Atypical crusted scabies in a patient with chronic liver disease caused by hepatitis B and D viruses

Abstract: Crusted scabies is a less common variant of scabies that is highly contagious, difficult to treat and involves infestation by Sarcoptes scabiei var. hominis. The classical clinical presentation includes crusted, scaly and generally non-pruritic lesions usually located on the head, neck, palmar, plantar and periungual region. It was first described in Norway in 1848 in patients with leprosy who presented with crusted lesions. In this study, we report the case of a patient with crusted scabies with florid clinical manifestations and chronic liver disease due to hepatitis B and delta virus infection.

Scabies is a neglected health problem

The disease "scabies" is a neglected worldwide health problem that is caused by the mite Sarcoptes scabiei that burrows in the stratum corneum of the skin. Scabies persists despite the availability of topical insecticides because the disease is transmitted before it is diagnosed and treated and significant resistance to insecticides has developed. The aim of this study was to investigate immunobiochemial response of the host's inflammatory/immune response to scabies during infestation. The number of eosinophil, neutrophil and serum interleukin [IL]-5 were assessed in 27 patients with 25 healthy control subjects. In the present study significantly higher number of eosinophil [13.90 +/- 2.40%vs. 3.02 +/- 1.33%; p<0.001] and highly significant elevation in neutrophil [%] in the scahies group compared to the healthy controls [35, 9 +/- 4.2%vs. 21.4 +/- 2.6%, p<0.001]. As regards IL-S [there was a highly significant elevation in lnterleukin-5 in the scabics group compared to the healthy normal controls [47.0 +/- 18.31 ugh vs. 10 +/- 3.13 ug/l p<0.001].The results of this study suggest that there is a potent inflammatory immune response during the infestation of sarcopties scabiei. In conclusion, scabies is a dangerous disease affecting the immune system and should be treated once discovered to prevent the hazards of being epidemics

Escabiasis / Scabies

Se revisan los principales aspectos epidemiológicos, clínicos, inmunológicos, de diagnóstico y terapéuticos; se insiste en las manifestaciones clínicas que caracterizan al padecimiento y en las medidas terapéuticas necesarias para adecuado manejo y control de la escabiasis

Serum immunoglobulin and complement values in scabietic patients

Immunity entails all the forces concerned with recognition, specific reaction and removal of foreign bodies after they again access into the body of the host. The immune system interacts with genetics and infectious agents as well as with metabolic, endocrine and environmental factors. The serum immunoglobulins [G, M, A and E] and complement [C3 and C4] were estimated in 16 parasitologically proven patients with scabies. The causative agent was Sarcoptes scabiei. The results showed a high significant increase in the mean average of IgG, IgM and in particular IgE pretreatment than in patients three months after treatment and in patients after treatment than in controls. On the other hand, there was a significant decrease in the mean average of IgA after treatment. The difference between the mean IgA levels after treatment and controls was insignificant. The C3 and C4 showed no significant changes in the mean average in the patients before or after treatment compared to controls. The changes in the IgG, IgM and in particular IgE may be specific reaction to the parasite or a nonspecific one to the dead parasite or its feces or even to a secondary infection developed. On the other hand, the decrease in the IgA may be due to the mite or its products which interfere with its synthesis. It is concluded that scabies is associated with a humoral immunological response against the mite infestation

Consideraciones sobre chancro atípico en un paciente inmunodeprimido / Atypical scabiotic chancre in an immunodepressed patient

Se presenta un paciente de 24 años de edad con lesiones exulceradas e induradas de pene, de 7 meses de evolución, con características totalmente inusuales por su número y expresión clínica, exudado abundante y resistencia a toda terapéutica. Se descartan múltiples patologías chancriformes. Al diagnóstico histopatológico, la lesión es compatible con chancro escabiótico atípico