Escabiosis en lactante: diagnóstico dermatoscópico y test de Müller / Infant scabies: dermoscopic diagnosis and Müller test

La escabiosis o sarna es la infestación cutánea por el ácaro Sarcoptes scabiei var. hominis, cuyo diagnóstico generalmente es clínico, pudiendo confirmarse mediante el test de Müller o, de forma sencilla y fiable, mediante estudio dermatoscópico. Se presenta un caso representativo de escabiosis en lactante y los hallazgos dermatoscópicos patognomónicos en un lactante de 6 meses de edad. Con la sospecha de escabiosis se realizó estudio con dermatoscopia de luz polarizada, confirmando el diagnóstico al visualizar surcos acarinos y lesiones en ala delta. Además, se realizó el test de Müller, observando el ácaro en el examen directo al microscopio óptico tras raspado de piel lesionada. Con este caso se pretende recordar la clínica típica con las características distintivas de la escabiosis en lactantes, y los principales métodos que permiten confirmar el diagnóstico, con especial relevancia de la dermatoscópica como técnica sencilla e inocua

Scabies, a skin infestation caused by Sarcoptes scabiei var. hominis, is generally easy to diagnose because of its characteristic clinical features. The diagnosis can be confirmed by the Müller test or by dermoscopy, a non-invasive, painless, and highly accurate technique. We present a representative case of infantile scabies with pathognomonic dermoscopic findings, in a 6-month-old girl referred for evaluation of a 2-week dermatitis. Under suspicion of scabies, a dermoscopy examination was performed, confirming the diagnosis by showing a distinctive dermoscopic feature composed of a S-shaped furrow with a triangle on one of its endings, known as delta wing jet sign. In addition, Müller test was performed, observing the mite on direct microscope examination after scraping one of the skin injuries. This case is a reminder of the typical clinical presentation of scabies in infants and the main methods that allow us to confirm the diagnosis. We want to highlight the usefulness of dermoscopy, as it is a simple and innocuous technique

Therapeutic potential of medicinal plants for the management of scabies.

Sarcoptes scabiei (S. scabiei), a parasite mite which causes scabies disease resulting in serious public health concern. The long-term scabies disease can lead to complications such as septicemia, acute post-streptococcal glomerulonephritis, heart disease, and secondary infections. Timely treatment to the affected patients is required to control the disease and get rid of the causative agent. Delayed diagnosis and inappropriate treatment can lead to serious consequences. The most common treatment strategy is the use of allopathic medicines which can immediately relieve the patient but have the drawback of side effects. The safe and cost-effective alternative treatment strategy is the use of medicinal plants which have beneficial therapeutic potential against variety of diseases due to the presence of many bioactive phytoconstituents with no or minimal side effects. For the present review, the published articles describing scabies disease and its phytotherapeutic modalities were searched through different data bases including Google Scholar, PubMed, Medline, and ScienceDirect using the keywords like S. scabiei, prevalence of scabies disease, and phytotherapy of scabies. A large number of medicinal plants, such as Melaleuca alternifolia, Curcuma longa, Azadirachta indica, Rosmarinus officinalis, Capsicum annuum, Cinnamomum camphor, Solanum nigrum, and Eupatorium perfoliatum, have been reviewed for the promising future treatments of scabies. All the studied plants have many bioactive compounds with potential therapeutic effects against scabies and can be utilized for therapeutic purposes for this disease. This literature study has limitations because of the lack of sufficient data due to limited pre-clinical trials in this particular area. This review provides a baseline to explore the therapeutic potential of these medicinal plants against skin diseases. However, extensive studies are required to identify, authenticate, and characterize the bioactive compounds present in these plants which may lead to value addition in pharmaceutical industries providing the cost-effective way of treatment with minimal side effects.

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.

Escabiosis / Scabies

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Eleven years of itching: a case report of crusted scabies.

Crusted scabies is a rare and highly contagious form of scabies that is characterized by uncontrolled proliferation of mites in the skin, extensive hyperkeratotic scaling, crusted lesions, and variable pruritus. We report the case of a 48-year-old man with an 11-year history of pruritic, hyperkeratotic, psoriasiform plaques and widespread erythematous papules that was diagnosed as crusted scabies.

Analysis of Sarcoptes scabiei finds no evidence of infection with Wolbachia.

The endosymbiont Wolbachia has been detected in a range of filarial nematodes and parasitic mites and is known to affect host reproductive compatibility and potentially evolutionary processes. PCR of Wolbachia surface protein (wsp), ftsZ and 16SrRNA genes from individual Sarcoptes scabiei mites obtained from a series of individual hosts, and database searches of an S. scabiei var. hominis EST library failed to detect Wolbachia genes. Therefore, Wolbachia appears not to be involved in the genetic subdivision observed between varieties of host-associated S. scabiei or, involved in the inflammatory disease pathogenesis of scabies unlike its activity in filarial infection.

Sarcoptes scabiei infestation among children in a displacement camp in Sierra Leone.

The prevalence of scabies was investigated among a study population of 125 children between the ages of 1-15 y. Confirmation of scabies was done by clinical examination of each child and by the identification of the mite by microscopically examining the scrapings from the scabies-like lesions. The prevalence was age dependent, with children under five years accounting for 77%, peaking to 86% among the 5 to 9-y-olds, and steadily declining with an increase in age. Lesions were found on almost all parts of the body, but lesions were more commonly located on the fingers, legs, hands, face, stomach, and genitalia. Sarcoptes scabiei var hominis was recovered from 84 (67%) of the 125 skin scrapings examined. The prevalence of scabies is high in children in the displacement camps, suggesting that it may be a serious public health problem not only in these camps, but also in the entire country. This may be due to the fact that certain environmental conditions like civil unrest, overcrowding, poor personal hygiene, poverty, and ignorance, which are conducive to the spread of scabies, is characteristically present among the camp residents. Control programs should be put in place and implemented in an integrated nature, by reducing overcrowding, and by improving health education, personal hygiene, treatment and surveillance among high-risk populations.

Sarna: revisión de la clínica y nuevos tratamientos / Scabies: Review of clinical practice and new treatments

Describimos la sarna como una enfermedad producida por un ácaro, el sarcoptes scabiei, que se transmite de unas personas a otras, favorecido por el contacto directo entre ellas, lo que puede ocasionar problemas en colectividades como residencias de ancianos, cuarteles, campamentos juveniles o centros penitenciarios. En esta revisión, repasamos la clínica, que generalmente es muy característica y orienta hacia el diagnóstico, si bien, existen otras formas clínicas menos frecuentes que también detallamos. De cara al tratamiento son fundamentales las medidas higiénicas de los pacientes y de sus ropas, utilizando los escabicidas clásicos. Ante la aparición de resistencias frente a esos tratamientos tópicos, se prescriben los nuevos preparados de permetrina e incluso los tratamientos orales con ivermectina. (AU)

Serum antibody to Sarcoptes scabiei and house dust mite prior to and during infestation with S. scabiei.

In this study, serum antibodies to Sarcoptes scabiei var. canis (SS), Dermatophagoides farinae (DF), and D. pteronyssinus (DP) were determined in 19 healthy, random-source dogs prior to infestation with scabies then again during a primary infestation, cure and challenge infestation with scabies. Prior to scabies infestation, serum of 11 dogs contained faintly detectable amounts of IgE and/or IgG to proteins in SS extract, probably resulting from sensitization to dust mites that share cross-reactive antigenic epitopes with SS. After becoming infested with scabies, the response to SS antigens became stronger with antibodies appearing to more antigens as the scabies infestation progressed. Three of the newly recognized proteins were 170, 155 and 142/133kD and could be used in a diagnostic test since antibodies to them appeared during the primary infestation. In addition, during the primary infestation, 14 of 15 dogs developed IgE to 1-11 new SS proteins in addition to an increase in IgE binding to those proteins recognized prior to infestation. Overall, the strongest antibody responses (IgE and IgG) were exhibited during cure of the first infestation, when dead mites were still present in the stratum corneum. As expected, the antibody response was strong and rapid during challenge when the infestation self-cured. The immunogenic SS proteins identified by serum antibody binding during challenge, when the hosts self-cured, are candidates for inclusion in a vaccine. These candidate proteins are 200, 185, 170, 155, 142/133, 112, 97, 74, 57, 45/42, 32 and 22kD. Some of the proteins in SS that exhibited new or increased antibody binding during the experiment also had IgE and IgG binding to proteins with similar molecular weights in DF and DP extracts. These results illustrate the difficulties involved in understanding and interpreting serum antibody for developing a serological test for the diagnosis of scabies, isolating relevant SS antigens that could be included in a vaccine for prevention of scabies, and for understanding the immune response mechanism to scabies.

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

Neonatal scabies.

Between 1981 and 1991, eleven infants (ranging in age from 2 to 9 months) were hospitalized in our department for evaluation of microscopically verified scabies infestations. Six presented signs of Norwegian scabies. All of the latter infants had been treated (prior to the scabies infestation) for long periods with topical steroids, in most cases for lesions suggestive of atopic dermatitis. We believe that the occurrence of the Norwegian form in these newborns was due to localized steroid-induced suppression of the normal immune response.

Scabies: occurrence, control and treatment in the Caribbean

The mite, Sarcoptes scabiei, which causes scabies in man produces an uncomfortable itch which, in itself, is not life-threatening. It is easily controlled when treated with appropriate scabicides, and with effictive public health education and proper hygiene an end to the infection is quickly achieved. However, secondary infection of the scabietic lesions with nephritogenic streptococci can lead to glomerulonephritis which, in the short term, results in hospitalisation with oedema, haematuria and proteinuria as common presenting symptoms. In the long-term, chronic renal disease leading to costly dialysis and renal transplant can occur after this preventable itchy and uncomfortable infection. (AU)

Estudio comparativo de la sarcoptosis en familias aseguradas a la CNS 1980-1990 Cbb Bolivia / Comparative study of sarcoptosis in families of the Social Security Health System

La sarcoptosis se presenta como una enfermedad de distribución mundial, y que en nuestro medio fué notificado como la cuarta enfermedad mas frecuente en 1990 según la Unidad sanitaria de Cochabamba. En la siguiente revisión efectuada, se realizo un estudio comparativo de esta afección, durante los años 1980 a 1990, valíendonos para esto de las notas clínicas existentes en las carpetas familiares. Se tomó muestreo de todas las familias aseguradas en cuatro policonsultorios, y se hizo un estudio en forma retrospectiva, eligiendo al azar el consultorio familiar, tomando el 10 del universo total de las carpetas familiares de ese consultorio. Se revisaron un total de 408 carpetas familiares (CF), las cuales se separon de acuerdo al número de personas por familia en dos grupos: Grupo I con menos de tres personas/f con 322 CF (76,2); Grupo II con mas de cuatro personas/f con 97 CF (23,8); la incidencia en ambos grupos fue: grupo I 16 CF con sarcoptosis (5,1 por ciento); grupo II 24 CF con sarcoptosis (24,8 por ciento); siendo este último grupo el mas suceptible a esta ectoparasitosis. Durante los años 1980-1990 hubo un promedio de 3,2 casos por año con una mínima de cero y una maxima de 5, pero durante 1990 los casos aumentaron a 8 por año, lo cual coinside con los ciclos epidémicos de la sarna. El sexo mas comprometido fue el femenino y el grupo etáreo mas prevalente se encontró entre los 0 a 9 años; la procedencia fluctuó entre 12,5 y 7,4 de una a otra área.

Tratamiento de la escabiosis / Treatment of the scabies

En el presente trabajo, fue probada la eficacia terapeutica del gamexane o lindano en el tratamiento de la ESCABIASIS en 200 personas, se han usado concentraciones de 1 a 2 % aplicadas en tres esquemas en cuanto se refiere al tiempo de aplicacion. Pudimos sacar al conclusion que el esquema mas eficas en el empleo de la concentracion al 1% durante 2 dias (95%) por la alta tasa de curaciones y menor numero de casos con efectos colarerales.