Scabies: A Neglected Global Disease

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Author(s): Alexander Leung*, Joseph Lam, Kin Fon Leong.

Journal Name: Current Pediatric Reviews

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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 greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment initiated.

Objective: To familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies.

Methods: A search was conducted with using Pubmed with the built-in "Clinical Queries" tool. using the keyword The search term "Scabies" was used. A narrow scope was applied to the categories of "epidemiology", "diagnosis", "therapy", "prevention", and "prognosis" for main search of primary clinical studies. The search strategy included mMeta-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 erup¬tion, serpiginous bur¬rows, 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, but¬tocks, 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 pel¬lets on microscopic examination of scrapings taken from skin lesions confirms the diag-nosis 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 expedite treatment are essential for the effective control of scabies and for the prevention of spread of the disease.

Keywords: Intractable pruritus, ivermectin, permethrin, Sarcoptes scabiei var. hominis, serpiginous burrows

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(E-pub Ahead of Print)
DOI: 10.2174/1573396315666190717114131

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