical interventions of a patient with Norwegian Scabies of his hands, which rendered them nonfunctional prior to intervention. The patient was initially misdiagnosed and underwent inappropriate treatments for several years prior to our assessment, and ultimately required surgical intervention that was therapeutic. Discussion Norwegian, or Crusted, Scabies is a severe infestation of S. scabiei in which the mite load is extreme in comparison to traditional scabies. This manifests as scaly plaques that are often misdiagnosed for other hyperkeratotic skin lesions. With this misdiagnosis, improper treatments are often recommended, and can even accelerate the manifestation. Traditional scabies therapies can be effective, however often due significant disease progression due to diagnostic delay, invasive measures, such as surgical debridement like presented here, are the only option. Conclusion The patient presented in this case harbored a rare infection, known as Norwegian Scabies, for several years, with inappropriate medical therapy. Due to his prolonged inadequate treatments, his disease became so pronounced that the recommended medical treatments were no longer adequate, thus he required surgical debridements which ultimately allowed him to regain function in his hands.
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Affiliation(s)
- William Aukerman
- Duke LifePoint Conemaugh Memorial Medical Center, Department of General Surgery, USA.
| | - Karleigh Curfman
- Duke LifePoint Conemaugh Memorial Medical Center, Department of General Surgery, USA.
| | - Daniel Urias
- Duke LifePoint Conemaugh Memorial Medical Center, Department of General Surgery, USA.
| | - Kamran Shayesteh
- Duke LifePoint Conemaugh Memorial Medical Center, Department of General Surgery, USA.
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Liu JM, Wang HW, Chang FW, Liu YP, Chiu FH, Lin YC, Cheng KC, Hsu RJ. The effects of climate factors on scabies. A 14-year population-based study in Taiwan. ACTA ACUST UNITED AC 2016; 23:54. [PMID: 27905271 PMCID: PMC5134670 DOI: 10.1051/parasite/2016065] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/20/2016] [Indexed: 11/27/2022]
Abstract
Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan’s Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson’s correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = −0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks.
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Affiliation(s)
- Jui-Ming Liu
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, 330 Taoyuan, Taiwan
| | - Hsiao-Wei Wang
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 110 Tapei, Taiwan - Division of Infection Diseases, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, 235 Tapei, Taiwan
| | - Fung-Wei Chang
- Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, 114 Tapei, Taiwan
| | - Yueh-Ping Liu
- Department of Emergency Medicine, National Taiwan University Hospital, 100 Tapei, Taiwan
| | - Feng-Hsiang Chiu
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, 235 Tapei, Taiwan - Superintendent Office, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo City, 315000 Zhejiang Province, PR China
| | - Yi-Chun Lin
- Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, 265 Luodong, Taiwan
| | - Kuan-Chen Cheng
- Graduate Institute of Food Science and Technology, National Taiwan University, 106 Tapei, Taiwan - Institute of Biotechnology, National Taiwan University, 106 Tapei, Taiwan
| | - Ren-Jun Hsu
- Graduate Institute of Life Sciences, National Defense Medical Center, 114 Tapei, Taiwan - Department of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital, National Defense Medical Center, 114 Tapei, Taiwan - Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, 114 Tapei, Taiwan
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7
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Yélamos O, Mir-Bonafé JF, López-Ferrer A, Garcia-Muret MP, Alegre M, Puig L. Crusted (Norwegian) scabies: an under-recognized infestation characterized by an atypical presentation and delayed diagnosis. J Eur Acad Dermatol Venereol 2014; 30:483-5. [PMID: 25428862 DOI: 10.1111/jdv.12867] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- O Yélamos
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J F Mir-Bonafé
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A López-Ferrer
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M P Garcia-Muret
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Alegre
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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8
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Abstract
The objectives of this study were 1) to describe a case of crusted scabies (CS) in a burned patient, which was primarily undiagnosed and led to a nosocomial outbreak in the burn unit; 2) to analyze and discuss the difficulties in diagnosing and treating this subset of patients with burn injury; and 3) to design a treatment strategy for future patients. Case analysis and literature review were performed. The index patient had undiagnosed crusted scabies (sive Scabies norvegica) with the ensuing mite hyperinfestation when admitted to the department with minor acute dermal burns. Conservative healing and autograft healing were impaired because of the condition. Successful treatment of the burns was only accomplished secondarily to scabicide treatment. An outbreak of scabies among staff members indirectly led to diagnosis. CS is ubiquitous, and diagnosis may be difficult. This is the first report of a burned patient with CS in the English language literature. CS is also highly contagious and may lead to a nosocomial outbreak. Furthermore, CS seems to have a detrimental impact on the burned patient's course of treatment. A scabicide treatment is necessary to guarantee successful treatment of the burns.
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9
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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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10
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Ramachandran V, Shankar EM, Devaleenal B, Pachamuthu B, Thousen SM, Sekar R, Suniti S, Nagalingeswaran K. Atypically distributed cutaneous lesions of Norwegian scabies in an HIV-positive man in South India: a case report. J Med Case Rep 2008; 2:82. [PMID: 18341688 PMCID: PMC2276223 DOI: 10.1186/1752-1947-2-82] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 03/14/2008] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Immune-compromised subjects, especially those with underlying HIV disease, are prone to be infected with Norwegian scabies, where the cutaneous lesions are classically distributed over the extremities. CASE PRESENTATION We report the case of an HIV-positive 16-year-old man with severe crusted Norwegian scabies initially misdiagnosed as a dermal fungal infection. The patient had extensive, generalized, thick, hyperkeratotic, crusting, yellowish papule lesions distributed on the entire body from his scalp to his toes.The patient was started with Ivermectin and topical Permethrin, which eventually resulted in complete resolution. Interestingly, despite quarantining efforts, one of the patient's acquaintances and a healthcare worker acquired the symptoms of itching. CONCLUSION This atypical presentation of Norwegian scabies emphasizes the need to include scabies in the differential diagnosis when HIV-infected patients present with crusted, generalized cutaneous lesions.
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Affiliation(s)
- Vignesh Ramachandran
- Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education, VHS Campus, Rajiv Gandhi Salai, Taramani, Chennai, India.
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11
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Bhattacharjee P, Glusac EJ. Langerhans cell hyperplasia in scabies: a mimic of Langerhans cell histiocytosis. J Cutan Pathol 2007; 34:716-20. [PMID: 17696920 DOI: 10.1111/j.1600-0560.2006.00723.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM In the absence of mites, the histologic diagnosis of human scabies can be difficult. Scabies can mimic a variety of inflammatory and lymphoproliferative disorders. It is under-recognized that scabies can also mimic Langerhans cell histiocytosis. METHODS Sixteen examples of scabies were reviewed histologically and immunohistochemically (CD1a, CD3, CD20, CD30 and S100). RESULTS Immunohistochemical labeling showed florid CD1a and S100 positivity in most cases, indicative of Langerhans cell hyperplasia. Scattered CD30+ lymphocytes were also typically present, within a dense infiltrate, primarily composed of T lymphocytes and eosinophils. CONCLUSION Because of the prominent CD1a+/S100+ component, scabies can mimic Langerhans cell histiocytosis. This finding should be considered in conjunction with scattered CD30+ cells and clinical features to avoid misdiagnosis.
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Affiliation(s)
- Pradip Bhattacharjee
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06520-8059, USA
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12
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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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13
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Rodríguez-Gómez FJ, Pastrana-Mejía GA, Lomas JM, Pujol E. [Advanced HIV infection and diffuse hyperkeratosic skin lesions in a male patient]. Enferm Infecc Microbiol Clin 2006; 24:587-9. [PMID: 17125680 DOI: 10.1157/13093881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Abstract
Parasitic agents determine some of the most common skin disorders. Although well known, they could present different manifestations or be modified by individual or external factors that make their diagnosis or treatment difficult. This review will discuss some of the most prevalent parasitic infections, scabies, and pediculosis and also mention reactions determined by contact with certain insects that, although rarely found, could induce important skin reactions.
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Affiliation(s)
- Tania Ferreira Cestari
- Department of Dermatology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil.
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15
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Wong SSY, Woo PCY, Yuen KY. Unusual laboratory findings in a case of Norwegian scabies provided a clue to diagnosis. J Clin Microbiol 2005; 43:2542-4. [PMID: 15872307 PMCID: PMC1153733 DOI: 10.1128/jcm.43.5.2542-2544.2005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The diagnosis of Norwegian scabies was missed for a year for an elderly long-term-care facility resident. Serpiginous tracks were noted on the surface of Sabouraud dextrose agar used for fungal culture of the skin scrapings. This unusual laboratory manifestation must alert clinical microbiologists to the possible diagnosis of scabies.
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Affiliation(s)
- Samson S Y Wong
- Department of Microbiology, The University of Hong Kong, Room 423 University Pathology Building, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, Hong Kong
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16
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Baysal V, Yildirim M, Türkman C, Aridogan B, Aydin G. Crusted scabies in a healthy infant. J Eur Acad Dermatol Venereol 2004; 18:188-90. [PMID: 15009301 DOI: 10.1111/j.1468-3083.2004.00846.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Crusted scabies is generally seen in mentally retarded and immunosuppressed individuals. We report the case of a patient with crusted scabies with neither systemic disease nor immunosuppression; all the lesions were cured with applications of 5% permethrin lotion.
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Affiliation(s)
- V Baysal
- Department of Dermatology, School of Medicine, University of Süleyman Demirel, Isparta, Turkey
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17
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Kabrhel C, Binder W. Clinical Pearls: A 37-year-old Man with a Rash…. Acad Emerg Med 2003. [DOI: 10.1111/j.1553-2712.2003.tb00072.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Affiliation(s)
- Christopher Kabrhel
- Harvard Affiliated Emergency Medicine Residency, Brigham and Women's Hospital, Boston, MA, USA.
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19
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Kim KJ, Roh KH, Choi JH, Sung KJ, Moon KC, Koh JK. Scabies incognito presenting as urticaria pigmentosa in an infant. Pediatr Dermatol 2002; 19:409-11. [PMID: 12383096 DOI: 10.1046/j.1525-1470.2002.00115.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Misdiagnosis is frequent in scabies of infants and children because of a low index of suspicion, secondary eczematous changes, and inappropriate therapy. Topical or systemic corticosteroids may modify the clinical presentation of scabies and that situation is referred to as scabies incognito. We describe a 10-month-old infant with scabies incognito mimicking urticaria pigmentosa.
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Affiliation(s)
- Kyoung-Jin Kim
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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20
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Affiliation(s)
- Louis Tran
- Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California, USA
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Abstract
BACKGROUND Scabies is a common public health problem with an estimated prevalence of 300 million. Infestation can cause considerable discomfort and intense itching. Severe adverse effects have been reported for some drugs used to treat scabies. OBJECTIVES The objective of this review is to assess the effects and toxicity of topical and systemic drug treatment for scabies. SEARCH STRATEGY We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, Embase, military records, traditional medicine databases. We also contacted international specialist centres and drug manufacturers. SELECTION CRITERIA Randomised controlled trials of any drug treatment for scabies. Tolerability and toxicity were sought in any study of humans taking any drug treatments for scabies. DATA COLLECTION AND ANALYSIS Two reviewers assessed trial quality and extracted data. MAIN RESULTS Eleven trials were included (7 compared drug treatments, 2 compared treatment regimes, 1 compared the drug vehicle and 1 was a community intervention). Compared with placebo in one small trial, ivermectin was associated with a significant higher clinical cure rate at seven days. Permethrin appeared to be more effective than crotamiton for clinical and parasitic cure rates. Permethrin appeared to be better than gamma benzene hexachloride for clinical cure rates in two small trials but had no advantage in the largest trial (test for heterogeneity p< 0.001). Permethrin also appeared more effective in reducing itch persistance than gamma benzene hexachloride. There appeared to be no difference in clinical cure rates between crotamiton and gamma benzene hexachloride. Single trials assessed: the effectiveness of oral versus topical treatment (ivermectin versus benzyl benzoate); treatment vehicle (pork fat versus cold cream); and mass community treatment (ivermectin) but were too small to demonstrate an effect. No randomised trials of malathion were identified. Serious adverse drug reactions (including death and convulsions) have been reported in other studies of scabies drugs, most notably gamma benzene hexachoride and ivermectin. REVIEWER'S CONCLUSIONS The evidence that permethrin is more effective than gamma benzene hexachloride is inconsistent. Permethrin appears to have less potential serious drugs reactions than gamma benzene hexachloride although this is not derived from trial data. More research is needed of the safety and effectiveness of ivermectin and malathion compared to permethrin, on community management, and on different regimes and vehicles for topical treatment.
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Affiliation(s)
- G J Walker
- Country Support Team for Central and South Asia, UNFPA, PO Box 5940, Kathmandu, Nepal.
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