Sarna costrosa en un paciente diabético / Crusted scabies in a diabetic patient

La sarna costrosa corresponde a una variedad muy rara y poco frecuente de escabiosis; una parasitosis humana causada por el ácaro Sarcoptes Scabiei (var. Hominis); se produce principalmente en pacientes inmunodreprimidos y se caracteriza por lesiones atípicas y extensas, sumamente contagiosas debido al compromiso inmunitario. Se presenta el caso clínico de un paciente de 68 años de edad con antecedentes de hipertensión arterial y diabetes mellitus tipo 2 con un mal control glucémico, que es atendido por el servicio de dermatología. Las lesiones se presentan como placas extensas pruriginosas, queratósicas, eritemato-escamosas de escamas gruesas y adherentes de seis meses de evolución en tronco, muslos y pliegues axilares, inguinales e interdigitales. La sospecha clínica de sarna costrosa fue confirmada por biopsia; el tratamiento se realizó con ivermectina con mejoría del cuadro clínico.

Crusted scabies corresponds to a very rare variety and little common scabies; a human parasitic disease caused by an acarid in this case Sarcoptes Scabiei (var. Hominis); it observed mainly among inmunosupressed patients and is characterized by atypical and extensive lesions, highly contagious due to their immune compromise. A case of a patient of 68 years old is described with a history of hypertension and diabetes mellitus type 2 with poor glycemic control, which is assist by the dermatology service. Lesions included extensive and pruritic badges, quetatotic, erythematous-squamous of thick and adherent scales of six months evolution in trunk, thighs and axillary, inguinal and interdigital folds. The clinical suspicion of crusted scabies was confirmed by biopsy; the treatment was performed with ivermectin with improvement of the clinical picture.

Sarna sarcóptica en cerdos criados en cama profunda. Reporte de caso / Sarcoptic mange in pigs in deep beeding. Case report

RESUMEN La sarna sarcóptica en los cerdos es causada por Sarcoptes scabiei var. suis el cual se distribuye ampliamente en los cinco continentes. Los productores porcícolas en general están preocupados por las infecciones parasitarias internas e ignoran las infestaciones parasitarias externas; estas últimas, causadas por S. scabiei tienen gran importancia económica ya que causa morbilidad, mortalidad, disminución de la fertilidad y de la tasa de conversión alimenticia. Este trabajo permitió determinar la presencia de sarna sarcóptica en cerdos criados bajo sistema de producción con cama profunda de una granja en el estado Guárico (Venezuela), utilizando las técnicas parasitológicas directas de flotación-concentración y microscopía directa. Los resultados demostraron que dos de siete muestras evaluadas fueron positivas con S. scabiei var. suis. El 100% de los animales presentaron lesiones de piel compatibles con la presencia del ácaro, pero el mismo solo pudo ser detectado en el 28,6% de ellos. La técnica de flotación-concentración fue más efectiva que la de microscopía directa. En este estudio describimos la primera detección de S. scabiei var. suis en cerdos domésticos en Venezuela criados en cama profunda.

ABSTRACT Sarcoptic mange infestation in pigs is caused by Sarcoptes scabiei var. suis. It is distributed worldwide. Pig owners are generally concerned about the internal parasitic infections and ignored the external parasitic infestations. But the external parasitic infestation with S. scabiei has economic significance as it causes morbidity, mortality, decreased fertility and lower feed conversion ratio. In this study the prevalence of sarcoptic mange in a pigs farm in deep beeding in Guárico state (Venezuela) was investigated, using the direct parasitological techniques of flotation-concentration and direct microscopy. Results showed that two of the seven pigs examined were positive for Sarcoptes scabiei var. suis. Skin lesions potentially attributable to this mite were present in 100% of animals, but the parasite could be detected in only 28.6% of them. A flotation-concentration technique was more effective than direct microscopy. In this report we describe for the first time the detection of Sarcoptes scabiei var. suis mites on domestic pigs in Venezuela in deep beeding.

Sarcoptic mange (Sarcoptes scabiei) in wild canids (Cerdocyon thous) / Sarna sarcóptica (Sarcoptes scabiei) em cachorro-do-mato (Cerdocyon thous)

Crab-eating foxes (Cerdocyon thous) are wild canids found in practically all Brazilian states. They usually live and hunt in pairs, but can be found in small groups, which favors the transmission of diseases such as sarcoptic mange. This study aims to describe the epidemiological, parasitological and pathological findings of two fatal cases of sarcoptic mange in C. thous. Two wild canids were necropsied and cytological examination of skin and crust samples and histologic evaluation of various tissue samples were performed. Gross findings included poor body condition and extensive alopecia with thick skin crusts interspersed by intensely reddened alopecic areas. The cytological examination revealed numerous mites with short gnathosoma and rounded idiosoma that were transversally striated and presented triangular spines on the dorsal surface, terminal anus, and short and thick legs, characteristic of Sarcoptes scabiei. Histologic examination of the skin revealed numerous tunnels into and under the stratum corneum of the epidermis containing high amounts of S. scabiei. The mites were associated with marked acanthosis and hyperkeratosis, and mild superficial dermatitis. The findings reveal that sarcoptic mange is an important disease in wild canids.(AU)

Cachorros-do-mato (Cerdocyon thous) são canídeos selvagens encontrados em praticamente todos os estados brasileiros. Geralmente vivem e caçam em pares, mas podem ser encontrados em pequenos grupos, o que favorece a transmissão de doenças, como a sarna sarcóptica. O presente trabalho tem como objetivo descrever os achados epidemiológicos, parasitológicos e patológicos de dois casos fatais de sarna sarcóptica em cachorros-do-mato. Foram realizados necropsia de dois cachorros do mato, exame citológico de amostras de pele e crostas e exame histológico de amostras dos órgãos e tecidos. Na necropsia foram observados mau estado corporal, extensas áreas de alopecia, crostas cutâneas espessas que se desprendiam e eram intercaladas por áreas alopécicas intensamente eritematosas. No exame citológico foi observada grande quantidade de ácaros com gnatossoma curto e largo, idiossoma globoso, transversalmente estriado e com espinhos triangulares na superfície dorsal, ânus terminal e pernas curtas e grossas, característicos de Sarcoptes scabiei. Ao exame histológico da pele havia muitos túneis no estrato córneo da epiderme e abaixo dele, contendo grande quantidade de S. scabiei. Essas estruturas parasitárias estavam associadas a acantose e hiperqueratose acentuadas e dermatite superficial discreta. Os achados revelam a sarna sarcóptica como uma doença importante em cachorros do mato.(AU)

Acaricidal activity of ethanolic extracts of Stryphnodendron adstringens and Lafoensia pacari and oil resins from Copaifera sp. and Pterodon emarginatus against Sarcoptes scabiei var. suis / Atividade acaricida dos extratos etanólicos de Stryphnodendron adstringens Mart. e Lafoensia pacari A. St Hil., bem como das óleo-resinas de Copaifera sp. e Pterodon emarginatus Vogel, 1837 contra Sarcoptes scabiei var. suis

In vitro bioassay using Sarcoptes scabiei as a test microorganism is a viable method of study for diverse drugs with acaricidal properties. A great amount of assays proves the diverse and efficient biological activity of extracts and compounds from Brazilian savanna plants. This study had as main object, test and compare the acaricidal activity of four Brazilian Cerrado bioproducts: Stryphnodendron adstringens Mart., Copaifera sp., Lafoensia pacari A. St Hil. and Pterodon emarginatus Vogel, 1837. To perform this test S. scabiei mites were collected from crusts removed on ears of highly infected sows. The mites were selected and separated in Petri dishes with three different concentrations (25, 50 and 75%) of each bioproduct, to evaluate their potential acaricidal activity. The mortality of the mites was counted in each Petri dish every hour, during five hours. The statistical analyses demonstrated differences between the bioproducts tested. The oleoresin of Copaifera sp. and P. emarginatus presented the best results with 100% of mites mortality after treatment. The ethanolic extracts of S. adstringens and L. pacari demonstrated lower acaricidal activity when compared to the oleoresins, with little or no difference among the control groups tested. This bioassay demonstrated to be efficient, reliable, low cost and easy accomplishment. Oil resins from Copaifera sp. and P. emarginatus have in vitro acaricidal activity against adult females of S. scabiei var. suis.(AU)

O uso de Sarcoptes scabiei como microrganismo teste para bioensaio in vitro é um método de estudo viável para diversas drogas acaricidas. Muitos ensaios comprovam a diversidade e eficiência de atividade biocida de extratos e componentes presentes em plantas do cerrado brasileiro. Este trabalho objetivou testar e comparar a atividade acaricida de quatro bioprodutos do cerrado brasileiro: Stryphnodendron adstringens Mart., Lafoensia pacari A. St Hil., Copaifera sp. e Pterodon emarginatus Vogel, 1837. Para este estudo, ácaros S. scabiei foram colhidos em crostas removidas de orelhas de fêmeas suínas altamente infestadas. Os ácaros foram selecionados, separados e colocados em placas de Petri com três diferentes concentrações (25, 50 e 75%) de bioprodutos, para avaliar o potencial de atividade acaricida de cada um. Foi realizada a contagem da mortalidade dos ácaros em cada placa de Petri a cada hora, durante cinco horas. As análises estatísticas demonstraram diferenças entre os bioprodutos testados. As óleo-resinas de Copaifera sp. e P. emarginatus apresentaram os melhores resultados, com 100% de mortalidade dos ácaros após tratamento. Os extratos etanólicos de S. adstringens Mart. e L. pacari demonstraram menor atividade acaricida quando comparados as óleo-resinas, com pequena ou nenhuma diferença entre os resultados dos grupos controle. Este ensaio demonstrou ser uma ferramenta eficiente, confiável, de baixo custo e de fácil realização. As óleo-resinas Copaifera sp. e P. emarginatus possuem atividade acaricida in vitro sobre fêmeas adultas de S. scabiei var. suis.(AU)

Norwegian scabies in a patient treated with Tripterygium glycoside for rheumatoid arthritis

Abstract: We report an 80-year-old male patient with severe rheumatoid arthritis who was treated with tripterygium glycoside, an immunosuppressive agent made from the extract of a Chinese medicinal herb called Tripterygium wilfordii Hook F. The patient had no apparent skin lesions before the treatment, but he developed aggressive hyperkeratotic lesions with rapid progression after using tripterygium glycoside. He was repeatedly diagnosed with eczema, but treatment failed to achieve efficacy. Interestingly, a microscopic examination of the lesions revealed numerous scabies mites and eggs. Thus, we confirmed the diagnosis of Norwegian scabies infection. Treated with crotamiton 10% cream and 10% sulfur ointment for one month, the patient's clinical symptoms disappeared.

Eficácia da ivermectina comprimido no tratamento da sarna sarcóptica em cães naturalmente infestados / Efficacy of the ivermectin tablet for treatment of sarcoptic mange in naturally infested dogs

O objetivo deste trabalho foi avaliar a eficácia da ivermectina comprimido administrada por via oral no tratamento de Sarcoptes scabiei em cães naturalmente infestados. Foram selecionados 14 cães com raspados cutâneos positivos para o ácaro S. scabiei, idade de 1-5 anos, sem raça definida, distribuídos na mesma proporção de ambos os sexos, em dois grupos experimentais, compondo 7 animais por grupo. Todos os animais foram tratados a cada 7 dias, totalizando quatro tratamentos em cada cão (Dias 0,7,14 e 21). No grupo I foi administrada a ivermectina5 comprimido na dosagem de 0,2mg/kg e no grupo controle positivo (Grupo II) foi administrado um produto comercial a base de ivermectina comprimido na mesma dosagem do grupo I. Raspados cutâneos, avaliações clinicas e laboratoriais complementares dos cães foram realizadas durante o período de estudo. Clinicamente, não houve diferença significativa entre as avaliações antes e após o tratamento entre os dois grupos. Raspados negativos foram observados em ambos os grupos a partir do dia D+14, mantendo-se negativos até o final do período experimental. As lesões dermatológicas iniciais observadas no acompanhamento clínico regrediram e a partir do dia D+14 a melhora clínica era evidente em ambos os grupos. A ivermectina (Ivermectan Pet, UCBVET Saúde Animal) administrada por via oral foi eficaz no tratamento de S. scabiei em cães naturalmente infestados.(AU)

The aim of this study was to evaluate the efficacy of the ivermectin tablet administered orally for treatment of Sarcoptes scabiei in naturally infested dogs. Fourteen 1 to 5 year-old Mongrel dogs presenting positive skin scrapings for S. scabiei mites, distributed into two groups with equal proportions of both sexes, containing seven animals per group were used in this study. All dogs were treated every 7 days, totaling four treatments in each dog (days 0, +7, +14 and +21). Group I was administered the ivermectin5 tablet at a dose of 0.2mg/kg and positive control group II as given an ivermectin commercial product at the same dose of group I. Skin scrapings, clinical and laboratorial parameters analysis were performed during the experimental period. Clinically there were no significant differences between the two groups evaluated prior and after treatments. Negative skin scrapings were observed in both groups from day +14, remaining negative until the end of the experimental period. The initial skin lesions observed in clinical evaluation regressed from day +14, and clinical improvement was evident in both groups. The ivermectin tablet (Ivermectan Pet, UCBVET Saúde Animal) administered orally was effective to treat S. scabiei infection in naturally infested dogs.(AU)

Manejo en atención primaria de escabiosis en una familia con ruralidad extrema / Primary care management of scabies in a family with extreme rurality

La dermatoparasitosis producida por el acaro Sarcoptes scabiei variedad hominis, presenta una distribución poblacional relacionada al hacinamiento, condiciones higiénicas deficientes, pobreza y características geoclimáticas. El contagio ocurre de forma directa cutánea o a través de fómites. Liquiñe,poblado fronterizo de la Región de los Ríos, Chile, presenta en gran parte de su población las características mencionadas, con difícil acceso a comunicación digital y derivación médica. La incidencia de sarna se ve modificada al realizar intervenciones educacionales y saneamiento local, tanto como el diagnostico precoz y el tratamiento oportuno logran una modificación sustancial de la prevalencia. Se presenta el reporte de un caso. Paciente sexo femenino, 33 años, que presenta lesiones por grataje, excoriadas, con pápulo-pústulas de dos años de evolución, con manejo inicial sintomático por diagnóstico de dermatitis y psoriasis sin mejora de las lesiones. Conjuntamente se identifica en la hija de 4 años, lesiones primarias de características similares a las iniciales. Las lesiones de la menor se presentan como vesículas en espacio interdigital, muñe-cas, región periumbilical y surco acarino, compatibles con sarna. Se inicia tratamiento tópico permetrina 5 %a toda la familia, basados en las recomendaciones de la guía de manejo MINSAL. Se logra tras 2 años de evolución regresión total de los signos y síntomas a los 2 meses de iniciada la terapia. La presente revisión de caso pretende reforzar las ideas de diagnóstico precoz, tanto de caso índice como de probables contactos,educación continua a la comunidad. Tratamiento efectivo y oportuno, adecuado a la realidad socio cultural década localidad, tomando en cuenta factores de riesgos para la presentación y el abandono de la terapia. Asimismo promover las redes institucionales para la distribución de tratamiento, asesoramiento por especialistas y conocimientos actualizados de la semiología de cada cuadro dermatológico por el médico general.

The dermato parasitosis producedby the Sarcoptes scabiei mite hominis variety, has apopulation distribution related to over crowding, poor sanitation, poverty and geo-climatic characteristics.Transmission occurs directly through skin or fomites.In the border town of Liquiñe in the Region de los Rios,Chile, a substantial amount of the population is subject to the above characteristics, with difficult access to digital communication and medical referrals. The incidence of scabies is modified through educational interventions, and local sanitation, as well as early diag-nosis and timely treatment thus achieving a substantial change in prevalence. A case report is presented. Female patient, 33 years old presents with excoriated crusted lesions, with papules and pustules following two years of development, initial symptomatic management diagnosis of psoriasis and dermatitis,showed no improvement of the lesions. At the same time the 4 year old daughter of the patient presented with primary lesions similar to baseline characteristics.The child ́s lesions presented as vesicles in interdigital space, wrists, periumbilical region and mite grooves compatible with scabies. Permethrin 5% topical treatment was prescribed for the whole family, basedon the recommendations of the MINSAL guide management is initiated. At 2 months of treatment therapy on set, complete recovery was achieved following two years of evolution of signs and symptoms.This case review aims to reinforce the ideas of earlydiagnosis, in both probable index case and contact,and continuing education in the community. Effective and timely treatment, in conjunction with the socio-cultural reality of each community, taking into account risk factors, such as seeking medical treatment and abandoning therapy. Furthermore, it is also intended to promote institutional networks for treatment dissemination, counseling by specialists and updated information for each dermatological presentation for the general medicine physician.

Serie parasitosis en dermatología: escabiosis / Series parasitosis in dermatology: scabies

La escabiosis es una ectoparasitosis pruriginosa producida por el ácaro Sarcoptes scabiei, variedad hominis, específica del ser humano. Si bien su distribución es universal, con frecuencia es subdiagnosticada por asociarla únicamente a hacinamiento y malos hábitos de higiene. Se transmite por contacto directo con una persona afectada o a través de fómites, por lo que es muy común el contagio de los convivientes. Presentamos un caso de escabiosis en una paciente anciana evaluada por prurito generalizado. (AU)

Scabies is a human specific pruritic ectoparasitosis produced by the mite Sarcoptes scabiei var. hominis. Although it has a worldwide distribution, it is often underdiagnosed because it is only associated with overcrowding and poor hygiene. It is transmitted by a direct contact with an affected person or through fomites. The transmission to cohabitants is very common. We present a case of scabies in an elderly patient with generalized pruritus. (AU)

Doença de Grover associada a Sarcoptes Scabiei: relato de caso / Grover?s disease associated with Sarcoptes scabiei: case report

A doença de Grover, ou dermatose acantolítica transitória, consiste em uma dermatose papulovesiculosa pruriginosa, caracterizada histologicamente por acantólise. A maior parte dos casos está representada por homens brancos acima de 40 anos de idade. Não existeetiologia conhecida, mas o calor e o suor excessivos são descritos com frequência como fatores desencadeantes ou agravantes. O diagnóstico é feito por suspeição clínica e confirmado pela biópsia das lesões cutâneas. Neste estudo é relatado o caso de um paciente de 53 anos de idade, com doença de Grover associada à infestação por Sarcoptes scabiei.

Grover?s disease, or transient acantholytic dermatosis, consists of a papulovesicular pruritic dermatosis histologically characterized by acantholysis. Most cases are represented by white men above 40 years of age. There is no known etiology; however, heat and excessive sweating are frequently described as triggering or aggravating factors. The diagnosis is made by clinical suspicion and confirmed by biopsy of cutaneous lesions. In this study the case of a 53-year-old patient is reported with Grover?s disease associated with infestation by Sarcoptes scabiei.

Examination of Burrows in a Norwegian Scabies Patient / 대한피부과학회지

No abstract available.

Diagnóstico por Teledermatologia em paciente do Alto Rio Solimões: um caso de escabiose crostosa / Diagnosis by Teledermatology of a patient from the Alto Solimões River: a case of Crusted Scabies / Diagnóstico por Teledermatología en paciente del Alto Río Solimões: un caso de Escabiosis Costrosa

A Teledermatologia estuda o uso das tecnologias de telecomunicação e informática na assistência dermatológica sem a atuação presencial do especialista. Neste trabalho, é relatado o processo diagnóstico de um caso de escabiose crostosa (sarna norueguesa) em paciente idoso da região do Alto Rio Solimões, por meio de recursos de Teledermatologia. Além disso, os autores discutem os avanços dessa tecnologia que possibilita a assistência a distância para comunidades ribeirinhas e indígenas, sobretudo em áreas isoladas da Amazônia Legal, nas quais inúmeras doenças são negligenciadas e subdiagnosticadas.

Teledermatology uses telecommunication technology and informatics on dermatologic practice without the presence of a specialist. This paper describes the diagnostic process of a Crusted Scabies (Norwegian Scabies) case in an elderly patient from the Alto Solimões River region using teledermatology resources. Moreover, the authors discuss the progress of these technologies, which allow healthcare assistance for those living in remote indigenous and riverine communities, particularly in isolated areas of the Legal Amazon where many diseases are neglected or underdiagnosed.

La Teledermatología usa las tecnologías de las telecomunicaciones y de la informática para dar asistencia dermatológica sin la presencia de un especialista. Este artículo describe el proceso de diagnóstico de un caso de escabiosis costrosa (sarna norueguesa) en un paciente anciano de la región del Alto Rio Solimões, a través de recursos de la Teledermatología. Además, los autores discuten los avances de estas tecnologías que permiten llevar asistencia médica a las comunidades costeras e indígenas remotas, especialmente a aquellas de zonas aisladas del Legal Amazon, en las cuales numerosas enfermedades son negligenciadas y subdiagnosticadas.

Norwegian scabies mimicking rupioid psoriasis / Sarna norueguesa mimetizando psoríase rupioide

Norwegian scabies is a highly contagious skin infestation caused by an ectoparasite, Scarcoptes scabiei var. Hominis, which mainly affects immunosuppressed individuals. Clinically, it may simulate various dermatoses such as psoriasis, Darier's disease, seborrheic dermatitis, among others. This is a case report of a 33-year-old woman, immunocompetent, diagnosed with generalized anxiety disorder (cancer phobia), who had erythematous, well-defined plaques, covered with rupioid crusts, on her neck, axillary folds, breast, periumbilical region, groin area, besides upper back and elbows, mimicking an extremely rare variant of psoriasis, denominated rupioid psoriasis.

A sarna norueguesa é uma infestação cutânea altamente contagiosa causada pelo ectoparasita Sarcoptes scabiei var. hominis, que atinge principalmente indivíduos imunossuprimidos. Clinicamente, pode simular várias dermatoses, tais como psoríase, doença de Darier, dermatite seborréica, entre outras. O artigo relata o caso de uma mulher de 33 anos, imunocompetente, porém com diagnóstico de transtorno de ansiedade generalizada e cancerofobia, que apresentava placas bem delimitadas, sobre base eritematosa, recobertas por crostas rupioides, nas regiões cervical, axilar, mamária, umbilical, inguinal, além de dorso superior e cotovelos, mimetizando uma variante extremamente rara de psoríase, denominada psoríase rupioide.

A survey of ectoparasite infestation in dogs in Tehran, Iran / Um levantamento da infestação de ectoparasitos em cães em Teerã, Irã

This survey was conducted to identify and estimate the frequencies of ectoparasites of dogs in Tehran, Iran. A total of 143 dogs attended at the Small Animal Hospital of the Veterinary School, the University of Tehran, were examined for the presence of ectoparasites and dermatological lesions. Ectoparasite specimens and blood samples were sent to parasitology and hematology laboratories, respectively. Ticks were the most frequent ectoparasite (36.4%, 52/143), followed by fleas (29.4%, 42/143), mites (25.9%, 37/143), and lice (8.4%, 12/143). Mixed infestations with two or more ectoparasites were detected in eight dogs. Rhipicephalus bursa was the most frequent ectoparasite in spring and summer. Ectoparasitic infestations were recorded mainly in large breeds and juvenile animals. Eosinophilia was more observed in dogs infested with Sarcoptes scabiei. The most common clinical sign, skin pruritus, was associated with mite and lice infestations. These results indicate that the tick R. bursa was the most prominent species of ectoparasite found in the evaluated group, followed by Ctenocephalides canis and S. scabiei var canis.

Esta pesquisa foi realizada para identificar e estimar a frequência de ectoparasitas de cães em Teerã, Irã. Um total de 143 cães, atendidos no Hospital de Pequenos Animais da Faculdade de Veterinária da Universidade de Teerã, foi examinado para a pesquisa de ectoparasitas e lesões cutâneas. Espécimes de ectoparasitos e amostras de sangue coletadas foram enviadas para exame em laboratório de parasitologia e hematologia, respectivamente. Os carrapatos foram os ectoparasitos mais frequentemente encontrados (36,4%, 52/143), seguidos por pulgas (29,4%, 42/143), sarnas (25,9%, 37/143) e piolhos (8,4%, 12/143). Infestações mistas com dois ou mais ectoparasitos foram observadas em oito cães. Rhipicephalus bursa foi o ectoparasito mais frequente na primavera e verão. Infestações de ectoparasitos foram registradas principalmente em raças maiores e animais jovens. Eosinofilia foi mais observado em cães infestados com Sarcoptes scabiei. O sinal clínico mais comum, prurido na pele, esteve associado às infestações por ácaros e piolhos. Estes resultados indicam o carrapato R. bursa como ectoparasito mais comum no grupo avaliado, seguido por Ctenocephalides canis e S. scabiei var canis.

Reemerging skin disease caused by arthropods I: scabies

Scabies is one of the most common world-wide arthropod-born diseases in both humans and animals caused by the "itch" mite Sarcoptes scabiei. The incidence of scabies has shown a tendency to increase for the last several years in Korea. The previous peak incidence in Korea was between the early 1970s and early 1980s. A substantial part of the cyclic resurgence of scabies has been considered the result of inexperience and indifference of medical doctors toward the disease. The recent resurgence is presumed to be derived from not only indifference of the doctors but also an increase in elderly patients admitted to nursing homes and eldercare hospitals. Scraping using mineral oil for scabies patients is a very simple and effective method for definite diagnosis. A new diagnostic method using a dermoscope is also effective, especially for very young patients. Lindane and crotamiton are two available antiscabietic preparations in Korea. Crotamiton is less effective, while infants and pregnant women should not use lindane. In conclusion, medical personnel should be alert coping with the resurgence of scabies, and it is strongly suggested that other antiscabietic drugs such as permethrin, ivermectin, etc. should be made available for resistant patients in the near future in the Republic of Korea.

Riesgo de contagio y prevención de brotes hospitalarios por Sarcoptes scabiei / Contagion risk and prevention of nosocomial outbreaks due to Sarcoptes scabiei

Introducción. Los brotes por Sarcoptes scabiei son frecuentes en todo tipo de instituciones sanitarias, iniciándose sobre todo a partir de pacientes con sarna noruega. En forma cada vez más contundente, se recomiendan medidas agresivas y precoces, incluso en casos equívocos. Materiales y métodos. Este artículo describe un brote en el que se actuó de forma rotunda, pero sólo cuando se había demostrado la transmisión hospitalaria. Objetivos. Describir y valorar las consecuencias de esta decisión. Resultados y discusión. Ocurrió un brote pequeño pero, dada la levedad de las consecuencias de la infestación y que se evitó desde un inicio la dispersión de casos por toda la institución, los autores consideran que una demora en la aplicación de medidas agresivas, si permite valorar inequívocamente el riesgo y es de corta duración, favorece un uso más juicioso de los recursos.

Introduction. Sarcoptes scabiei outbreaks are common in all types of health institutions, starting mostly from patients with Norwegian scabies. Recommendations for action are growing stronger, such as early and aggressive action even in unclear cases. Materials and methods. This article describes an outbreak where aggressive action was taken, but only when nosocomial transmission was demonstrated. Objectives. To describe and assess the consequences of this decision. Results and discussion. A small epidemic occurred, but given the lightness of the infestation consequences and that the spread of cases across the institution was avoided from the beginning, the authors believe that a delay in the implementation of aggressive measures favors a more judicious use of resources, if it allows to assess the risk unambiguously and is short termed.

Dermoscopia da sarna crostosa associada à síndrome da imunodeficiência adquirida / Dermoscopy of Norwegian scabies in a patient with acquired immunodeficiency syndrome

Os autores relatam o caso de uma paciente com sarna norueguesa e síndrome da imunodeficiência adquirida com baixa aderência à terapia antirretroviral. O diagnóstico definitivo foi confirmado pelo exame parasitológico direto. A dermatoscopia mostrou sulcos escabióticos e estruturas acastanhadas em asa-delta já descritas, além de uma estrutura morfologicamente semelhante a um gongolo (diplopodasímile). Esta última representa um elemento patodiagnóstico da SN não previamente descrito. Houve boa reposta clínica ao uso oral da ivermectina e ao uso tópico da vaselina com enxofre a 10 por cento, com concomitante melhora dos parâmetros dermatoscópicos.

The authors report here on the case of a female patient with Norwegian (crusted) scabies and acquired immunodeficiency syndrome whose compliance with antiretroviral therapy was poor. Definitive diagnosis was confirmed by direct microscopic examination, which revealed numerous Sarcoptes scabei. Dermoscopy showed pathognomonic scabetic burrows and brownish structures in the shape of a hand-glider with a millipede-like appearance. The latter constitutes a diagnostic feature in the pathology of Norwegian scabies that has not yet been described. The patient responded well to oral ivermectin and topical vaseline with sulphur at a proportion of 10 percent. There was a simultaneous improvement in dermoscopic parameters.

Sarna humana: el ácaro y sus circunstancias / Human Scabies: The Mite And Its Circumstances

La sarna humana, dermatosis milenaria, nos sigue sorprendiendo en la actualidad por su capacidad para producir diversas manifestaciones clínicas, cuyo reconocimiento puede ser dificultoso para el clínico generalista y aún para el dermatólogo experimentado. Es una enfermedad frecuente, cuyas manifestaciones dependen del delicado interjuego que existe entre el huésped, el parásito y el medio ambiente. Realizamos una descripción de variedades poco frecuentes de escabiosis y la ilustramos a través de nueve casos.

At the present time, human scabies, millenarian disease, surprised us because of its ability to produce diverse clinical manifestations, whose recognition still can be difficult for clinical and for the experienced dermatologist. It is a common disease, whose clinical expression depends on the delicate interplay between the host, the parasite and the environment. We present a description of rare varietes of scabies, illustrated with nine clinical cases.

Crusted (Norwegian) Scabies Following Systemic and Topical Corticosteroid Therapy

It is a case study of a 62-yr-old female with crusted (Norwegian) scabies, which appeared during her treatment with systemic and topical corticosteroid therapy, under the diagnosis of erythroderma. In the same time, the patient had been suffered from hypothyoidism, and her skin changes were misdiagnosed, because it was thought that they are associated with her endocrine disorder. Suddenly, beside the erythema, her skin became hyperkeratotic, with widespread scaling over the trunk and limbs, and crusted lesions appeared on her scalp and ears. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites and eggs. Repeated topical treatments with lindan, benzoyl benzoat and 10% precipitated sulphur ointment led to the complete resolution of her skin condition.

A Survey of Ectoparasite Infestations in Stray Dogs of Gwang-ju City, Republic of Korea

This study was designed to investigate the incidence of ectoparasite infestation among stray dogs in Gwang-ju City, Republic of Korea. A total of 103 stray dogs collected in the Animal Shelter of Gwang-ju City from November 2003 to August 2005 were investigated in this study. Ectoparasites of one or more genera were detected in 45.6% (47 / 103) of the dogs examined for dermatologic lesions and/or skin scrapings (from 3-5 affected areas). Otodectes cynotis was found to be the most frequent parasite (22.3%, 23 / 103), followed by Sarcoptes scabiei var canis (19.4%, 20 / 103), Ctenocephalides canis (6.8%, 7 / 103), Demodex canis (4.9%, 5 / 103), and Trichodectes canis (1.0%, 1 / 103). Monospecific infestation was found in 83.0% (39 / 47) of the affected dogs, whereas concurrent infestations with 2 or more ectoparasites per animal were found in 17.0% (8 / 47) of the affected dogs. Trichodectes canis is reported for the first time in the Republic of Korea. Dogs less than 1 yr old were more heavily infected than other age groups (66.7%), and small-sized dogs of less than 3 kg body weight were more heavily infected than larger dogs (41.7%).

A Survey of Ectoparasite Infestations in Stray Dogs of Gwang-ju City, Republic of Korea

This study was designed to investigate the incidence of ectoparasite infestation among stray dogs in Gwang-ju City, Republic of Korea. A total of 103 stray dogs collected in the Animal Shelter of Gwang-ju City from November 2003 to August 2005 were investigated in this study. Ectoparasites of one or more genera were detected in 45.6% (47 / 103) of the dogs examined for dermatologic lesions and/or skin scrapings (from 3-5 affected areas). Otodectes cynotis was found to be the most frequent parasite (22.3%, 23 / 103), followed by Sarcoptes scabiei var canis (19.4%, 20 / 103), Ctenocephalides canis (6.8%, 7 / 103), Demodex canis (4.9%, 5 / 103), and Trichodectes canis (1.0%, 1 / 103). Monospecific infestation was found in 83.0% (39 / 47) of the affected dogs, whereas concurrent infestations with 2 or more ectoparasites per animal were found in 17.0% (8 / 47) of the affected dogs. Trichodectes canis is reported for the first time in the Republic of Korea. Dogs less than 1 yr old were more heavily infected than other age groups (66.7%), and small-sized dogs of less than 3 kg body weight were more heavily infected than larger dogs (41.7%).