Escabiose: aspectos gerais e a importância no reconhecimento e tratamento precoces / Scabies: general aspects and the importance of early recognition and treatment

A escabiose é uma dermatose infecto parasitária mais prevalente no mundo, sobretudo nas regiões tropicais e em países de baixa renda. Surtos são comuns em locais de aglomeração como presídios, escolas e campos de refugiados, e tanto o atraso no diagnóstico como o tratamento inadequado são responsáveis pela propagação da doença. Este trabalho tem por objetivos destacar os principais aspectos da escabiose bem como as apresentações dermatológicas, a fim de auxiliar no diagnóstico e tratamentos precoces, tendo como foco o médico generalista. O estudo foi realizado no Departamento de Clínica de Dermatologia do Hospital das Clínicas da Faculdade de Medicina de São Paulo (HCFMUSP), através de uma revisão de literatura com acesso aos bancos de dados eletrônicos PubMed. A escabiose é causada pelo Sarcoptes scabiei, caracterizada pelo prurido intenso e por lesões cutâneas sugestivas e localizações típicas, mas que podem variar de acordo com a faixa etária ou estados de imunossupressão. É considerada pela Organização Mundial da Saúde uma doença tropical negligenciada, podendo causar grande impacto socioeconômico e, ainda que com menor frequência, levar a complicações, muitas vezes decorrentes de infecções bacterianas secundárias, sobretudo nas formas mais graves da doença (vistas principalmente em pacientes imunossuprimidos). Por esses motivos, o reconhecimento das principais formas de apresentação clínica e sintomas associados são importantes para que o diagnóstico seja estabelecido de forma breve, possibilitando a instituição correta do tratamento e, com isso, cessando o ciclo de transmissão do ácaro.

Sarna costrosa: revisión sobre aspectos clínicos de una ectoparasitosis desatendida y de presentación infrecuente / Crusty scabies: review of the clinical aspects of a neglected and infrequent ectoparasitosis

En esta revisión de la literatura se describen aspectos epidemiológicos, fisiopatológicos, clínicos y terapéuticos sobre una presentación atípica y grave de escabiosis, la sarna costrosa o noruega. Esta presentación de escabiosis destaca por afectar principalmente a personas con condiciones de inmunodepresión o sociales que las hacen susceptibles de una alta carga parasitaria, además se asocia a un peor pronóstico y a riesgo de complicaciones. Desde el punto de vista terapéutico, sus estrategias difieren del manejo de la escabiosis clásica.(AU)

This literature review describes epidemiological, pathophysiological, clinical and therapeutic aspects of an atypical and severe presentation of scabies, Norwegian or crusty scabies. This presentation of scabies stands out because it mainly affects people with immunosuppressive or social conditions that make them susceptibleto a high parasite load, it is also associated with a worse prognosis and risk of complications. From a therapeutic point of view, their strategies differ from the management of classic scabies.(AU)

Digital dermoscopy: a complementary method in the diagnosis of scabies

Abstract Scabies is an ectoparasitosis caused by Sarcoptes scabiei var. hominis, characterized clinically by pruritic lesions in typical locations; the crusted form is a rare manifestation. The diagnosis is usually established based on the clinical picture, but dermoscopy can be an important complementary method, as it allows the observation of a brownish triangular structure with a hang-glider appearance. A case of crusted scabies is reported; the magnification of the images obtained by digital dermoscopy allowed the demonstration of a structure usually observed only with videodermoscopy.

Escabiasis costrosa imitando una acrodermatitis continua de Hallopeau / Crusted scabies mimicking an acrodermatitis continua of Hallopeau

Resumen Introducción: La escabiasis costrosa (EC) es una variante poco común de sarcoptiosis clásica, altamente contagiosa. Las lesiones poseen una elevada concentración del ácaro Sarcoptes scabiei var hominis, lo que conlleva a un cuadro clínico más extenso que en la escabiasis clásica. Se observa principalmente en pacientes con algún tipo de inmunocompromiso y se relaciona con el síndrome de Down. Caso clínico: Se describe una paciente pediátrica con síndrome de Down quien presentó placas escamosas que afectaron la porción distal de los dedos, asociadas con distrofia ungueal e hiperqueratosis subungueal, por lo que se consideró acrodermatitis continua de Hallopeau como diagnóstico diferencial. Se realizó una biopsia tipo punch con lo que se llegó al diagnóstico de EC. La paciente recibió tratamiento sistémico con ivermectina vía oral y tratamiento tópico con crema hidratante y desonida al 0.1%. Mostró mejoría clínica notoria dos semanas después de finalizar el tratamiento. Conclusiones: La EC es una variante prevalente en pacientes inmunocomprometidos y con síndrome de Down que fácilmente puede confundirse con patologías inflamatorias con alteración de la queratinización epidérmica. Este caso se considera una presentación atípica debido a la afección localizada en los dedos de las manos asociada con distrofia ungueal. El estudio histopatológico fue necesario para realizar el diagnóstico y descartar diagnósticos diferenciales.

Abstract Background: Crusted scabies (CS) is an uncommon, highly contagious, variant of classic scabies. Elevated concentrations of the mite Sarcoptes scabiei var. hominis are found in the skin lesions, which lead to a more exaggerated clinical picture than in classic scabies. This disease is mainly observed in patients with any kind of immunosuppression and relates to Down syndrome. Case report: A pediatric female patient with Down syndrome, who presented a crusty white plaque associated with nail dystrophy and subungual hyperkeratosis affecting the distal portion of the fingers is described. Because of these findings, the diagnosis of acrodermatitis continua of Hallopeau was considered. A punch biopsy was performed, attaining the diagnosis of CS. She received systemic treatment with oral ivermectin, topical treatment with emollient cream and desonide 0.1%. Notorious clinical improvement was observed two weeks after finalizing treatment. Conclusions: CS is variant of scabies prevalent in immunocompromised patients and Down syndrome that can be easily confused with inflammatory pathologies with abnormal epidermal keratinization. This case is considered as an atypical presentation of the disease because of local affection of the fingers and nail dystrophy. The histopathological study was necessary to obtain the diagnosis and rule out differential diagnosis.

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)

Scabies mimicking graft versus host disease in a hematopoietic cell transplant recipient / 소아과

Scabies is a highly contagious skin infestation caused by the mite, Sarcoptes scabiei var. hominis. Complex responses to scabies mites in the innate, humoral, and cellular immune systems can cause skin inflammation and pruritus. Diagnosis can be challenging because scabies resembles other common skin conditions. We report the first Korean case of scabies in a hematopoietic cell transplant (HCT) recipient, initially suspected of skin graft versus host disease (GVHD). A T-cell acute lymphocytic leukemia patient underwent a sibling-matched allogeneic HCT and developed pruritus after cell engraftment. Treatment for GVHD did not improve the symptoms. He was diagnosed with scabies 30 days after the onset of symptoms.

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)

A Case of Facial Sarcoptes scabiei in a Female Child

No abstract available.

Effective Diagnosis and Treatment of Scabies in Cases from 3 Generations Using Dermoscopy-oriented Skin Scraping with Microscopic Examination / 대한피부과학회지

Scabies is caused by a mite, Sarcoptes scabiei var hominis, an obligate human parasite that burrows downwards into the epidermis. Scabies may be transmitted from objects, but it is most often transmitted by direct skin-to-skin contact, with a higher risk from prolonged contact. Treatment must involve the entire household or community to prevent reinfection. In Korea, the incidence of scabies has decreased dramatically since the late 1980s, but recent outbreaks in nursing homes and hospitals have been raising public health concerns. Herein, we describe 5 cases of scabies that occurred in 3 generations of a family and were confirmed by dermoscopy-oriented skin scraping with microscopic examination.

Skin impression with acetate tape in Demodex canis and Scarcoptes scabiei var. vulpes diagnosis / Impressão cutânea com fita de acetato no diagnóstico de Demodex canis e Sarcoptes scabiei var. vulpes

This study compares the efficacy of skin impression with acetate tape and the deep skin scraping test to find D. canis and S. scabiei in dogs. During six months, 134 samples were collected by both techniques from 115 dogs treated at the dermatology service of the Veterinary Hospital of the Federal University of Santa Maria (HVU-UFSM). Of these patients, 27 had demodicosis and 12 had scabies. The impression with acetate tape test (ITT) was shown to be significantly superior to the deep skin scraping test (DSST) in finding D. canis and S. scabiei mites (p = 0.007). Based on our results we could conclude that acetate tape impression is a reliable method for diagnosing and monitoring therapy of dermatopathies caused by mites and can be used to replace the traditional deep skin scraping method. In addition, since it is less traumatic for the dog, this method shows more acceptance by the owner.

Este estudo compara a eficácia da impressão cutânea com fita de acetato ao raspado cutâneo profundo para a pesquisa de D. canis e S. scabiei. Em um período de seis meses, foram coletadas 134 amostras de cada uma das técnicas de um total de 115 cães atendidos na rotina dermatológica do Hospital Veterinário Universitário da Universidade Federal de Santa Maria (HVU-UFSM). Desses pacientes, 27 cães apresentavam sarna demodécica e 12 cães, escabiose. A impressão cutânea com fita de acetato, quando comparada ao raspado cutâneo profundo, demonstrou ser significativamente superior na pesquisa dos ácaros D. canis e S. scabiei (p = 0,007). Conclui-se que o método da fita de acetato pode ser usado em substituição ao raspado profundo de pele para o diagnóstico e controle da terapia das enfermidades dermatológicas produzidas por ácaros. Além de ser um método sensível, ele é menos traumático para o animal, sendo, dessa forma, mais aceito pelo proprietário.

Sarna sarcóptica: comunicación de un brote en un grupo familiar y su mascota / Sarcoptic mange: report of an outbreak in a family and their pet

Scabies caused by the genus Sarcoptes scabiei var canis is a prevalent infection in dogs and affects abandoned, malnourished and overcrowded animals, causing hair loss and an intensely pruritic crusting dermatitis. In humans the manifestation is a self-limiting pruritic dermatitis, but persistent cases are described. An outbreak of sarcoptic mange is reported in a family group (seven people, including a 5 month infant and his mother). The infective source was their own house dog who was taken from the street. The diagnosis was confirmed by the detection of mites and eggs in the acarotest of the dog and mites of S. scabei in the infant. Sarcoptic mange should be suspected in individuals with allergic dermatitis who have contact with dogs. Treatment in humans is usually symptomatic and may need miticides if the infection persists. The control of the disease requires an appropriate pet treatment.

La sarna producida por el género Sarcoptes scabiei var canis, infección prevalente en perros y de alto potencial zoonótico, afecta a animales abandonados, desnutridos y hacinados y causa alopecia y una dermatitis costrosa intensamente pruriginosa. En el ser humano produce una dermatitis pruriginosa generalmente autolimitada, pero se describen casos persistentes. Se reporta un brote de sarna sarcóptica en un grupo familiar (siete personas, incluidas una lactante y su madre) cuya fuente de infección fue su mascota canina recogida de la calle. El diagnóstico fue confirmado por visualización en el ácarotest de ácaros y huevos en el perro y ácaros de S. scabiei en la lactante. La sarna sarcóptica debe sospecharse en casos de dermatitis alérgica en personas con contacto con perros. El tratamiento en el humano, habitualmente sintomático, puede necesitar acaricidas si el cuadro persiste. El control de la enfermedad requiere el adecuado tratamiento de la mascota.

Bullous Scabies with Bullous Pemphigoid / 대한피부과학회지

We report a rare case of bullous scabies with bullous pemphigoid in a 59-year-old male patient. He presented with a 9-month history of exhibiting multiple, variable-sized, red-to-brown, pruritic cutaneous patches, and papules with tense bullae on his whole body. A direct smear of the bullous lesions was performed and was negative for scabies mites. Histopathologic findings (hematoxylin and eosin staining) revealed Sarcoptes scabiei in the stratum corneum. There were sub-epidermal blisters with massive eosinophil and lymphocyte infiltration in the epidermis and upper dermis. Direct immunofluorescence microscopy showed linear deposition of IgG at the dermo-epidermal junction. Indirect immunofluorescence microscopy of samples acquired for the salt-split skin test showed linear IgG deposition in the epidermis. Skin lesions improved after the patient was treated with an anti-scabietic and steroids.

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.