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Meyersburg D, Welponer T, Kaiser A, Selhofer S, Tatarski R, Handisurya A, Bauer JW. Comparison of topical benzyl benzoate vs. oral ivermectin in treating scabies: A randomized study. J Eur Acad Dermatol Venereol 2023; 37:160-165. [PMID: 36097258 PMCID: PMC10087012 DOI: 10.1111/jdv.18573] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/18/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scabies is an itchy, parasitic infection of the skin. Recent reports indicate there is a decreasing efficacy of the standard treatment of choice, topical 5% permethrin cream. OBJECTIVE To evaluate the comparative efficacy, safety and tolerability of topical benzyl benzoate (BB) with oral ivermectin in the treatment of scabies. METHODS Patients with dermoscopy-verified scabies visiting the dermatologic outpatient clinic were assessed for enrolment in the study. In total, 224 patients were enrolled and sequentially randomized into two equally sized groups. Group A received topical 25% or 10% BB for the daily use over a period of three consecutive days, group B received oral ivermectin (200 μg/kg body weight) twice, 1 week apart. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit. RESULTS Treatment resulted in a cure rate of 87% in group A and 86% in group B. After initial therapy failure in group A, six out of eight patients showed treatment response upon repeated application of BB, five of five when retreated with ivermectin and two of two with BB plus ivermectin, respectively. In group B, successful retreatment was observed in three out of three patients with ivermectin, two of two patients with BB and 11 of 11 patients with the combination of BB plus ivermectin, respectively. Tolerability and safety profile of oral ivermectin was excellent, while BB produced short burning sensations in 14%. CONCLUSION Topical BB and oral ivermectin have shown comparable good therapeutic efficacy. Therefore, both agents constitute an adequate first-line therapy in the treatment of scabies. A combination of both agents may be considered in recalcitrant and extensively infested cases, additionally to crusted scabies.
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Affiliation(s)
- Damian Meyersburg
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Tobias Welponer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Andreas Kaiser
- Department of Psychosomatics and Inpatient Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
| | - Sylvia Selhofer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | - Rafaella Tatarski
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
| | | | - Johannes Wolfgang Bauer
- Department of Dermatology and Allergology, University Hospital Salzburg of the Paracelsus Medical University, Salzburg, Austria
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Asnawi V, Maulida M, Hidayati A, Gunawan H, Dwiyana RF, Hindritiani R. Combination of Crusted Scabies with Bullous Scabies: A Rare Case. Int Med Case Rep J 2023; 16:153-158. [PMID: 36936186 PMCID: PMC10018284 DOI: 10.2147/imcrj.s396234] [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: 11/24/2022] [Accepted: 02/15/2023] [Indexed: 03/21/2023] Open
Abstract
Scabies is a parasitic skin disease caused by Sarcoptes scabiei var. hominis. Crusted scabies, also known as Norwegian scabies, is a rare and severe form of scabies that occurs more frequently in immunocompromised, elderly, disabled, and debilitated patients. The present study reports a case of crusted scabies combined with bullous scabies. A 44-year-old man was admitted with the chief complaint of red, thick, scaly patches of skin accompanied by crusting that felt itchy and worsened at night. The lesions had appeared all over his body intermittently for the last 10 years; however, the complaints worsened in the last 2 months. From dermatological status, the anterior and posterior thoracic regions and between the fingers of both hands showed generalized distribution of erythematous, yellowish, hyperkeratotic plaques with clear boundaries, pustules, and blisters on an erythematous base with multiple erosions and excoriations. S. scabiei were found on skin scraping examination, and histopathological examination supported the diagnosis of bullous scabies. The patient received 5% permethrin lotion topical therapy and systemic ivermectin therapy. In addition, the patient was given systemic antibiotics. The lesions improved after 2 weeks of therapy, and no S. scabiei were found on the subsequent microscopic examination. Treatment with a combination of topical and systemic scabicidal agents produced a favorable outcome in this patient.
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Affiliation(s)
- Vella Asnawi
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zainoel Abidin General Hospital, Banda Aceh, Aceh, Indonesia
- Correspondence: Vella Asnawi, Department of Dermatology and Venereology, Dr. Zainoel Abidin General Hospital, Jl. Tgk.Daud Beureueh No. 108, Banda Aceh, Aceh, Indonesia, Tel +6281938199931, Email
| | - Mimi Maulida
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zainoel Abidin General Hospital, Banda Aceh, Aceh, Indonesia
| | - Arie Hidayati
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Department of Dermatology and Venereology, Dr. Zainoel Abidin General Hospital, Banda Aceh, Aceh, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Dermatology and Venereology, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Reiva Farah Dwiyana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Dermatology and Venereology, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Reti Hindritiani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Dermatology and Venereology, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
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Antiparasitic Activity of Tea Tree Oil (TTO) and Its Components against Medically Important Ectoparasites: A Systematic Review. Pharmaceutics 2022; 14:pharmaceutics14081587. [PMID: 36015213 PMCID: PMC9416580 DOI: 10.3390/pharmaceutics14081587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 12/04/2022] Open
Abstract
Ectoparasites are pathogens that can infect the skin and cause immense pain, discomfort, and disease. They are typically managed with insecticides. However, the fast-emerging antimicrobial resistance and the slow rate of development of new bio-actives combined with environmental and health concerns over the continued use of neurotoxic insecticides warrant newer and alternative methods of control. Tea tree oil (TTO), as an alternative agent, has shown remarkable promise against ectoparasites in recent studies. To our knowledge, this is the first systematic review to assess preclinical and clinical studies exploring the antiparasitic activity of TTO and its components against clinically significant ectoparasites, such as Demodex mites, scabies mites, house dust mites, lice, fleas, chiggers, and bed bugs. We systematically searched databases, including PubMed, MEDLINE (EBSCOhost), Embase (Scopus), CENTRAL, Cochrane Library, CINAHL, ScienceDirect, Web of Science, SciELO, and LILACS in any language from inception to 4 April 2022. Studies exploring the therapeutic activity of TTO and its components against the ectoparasites were eligible. We used the ToxRTool (Toxicological data reliability assessment) tool, the Joanna Briggs Institute (JBI) critical appraisal tools, and the Jadad scale to assess the methodological qualities of preclinical (in vitro and in vivo) studies, non-randomised controlled trials (including cohort, case series, and case studies), and randomised controlled trials, respectively. Of 497 identified records, 71 studies were included in this systematic review, and most (66%) had high methodological quality. The findings of this review revealed the promising efficacy of TTO and its components against ectoparasites of medical importance. Most importantly, the compelling in vitro activity of TTO against ectoparasites noted in this review seems to have translated well into the clinical environment. The promising outcomes observed in clinical studies provide enough evidence to justify the use of TTO in the pharmacotherapy of ectoparasitic infections.
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Fraccaroli L, Ruiz MD, Perdomo VG, Clausi AN, Balcazar DE, Larocca L, Carrillo C. Broadening the spectrum of ivermectin: Its effect on Trypanosoma cruzi and related trypanosomatids. Front Cell Infect Microbiol 2022; 12:885268. [PMID: 35967842 PMCID: PMC9366347 DOI: 10.3389/fcimb.2022.885268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022] Open
Abstract
Chagas disease is an endemic American parasitosis, caused by Trypanosoma cruzi. The current therapies, benznidazole (BZN) and nifurtimox (NFX), show limited efficacy and multiple side effects. Thus, there is a need to develop new trypanocidal strategies. Ivermectin (IVM) is a broad-spectrum antiparasitic drug with low human and veterinary toxicity with effects against T. brucei and Leishmania spp. Considering this and its relatively low cost, we evaluate IVM as a potential repurposed trypanocidal drug on T. cruzi and other trypanosomatids. We found that IVM affected, in a dose-dependent manner, the proliferation of T. cruzi epimastigotes as well as the amastigotes and trypomastigotes survival. The Selectivity Index for the amastigote stage with respect to Vero cells was 12. The IVM effect was also observed in Phytomonas jma 066 and Leishmania mexicana proliferation but not in Crithidia fasciculata. On the epimastigote stage, the IVM effect was trypanostatic at 50 μM but trypanocidal at 100 μM. The assays of the drug combinations of IVM with BNZ or NFX showed mainly additive effects among combinations. In silico studies showed that classical structures belonging to glutamate-gated Cl channels, the most common IVM target, are absent in kinetoplastids. However, we found in the studied trypanosomatid genomes one copy for putative IMPα and IMPβ, potential targets for IVM. The putative IMPα genes (with 76% similarity) showed conserved Armadillo domains but lacked the canonical IMPβ binding sequence. These results allowed us to propose a novel molecular target in T. cruzi and suggest IVM as a good candidate for drug repurposing in the Chagas disease context.
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Affiliation(s)
- Laura Fraccaroli
- Laboratorio de Biología Molecular y Bioquímica en Trypanosoma cruzi y otros agentes infecciosos, CONICET for Instituto de Ciencia y Tecnología (ICT) Milstein - Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- *Correspondence: Laura Fraccaroli, ; Carolina Carrillo,
| | - María Daniela Ruiz
- Laboratorio de Biología Molecular y Bioquímica en Trypanosoma cruzi y otros agentes infecciosos, CONICET for Instituto de Ciencia y Tecnología (ICT) Milstein - Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Virginia Gabriela Perdomo
- Área Parasitología, Microbiología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario (UNR), Rosario, Argentina
| | - Agustina Nicole Clausi
- Laboratorio de Biología Molecular y Bioquímica en Trypanosoma cruzi y otros agentes infecciosos, CONICET for Instituto de Ciencia y Tecnología (ICT) Milstein - Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Darío Emmanuel Balcazar
- Área Parasitología, Microbiología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario (UNR), Rosario, Argentina
| | - Luciana Larocca
- Laboratorio de Biología Molecular y Bioquímica en Trypanosoma cruzi y otros agentes infecciosos, CONICET for Instituto de Ciencia y Tecnología (ICT) Milstein - Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Carolina Carrillo
- Laboratorio de Biología Molecular y Bioquímica en Trypanosoma cruzi y otros agentes infecciosos, CONICET for Instituto de Ciencia y Tecnología (ICT) Milstein - Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- *Correspondence: Laura Fraccaroli, ; Carolina Carrillo,
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Crusted Scabies, a Neglected Tropical Disease: Case Series and Literature Review. Infect Dis Rep 2022; 14:479-491. [PMID: 35735761 PMCID: PMC9223105 DOI: 10.3390/idr14030051] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
Crusted scabies is a rare form of scabies that presents with more severe symptoms than those of classic scabies. It is characterized by large crusted lesions, extensive scales, thick hyperkeratosis, and contains a large number of highly contagious itch mites. Crusted scabies is more prevalent in immunocompromised, malnourished, and disabled individuals. This disease has been linked to a variety of health problems, including delayed diagnosis, infection risk, and high mortality, mainly from sepsis, and it has the potential to cause an outbreak due to its hyper-infestation, which makes it highly infectious. This article reports three cases of crusted scabies in North Sulawesi, Indonesia. Recent updates and a comprehensive review of the literature on the disease are also included, emphasizing the critical importance of early diagnosis and effective medical management of patients, which are necessary to prevent the complications and spread in communities.
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Gramp P, Gramp D. Scabies in remote Aboriginal and Torres Strait Islander populations in Australia: A narrative review. PLoS Negl Trop Dis 2021; 15:e0009751. [PMID: 34591843 PMCID: PMC8483324 DOI: 10.1371/journal.pntd.0009751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Scabies has recently gained international attention, with the World Health Organization (WHO) recognizing it as a neglected tropical disease. The International Alliance for the Control of Scabies recently formed as a partnership of more than 15 different countries, with an aim to lead a consistent and collaborative approach to preventing and controlling scabies globally. Scabies is most prevalent in low-resource and low socioeconomic areas that experience overcrowding and has a particularly high prevalence in children, with an estimated 5% to 10% in endemic countries. Scabies is widespread in remote Aboriginal and Torres Strait Islander communities in Australia with the prevalence of scabies in Aboriginal and Torres Strait Islander children in remote communities estimated to be as high as 33%, making it the region with the third highest prevalence in the world. This population group also have very high rates of secondary complications of scabies such as impetigo, poststreptococcal glomerulonephritis (PSGN), and rheumatic heart disease (RHD). This article is a narrative review of scabies in remote Aboriginal and Torres Strait Islander populations in Australia, including clinical manifestations of disease and current treatment options and guidelines. We discuss traditional approaches to prevention and control as well as suggestions for future interventions including revising Australian treatment guidelines to widen the use of oral ivermectin in high-risk groups or as a first-line treatment.
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Affiliation(s)
- Prudence Gramp
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Dallas Gramp
- Gold Coast University Hospital, Southport, Queensland, Australia
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The Unmet Needs in Atopic Dermatitis Control in Latin America: A Multidisciplinary Expert Perspective. Dermatol Ther (Heidelb) 2021; 11:1521-1540. [PMID: 34449071 PMCID: PMC8395384 DOI: 10.1007/s13555-021-00595-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction Adoption of control tools for atopic dermatitis (AD) in Latin America (LA) is currently very limited. Clinical assessment tools represent a practical method to measure the impact of treatment on disease activity and on the quality of life of patients. However, the use of these tools in the LA clinical practice setting is limited. Methods A selected panel of Latin American experts in fields related to atopic dermatitis were provided with a series of relevant questions to address prior to the multi-day conference. Within this conference, each narrative was discussed and edited by the entire group, through numerous drafts and rounds of discussion, until a consensus was achieved. Results The panel proposes specific and realistic recommendations for implementing control tools for AD care in LA. In creating these recommendations, the authors strove to address all barriers to the widespread use of these tools. Conclusion This article includes a narrative analysis of barriers to AD control in LA and provides necessary recommendations to integrate and increase the use of validated AD control assessment tools throughout the region.
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Seiler JC, Keech RC, Aker JL, Miller W, Belcher C, Mettert KW. Spinosad at 0.9% in the treatment of scabies: Efficacy results from 2 multicenter, randomized, double-blind, vehicle-controlled studies. J Am Acad Dermatol 2021; 86:97-103. [PMID: 34391812 DOI: 10.1016/j.jaad.2021.07.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/24/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Scabies is a contagious skin disease resulting from Sarcoptes scabiei infestation. There are no approved over-the-counter treatments, and approved prescription products have disadvantages, including potential resistance. Spinosad, an insecticide derived from fermentation of a soil actinobacterium, shows promise as a potential treatment agent. OBJECTIVE Combined results from 2 controlled clinical studies were used to evaluate the efficacy of 0.9% spinosad topical suspension in the eradication of scabies. METHODS Each study included index subjects (the youngest household members with active scabies) and up to 5 other members in each household. Subjects applied 0.9% spinosad or vehicle once. Primary efficacy was the percentage of index subjects with complete cure on day 28. Additional efficacy included clinical cure, microscopic cure, and lesion counts. RESULTS Spinosad at 0.9% is not equivalent to vehicle in the percentage of index subjects achieving complete cure on day 28 (78.1% vs 39.6%, respectively; P < .0001; n = 206). Additional efficacy analyses confirmed the consistent treatment effect of 0.9% spinosad. No safety signals were observed. LIMITATIONS The studies used small sample sizes to assess equivalency. CONCLUSIONS Spinosad at 0.9% performed better than vehicle in the treatment of scabies in these studies of subjects of 4 years of age or older following 1 application of study drug.
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Sanei-Dehkordi A, Soleimani-Ahmadi M, Zare M, Jaberhashemi SA. Risk factors associated with scabies infestation among primary schoolchildren in a low socio-economic area in southeast of Iran. BMC Pediatr 2021; 21:249. [PMID: 34034686 PMCID: PMC8145826 DOI: 10.1186/s12887-021-02721-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023] Open
Abstract
Background Scabies is a neglected tropical disease caused by the mite Sarcoptes scabiei that burrows under the skin. It is a major health problem in tropical areas, largely affecting children. Scabies is common and highly contagious and in schoolchildren spreads quite rapidly, due to overcrowding and close contact within the schools. This study aimed to determine the risk factors associated with scabies infestation among primary schoolchildren in Bashagard County, one of the low socio-economic areas in southeast of Iran. Methods To conduct this community-based, descriptive, and cross-sectional study, four primary schools were randomly selected in the Bashagard County. All students in these schools were selected and examined for scabies. Clinical examination and sociodemographic profile of students were assessed using a pre-tested structured questionnaire. Chi-square test, and binary logistic regression were used to analyse the factors associated with scabies infestation by SPSS version 21 software. Results Out of 480 studied schoolchildren, 15 cases of scabies with a prevalence of 3.1 % were observed. The frequency of infestation in males was 1.6 % and it was 4.7 % in females. Independent factors associated with a high risk of scabies infestation in unadjusted analysis were being student of grade 5–6 (cOR = 13.12, 95 % CI 2.92–58.89, p = 0.0001), low educational level of father (cOR = 4.37, 95 % CI 0.97–19.59, p = 0.036), low educational level of mother (cOR = 4.14, 95 % CI 1.92–18.57, p = 0.045), joblessness of father (cOR = 14.77, 95 % CI 4.97–43.89, p = 0.0001), employment of mother (cOR = 5.28, 95 % CI 1.38–20.16, p = 0.007), large family size (cOR = 3.34, 95 % CI 1.05–10.64, p = 0.031), use of shared articles (cOR = 33.37, 95 % CI 10.82–102.90, p = 0.0001), and absence of bathroom in the house (cOR = 11.77, 95 % CI 2.16–63.94, p = 0.0001). Conclusions Results of this study confirmed that scabies is still one of the most important health problems in the primary schools of the Bashagard County. Low socioeconomic status and personal hygiene of the schoolchildren were the most important factors influencing the prevalence of scabies. Improvement of socioeconomic conditions and implementation of appropriate educational programs and active surveillance system to quickly detect and treat scabies cases are necessary in order to reduce the prevalence of scabies in schoolchildren in this area.
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Affiliation(s)
- Alireza Sanei-Dehkordi
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | - Moussa Soleimani-Ahmadi
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran. .,Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, P.O. Box: 79145-3838, Bandar Abbas, Iran.
| | - Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Fölster-Holst R. [Parasitoses in childhood]. Hautarzt 2021; 72:232-242. [PMID: 33599802 DOI: 10.1007/s00105-021-04767-8] [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] [Accepted: 01/19/2021] [Indexed: 11/26/2022]
Abstract
Parasitoses are a frequent occurrence in pediatric consultations in both hospitals and private practices. Responsible for this are parasites that permanently infest human skin, such as Sarcoptes scabiei hominis and Pediculus humanus capitis (persistent parasites) as well as those that only attack the skin for feeding, such as Pulex irritans, Cimex lectularius und Neotrombicula autumnalis (transient parasites). The main symptom of parasitoses is pruritus, which is caused by a delayed allergic reaction to proteins in the saliva of the parasites. In some parasitoses, such as scabies, the pruritus is typical, occurs particularly at night and is associated with a considerable impairment in the quality of life due to the resulting lack of sleep, whereas the pruritus is often absent in the case of pediculosis capitis. In this article persistent and transient parasitoses are characterized based on the patient history, morphology and symptoms.
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Affiliation(s)
- R Fölster-Holst
- Dermatologie, Venerologie, Allergologie, UKSH, Campus Kiel, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland.
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11
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Komoda M, Miyajima A, Koshino M, Akutsu S, Yamada M, Ozeki R, Makigami K. Case series of elderly patients with scabies topically applied with ivermectin via whole-body bathing. J Dermatol 2021; 48:559-563. [PMID: 33410137 DOI: 10.1111/1346-8138.15746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
As a novel method of ivermectin (IVM) administration for the treatment of scabies, we devised a whole-body bathing (WBB), in which patients are immersed in a fluid that contains IVM. A multi-institutional trial for elderly patients with scabies was conducted to investigate the efficacy and safety of IVM-WBB. Seven elderly patients with scabies were enrolled and received IVM-WBB up to four times at 1-week interval. The cure for scabies was defined as the absence of mites in two consecutive microscopic or dermoscopic examinations at weekly intervals and the absence of new skin lesions indicative of scabies. Consequently, the cure rate on day 22, the primary end-point, was 71.4%, and all patients had been cured until day 29. Additionally, neither significant adverse events nor clinically problematic abnormal blood test values were obtained. Furthermore, no IVM was detected in the optional plasma (five cases) collected for IVM measurement after bathing. These results suggest that IVM-WBB was effective to treat scabies, causing no serious adverse events and with a very low internal exposure of IVM.
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Affiliation(s)
- Masayo Komoda
- Department of Medical Safety, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan.,Center of Translational Research, Research Institute for Science and Technology, Tokyo University of Science, Noda, Japan
| | - Atsushi Miyajima
- Department of Biopharmaceutics, Meiji Pharmaceutical University, Tokyo, Japan.,Department of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Machi Koshino
- Department of Medical Safety, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Shunta Akutsu
- Department of Medical Safety, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Mizuki Yamada
- Department of Medical Safety, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Rie Ozeki
- Department of Medical Safety, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Kuniko Makigami
- Tsubasa Home Care Clinic, Ohta, Japan.,Department of Rehabilitation, Ota Hospital, Higashikagawa, Japan
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Abstract
Sarcoptes scabiei is a causative organism for scabies that affects an estimated global population of 300 million and remains a disease of significant concern. Recently, a number of potential drug targets were identified for scabies, including hydrolytic enzymes, inactivated paralogues of hydrolytic enzymes, inhibitors of host proteolytic enzymes and other proteins of interest. These discoveries remain confined to academic laboratories and institutions, failing to attract interest from researchers in commercial drug development. Here, we summarize the latest developments in the scabies mite biology and the drug targets that were subsequently identified, and we propose several peptide and nonpeptide ligands targeting the hot spots for protein-protein interactions. We also identify gaps in the development of ligands as inhibitors or modulators of these macromolecules.
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Agyei M, Ofori A, Tannor EK, Annan JJ, Norman BR. A forgotten parasitic infestation in an immunocompromised patient-a case report of crusted scabies. Pan Afr Med J 2020; 36:238. [PMID: 33708329 PMCID: PMC7908331 DOI: 10.11604/pamj.2020.36.238.24288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022] Open
Abstract
Crusted scabies is a rare and highly contagious form of Sarcoptes scabiei var hominis infestation whose incidence may increase in the near future due to increasing use of immunosuppressive therapies and a general lack of awareness about the condition. It is misdiagnosed as psoriasis, irritant dermatitis or eczema. Delays in diagnosis lead to widespread transmission amongst contacts leading to potential community outbreak. Crusted scabies is extremely difficult to treat and there are growing concerns of possible resistance to current treatment. This case report describes a 44-year-old Ghanaian woman with human immunodeficiency virus (HIV) infection and diagnosed with skin scrapings. Treatment was initiated but the patient died from HIV related complications. Crusted scabies, though rare, should be an issue of global concern due to the potential for widespread dissemination. Adequate resources need to be channeled into scabies eradication as well as education of health personnel to promptly identify and treat cases.
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Affiliation(s)
- Martin Agyei
- Dermatology Unit, Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Afua Ofori
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - John Jude Annan
- Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Betty Roberta Norman
- Dermatology Unit, Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Abstract
The morphology of scabies, a mite infestation of worldwide proportion, is characterized by a variety of cutaneous lesions. Patients with classic scabies present with characteristic burrows often located on the web spaces of the fingers and toes. Scabies surrepticius refers to the non-classic atypical presentation of scabies; establishing the diagnosis of scabies in these individuals can be difficult. To facilitate the diagnosis of scabies, criteria have been proposed by the International Alliance for the Control of Scabies (IACS). These criteria are intended for scabies research; however, they can be utilized by clinicians to establish either a confirmed diagnosis, a clinical diagnosis or a suspected diagnosis of scabies. Visualization of mites, eggs or feces is necessary for a confirmed diagnosis of scabies. A clinical diagnosis can be established by observation of either genital lesions in men or burrows or classically distributed classical lesions in individuals with two historic features: pruritus and close contact with an individual who itches and has classically distributed classical scabetic lesions. The clinical features and management of a woman residing in an assisted living environment with a confirmed diagnosis of scabies and a man with a clinical diagnosis of scabies are described. The criteria for the suspected diagnosis of scabies require either one historic feature and typical lesions in a typical distribution or both historic features and the presence of atypical lesions or an atypical distribution of the skin lesions. Once the diagnosis of scabies is established, not only the patient but also close contacts should receive treatment with either a topical medication (such as permethrin 5% cream) or a systemic drug (ivermectin) or both. The number and frequency of treatments are variable; classic scabies typically is managed with a total of two treatments performed weekly to biweekly. Patients with crusted scabies usually require multiple topical and oral antiscabetic treatments in addition to topical keratolytic therapy. Bacterial impetiginization or infection (most commonly by Staphylococcus aureus or Streptococcus pyogenes) can complicate scabies infestation and potentially result in cellulitis, abscess, sepsis, rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis; therefore, in some patients, systemic antimicrobial therapy may be necessary in addition to scabies-directed treatment. In addition to systemic antihistamines, oral and/or topical corticosteroids may be used to provide symptomatic pruritus relief once the diagnosis of scabies has been established and mite-directed treatment has been initiated. The clinician should consider several potential causes (such as inadequate treatment, reinfection, mite resistance, delusions of parasitosis and the development of a new non-scabetic dermatosis) in scabies patients who fail to respond to treatment with a topical or oral scabicide therapy.
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Affiliation(s)
- Philip R Cohen
- Dermatology, San Diego Family Dermatology, National City, USA
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15
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Leung AKC, Lam JM, Leong KF. Scabies: A Neglected Global Disease. Curr Pediatr Rev 2020; 16:33-42. [PMID: 31544694 DOI: 10.2174/1573396315666190717114131] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. OBJECTIVE The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. METHODS A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. RESULTS Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. CONCLUSION Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kin F Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
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16
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Of microbes and mange: consistent changes in the skin microbiome of three canid species infected with Sarcoptes scabiei mites. Parasit Vectors 2019; 12:488. [PMID: 31619277 PMCID: PMC6796464 DOI: 10.1186/s13071-019-3724-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background Sarcoptic mange is a highly contagious skin disease caused by the ectoparasitic mite Sarcoptes scabiei. Although it afflicts over 100 mammal species worldwide, sarcoptic mange remains a disease obscured by variability at the individual, population and species levels. Amid this variability, it is critical to identify consistent drivers of morbidity, particularly at the skin barrier. Methods Using culture-independent next generation sequencing, we characterized the skin microbiome of three species of North American canids: coyotes (Canis latrans), red foxes (Vulpes vulpes) and gray foxes (Urocyon cinereoargenteus). We compared alpha and beta diversity between mange-infected and uninfected canids using the Kruskal–Wallis test and multivariate analysis of variance with permutation. We used analysis of composition of microbes and gneiss balances to perform differential abundance testing between infection groups. Results We found remarkably consistent signatures of microbial dysbiosis associated with mange infection. Across genera, mange-infected canids exhibited reduced microbial diversity, altered community composition and increased abundance of opportunistic pathogens. The primary bacteria comprising secondary infections were Staphylococcus pseudintermedius, previously associated with canid ear and skin infections, and Corynebacterium spp., previously found among the gut flora of S. scabiei mites and hematophagous arthropods. Conclusions This evidence suggests that sarcoptic mange infection consistently alters the canid skin microbiome and facilitates secondary bacterial infection, as seen in humans and other mammals infected with S. scabiei mites. These results provide valuable insights into the pathogenesis of mange at the skin barrier of North American canids and can inspire novel treatment strategies. By adopting a “One Health” framework that considers mites, microbes and the potential for interspecies transmission, we can better elucidate the patterns and processes underlying this ubiquitous and enigmatic disease.![]()
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Ejigu K, Haji Y, Toma A, Tadesse BT. Factors associated with scabies outbreaks in primary schools in Ethiopia: a case-control study. Res Rep Trop Med 2019; 10:119-127. [PMID: 31695552 PMCID: PMC6717729 DOI: 10.2147/rrtm.s214724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/12/2019] [Indexed: 12/28/2022] Open
Abstract
Background Scabies is a neglected tropical disease affecting more than 200 million people worldwide every year. Scabies in school adolescents and young adults could affect their school performance. The current study investigates the factors associated with an outbreak of scabies at primary schools in southern Ethiopia. Method A team of health professionals investigated an outbreak of scabies that occurred in primary schools from May 1 to 30, 2018. An unmatched case–control study was employed to assess factors which predisposed for the scabies outbreak. Cases of scabies were individuals having a skin lesion compatible with the WHO case definitions of scabies. Controls were from the same locality with no skin lesions. Data on sociodemographic and behavioral variables were collected using questionnaires. Data on clinical presentations of scabies among cases were recorded by two trained and experienced health professionals. Factors associated with scabies were assessed using bivariate and multivariate logistic regression, and strength of association was described using odds ratio (OR) and 95% confidence intervals (CIs). Results A total of 711 (237 cases and 474 controls) study subjects participated in the study. The mean age of study participants was 17.56±2.66 years. Poor knowledge about scabies, adjusted odds ratio (AOR)=4.32 (95% CI: 2.93, 6.36); male sex, AOR=2.69 (95% CI: 1.82, 3.96); and parental illiteracy, AOR =3.49 (95% CI: 2.06, 5.94) predicted scabies infestation. Additionally, socioeconomic variables like sharing clothes/beds or contact with others, AOR=3.12 (95% CI: 2.12, 4.59); low household annual income, AOR=2.13 (95% CI: 1.32, 3.44); and family size greater than five, AOR=1.77 (95% CI: 1.04, 3.01) were significantly associated with scabies infestation. Inaccessibility and poor utilization of water, AOR=1.64 (95% CI: 1.12, 2.40) and poor personal hygiene, AOR=1.69 (95% CI: 1.14, 2.51) were also factors independently associated with scabies. Conclusion Modifiable risk factors such as personal hygiene and literacy level were found to be independent predictors of scabies infestation. Access to and utilization of water were also important predictors. Strategies for poverty alleviation and awareness creation on personal hygiene and efficient use of water are recommended for effective prevention of scabies infestation in closed institutions.
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Affiliation(s)
- Kefele Ejigu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yusuf Haji
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Alemayehu Toma
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Pediatrics, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Aktaş H, Cebecik A. Changes in incidence and age distribution of scabies: A retrospective cohort study in a tertiary hospital. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2019. [DOI: 10.25000/acem.454426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ong CY, Vasanwala FF. Infected with Scabies Again? Focus in Management in Long-Term Care Facilities. Diseases 2018; 7:diseases7010003. [PMID: 30597979 PMCID: PMC6473425 DOI: 10.3390/diseases7010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/11/2018] [Accepted: 12/22/2018] [Indexed: 12/01/2022] Open
Abstract
Scabies is a significant public health condition in long-term care facilities, plaguing even developed countries. Although treatments are available, eradication and control of scabies cases still remain a challenge due to delays in diagnosis and difficulties in maintaining preventive and surveillance measures. Prompt treatment of patients and their contacts that are affected, along with concomitant education of health staff and family members, are paramount. Environmental disinfestation is also a concern.
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Affiliation(s)
- Chong Yau Ong
- Department of Family Medicine, Division of Medicine, Sengkang General Hospital, Singapore 544886, Singapore.
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 544886, Singapore.
| | - Farhad Fakhrudin Vasanwala
- Department of Family Medicine, Division of Medicine, Sengkang General Hospital, Singapore 544886, Singapore.
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore 544886, Singapore.
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20
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Dietrich A, Joshi K, Sayed C. Infestations in the Geriatric Patient. CURRENT GERIATRICS REPORTS 2018. [DOI: 10.1007/s13670-018-0255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Treatment of Sarcoptic Mange in an American Black Bear ( Ursus americanus) with a Single Oral Dose of Fluralaner. J Wildl Dis 2018; 55:250-253. [PMID: 30016212 DOI: 10.7589/2017-12-310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sarcoptic mange in American black bears ( Ursus americanus) is a recent topic of concern in the mid-Atlantic US as accounts of affected bears have increased in recent years. We describe a black bear with sarcoptic mange that was successfully treated with one oral dose of fluralaner. The outcome of this case has positive implications for the treatment options available for free-ranging black bears.
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22
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Thomas J, Davey R, Peterson GM, Carson C, Walton SF, Spelman T, Calma T, Dettwiller P, Tobin J, McMillan F, Collis P, Naunton M, Kosari S, Christenson JK, Bartholomaeus A, McEwen J, Fitzpatrick P, Baby KE. Treatment of scabies using a tea tree oil-based gel formulation in Australian Aboriginal children: protocol for a randomised controlled trial. BMJ Open 2018; 8:e018507. [PMID: 29858405 PMCID: PMC5988111 DOI: 10.1136/bmjopen-2017-018507] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION In remote Aboriginal communities in Australia, scabies affects 7 out of 10 children before their first birthday. This is more than six times the rate seen in the rest of the developed world. Scabies infestation is frequently complicated by bacterial infection, leading to the development of skin sores and other more serious consequences, such as septicaemia and chronic heart and kidney diseases. Tea tree oil (TTO) has been used as an antimicrobial agent for several decades with proven clinical efficacy. Preclinical investigations have demonstrated superior scabicidal properties of TTO compared with widely used scabicidal agents, such as permethrin 5% cream and ivermectin. However, current data are insufficient to warrant a broad recommendation for its use for the management of scabies because previous studies were small or limited to in vitro observations. METHODS AND ANALYSIS A pragmatic first trial will examine the clinical efficacy of a simple and low-cost TTO treatment against paediatric scabies and the prevention of associated secondary bacterial infections, with 1:1 randomisation of 200 participants (Aboriginal children, aged 5-16 years and living in remote Australia) into active control (permethrin 5% cream) and treatment (5% TTO gel) groups. The primary outcome for the study is clinical cure (complete resolution). Secondary outcome measures will include relief of symptoms, recurrence rate, adverse effects, adherence to treatment regimen and patient acceptability. ETHICS AND DISSEMINATION The project has received approvals from the University of Canberra Human Research Ethics Committee (HREC 16-133), Wurli-Wurlinjang Health Service Indigenous subcommittee and the Aboriginal Medical Services Alliance Northern Territory reference group. The results of this study will be published in core scientific publications, with extensive knowledge exchange activities with non-academic audiences throughout the duration of the project. TRIAL REGISTRATION ACTRN12617000902392; Pre-results.
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Affiliation(s)
- Jackson Thomas
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Rachel Davey
- Faculty of Health, University of Canberra, Canberra, Australia
| | | | - Christine Carson
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
- Translational Renal Research Group, Harry Perkins Institute of Medical Research, Perth, Australia
| | - Shelley F Walton
- Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, Australia
| | - Tim Spelman
- Burnet Institute for Medical Research and Public Health, Melbourne, Australia
| | - Tom Calma
- University of Canberra, Canberra, Australia
| | - Pascale Dettwiller
- Flinders University Rural Clinic School, Flinders University, Adelaide, Australia
| | - Jacinta Tobin
- Department of Child and Adolescent Health, Mackay Hospital and Health Service, West Mackay, Australia
| | - Faye McMillan
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, Australia
| | - Paul Collis
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Mark Naunton
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Sam Kosari
- Faculty of Health, University of Canberra, Canberra, Australia
| | | | | | - John McEwen
- Faculty of Health, University of Canberra, Canberra, Australia
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Abstract
Scabies is an infestation of the skin by the mite Sarcoptes scabiei. It manifests with pruritic erythematous papules and excoriations, in addition to the pathognomonic burrows. Multiple drugs can be used for treatment, but resistance to conventional therapy is increasing throughout the years. This paper will review the mechanisms of resistance proposed in the literature and some of the potential solutions to this problem.
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Thomas J, Christenson JK, Walker E, Baby KE, Peterson GM. Scabies-An ancient itch that is still rampant today. J Clin Pharm Ther 2017; 42:793-799. [DOI: 10.1111/jcpt.12631] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 09/04/2017] [Indexed: 12/31/2022]
Affiliation(s)
- J. Thomas
- Faculty of Health; University of Canberra; Bruce ACT Australia
| | | | - E. Walker
- Faculty of Health; University of Canberra; Bruce ACT Australia
| | - K. E. Baby
- The Canberra Hospital; Yamba Drive; Garran ACT Australia
| | - G. M. Peterson
- Faculty of Health; University of Tasmania; Hobart TAS Australia
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Neglected Tropical Diseases: Epidemiology and Global Burden. Trop Med Infect Dis 2017; 2:tropicalmed2030036. [PMID: 30270893 PMCID: PMC6082091 DOI: 10.3390/tropicalmed2030036] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/19/2017] [Accepted: 08/02/2017] [Indexed: 12/22/2022] Open
Abstract
More than a billion people—one-sixth of the world’s population, mostly in developing countries—are infected with one or more of the neglected tropical diseases (NTDs). Several national and international programs (e.g., the World Health Organization’s Global NTD Programs, the Centers for Disease Control and Prevention’s Global NTD Program, the United States Global Health Initiative, the United States Agency for International Development’s NTD Program, and others) are focusing on NTDs, and fighting to control or eliminate them. This review identifies the risk factors of major NTDs, and describes the global burden of the diseases in terms of disability-adjusted life years (DALYs).
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Abstract
The disease scabies is one of the earliest diseases of humans for which the cause was known. It is caused by the mite, Sarcoptes scabiei, that burrows in the epidermis of the skin of humans and many other mammals. This mite was previously known as Acarus scabiei DeGeer, 1778 before the genus Sarcoptes was established (Latreille 1802) and it became S. scabiei. Research during the last 40 years has tremendously increased insight into the mite’s biology, parasite-host interactions, and the mechanisms it uses to evade the host’s defenses. This review highlights some of the major advancements of our knowledge of the mite’s biology, genome, proteome, and immunomodulating abilities all of which provide a basis for control of the disease. Advances toward the development of a diagnostic blood test to detect a scabies infection and a vaccine to protect susceptible populations from becoming infected, or at least limiting the transmission of the disease, are also presented.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, USA.
| | - Marjorie S Morgan
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, USA
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27
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Mila-Kierzenkowska C, Woźniak A, Krzyżyńska-Malinowska E, Kałużna L, Wesołowski R, Poćwiardowski W, Owcarz M. Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Ointment in Treatment of Scabies. J Arthropod Borne Dis 2017; 11:1-9. [PMID: 29018829 PMCID: PMC5629290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 09/13/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to compare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment. METHODS Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals. RESULTS At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001) and sulfur group (P< 0.001). At the end of two-week interval, the cure rate at permethrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001). At 4-week follow up the applied treatment was effective in all studied individuals. CONCLUSION The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.
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Affiliation(s)
| | - Alina Woźniak
- The Chair of Medical Biology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Lucyna Kałużna
- Department of Cosmetology and Aesthetic Dermatology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Roland Wesołowski
- The Chair of Medical Biology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Wojciech Poćwiardowski
- Institute of Food Technology, Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences, Bydgoszcz, Poland
| | - Marcin Owcarz
- Ludwik Rydygier Voivodship Polyclinical Hospital, Toruń, Poland
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Romero C, Heredia R, Pineda J, Serrano JA, Mendoza GD, Trápala P, Cordero AM. Efficacy of fluralaner in 17 dogs with sarcoptic mange. Vet Dermatol 2016; 27:353-e88. [DOI: 10.1111/vde.12363] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Camilo Romero
- Centro Universitario UAEM Amecameca Universidad Autónoma del Estado de México Carretera Amecameca‐Ayapango Km 2.5 Amecameca de Juárez CP 56900 Estado de México México
| | - Rafael Heredia
- Doctorado en Ciencias Agropecuarias y Recursos Naturales Universidad Autónoma del Estado de México kilometro 14.5 carretera Toluca‐Atlacomulco desviación a Tlachalo El Cerrillo Piedras Blancas Toluca 50200 Estado de México México
| | - Jocelyn Pineda
- Centro Universitario UAEM Amecameca Universidad Autónoma del Estado de México Carretera Amecameca‐Ayapango Km 2.5 Amecameca de Juárez CP 56900 Estado de México México
| | - Jonathan A. Serrano
- Licenciatura de Medicina Veterinaria y Zootecnia Centro Universitario UAEM Amecameca Universidad Autónoma del Estado de México Carretera Amecameca‐Ayapango Km 2.5 Amecameca de Juárez 56900 Estado de México México
| | - Germán D. Mendoza
- Universidad Autónoma Metropolitana Unidad Xochimilco Calzada del Hueso 1100 Coyoacan 04960 Mexico DF México
| | - Porfirio Trápala
- Clinica Veterinaria Alhaurin Río Panuco No. 2424 Colonia México Monterrey 64740 NL México
| | - Alberto M. Cordero
- Veterinaria Dermatología Veterinaria Especializada Argentina No. 690 colonia moderna Guadalajara 44190 Jalisco México
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Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, Hossny E, García E, Rosario N, Ansotegui I, Puerta L, Sánchez J, Cardona V. Particularities of allergy in the Tropics. World Allergy Organ J 2016; 9:20. [PMID: 27386040 PMCID: PMC4924335 DOI: 10.1186/s40413-016-0110-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 05/25/2016] [Indexed: 12/27/2022] Open
Abstract
Allergic diseases are distributed worldwide and their risk factors and triggers vary according to geographical and socioeconomic conditions. Allergies are frequent in the Tropics but aspects of their prevalence, natural history, risk factors, sensitizers and triggers are not well defined and some are expected to be different from those in temperate zone countries. The aim of this review is to investigate if allergic diseases in the Tropics have particularities that deserve special attention for research and clinical practice. Such information will help to form a better understanding of the pathogenesis, diagnosis and management of allergic diseases in the Tropics. As expected, we found particularities in the Tropics that merit further study because they strongly affect the natural history of common allergic diseases; most of them related to climate conditions that favor permanent exposure to mite allergens, helminth infections and stinging insects. In addition, we detected several unmet needs in important areas which should be investigated and solved by collaborative efforts led by the emergent research groups on allergy from tropical countries.
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Affiliation(s)
- Luis Caraballo
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Josefina Zakzuk
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Bee Wah Lee
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nathalie Acevedo
- />Department of Medicine Solna, Karolinska Institutet, Translational Immunology Unit, Stockholm, Sweden
| | - Jian Yi Soh
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mario Sánchez-Borges
- />Allergy and Clinical Immunology Department, Centro Médico- Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Elham Hossny
- />Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt
| | - Elizabeth García
- />Allergy Section, Fundación Santa Fe de Bogotá, Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Nelson Rosario
- />Federal University of Parana, Rua General Carneiro, Curitiba, Brazil
| | - Ignacio Ansotegui
- />Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bilbao, Spain
| | - Leonardo Puerta
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Jorge Sánchez
- />Department of Pediatrics, Graduate Program on Allergology, University of Antioquia, Medellín, Colombia
| | - Victoria Cardona
- />Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain
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Morgan MS, Arlian LG, Rider SD, Grunwald WC, Cool DR. A Proteomic Analysis of Sarcoptes scabiei (Acari: Sarcoptidae). JOURNAL OF MEDICAL ENTOMOLOGY 2016; 53:553-561. [PMID: 26792847 PMCID: PMC4892810 DOI: 10.1093/jme/tjv247] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/13/2015] [Indexed: 06/05/2023]
Abstract
The pruritic skin disease scabies is caused by the burrowing of the itch mite Sarcoptes scabiei (De Geer). It is difficult to diagnose this disease because its symptoms often resemble those of other skin diseases. No reliable blood or molecular diagnostic test is available. The aim of this project was to begin to characterize the scabies proteome to identify scabies mite proteins, including those that may be useful in the development of a diagnostic test or vaccine. Various scabies mite extracts were separated by two-dimensional electrophoresis, and 844 Coomassie Blue-stained protein spots were excised, subjected to trypsin digestion, and analyzed by Matrix Assisted Laser Desorption/Ionization Time-Of-Flight/Time-Of-Flight (MALDI-TOF/TOF) mass spectrometry (MS). Tryptic fragment sequences determined by MS were searched against the recently completed S. scabiei annotated genome, leading to the identification of >150 proteins. Only 10 proteins hit to previously identified scabies proteins including actin, tropomyosin, and several ABC transporters. Thirteen proteins had homology to dust mite allergens (members of groups 8, 10, 13, 17, 20, 25, and 28). Most other sequences showed some homology to proteins in other mites and ticks including homologs of calmodulin, calreticulin, lipocalin, and glutathione-S-transferase. These data will now allow the identification of the proteins to which scabies patients produce antibodies, including those that may be good candidates for inclusion in a diagnostic test and vaccine.
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Affiliation(s)
- Marjorie S Morgan
- Department of Biological Sciences, Wright State University, Dayton, OH 45435 (; ; )
| | - Larry G Arlian
- Department of Biological Sciences, Wright State University, Dayton, OH 45435 (; ; ),
| | - S Dean Rider
- Department of Biological Sciences, Wright State University, Dayton, OH 45435 (; ; )
| | - William C Grunwald
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435 (; )
| | - David R Cool
- Department of Pharmacology & Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435 (; )
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Rider SD, Morgan MS, Arlian LG. Draft genome of the scabies mite. Parasit Vectors 2015; 8:585. [PMID: 26555130 PMCID: PMC4641413 DOI: 10.1186/s13071-015-1198-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/05/2015] [Indexed: 12/11/2022] Open
Abstract
Background The disease scabies, caused by the ectoparasitic mite, Sarcoptes scabiei, causes significant morbidity in humans and other mammals worldwide. However, there is limited data available regarding the molecular basis of host specificity and host-parasite interactions. Therefore, we sought to produce a draft genome for S. scabiei and use this to identify molecular markers that will be useful for phylogenetic population studies and to identify candidate protein-coding genes that are critical to the unique biology of the parasite. Methods S. scabiei var. canis DNA was isolated from living mites and sequenced to ultra-deep coverage using paired-end technology. Sequence reads were assembled into gapped contigs using de Bruijn graph based algorithms. The assembled genome was examined for repetitive elements and gene annotation was performed using ab initio, and homology-based methods. Results The draft genome assembly was about 56.2 Mb and included a mitochondrial genome contig. The predicted proteome contained 10,644 proteins, ~67 % of which appear to have clear orthologs in other species. The genome also contained more than 140,000 simple sequence repeat loci that may be useful for population-level studies. The mitochondrial genome contained 13 protein coding loci and 20 transfer RNAs. Hundreds of candidate salivary gland protein genes were identified by comparing the scabies mite predicted proteome with sialoproteins and transcripts identified in ticks and other hematophagous arthropods. These include serpins, ferritins, reprolysins, apyrases and new members of the macrophage migration inhibitory factor (MIF) gene family. Numerous other genes coding for salivary proteins, metabolic enzymes, structural proteins, proteins that are potentially immune modulating, and vaccine candidates were identified. The genes encoding cysteine and serine protease paralogs as well as mu-type glutathione S-transferases are represented by gene clusters. S. scabiei possessed homologs for most of the 33 dust mite allergens. Conclusion The draft genome is useful for advancing our understanding of the host-parasite interaction, the biology of the mite and its phylogenetic relationship to other Acari. The identification of antigen-producing genes, candidate immune modulating proteins and pathways, and genes responsible for acaricide resistance offers opportunities for developing new methods for diagnosing, treating and preventing this disease. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1198-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Dean Rider
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, USA.
| | - Marjorie S Morgan
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, USA.
| | - Larry G Arlian
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Hwy, Dayton, OH, 45435, USA.
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