Editor Teledermatology (TD) was previously described as an efficient substitute for in-person visits for COVID-19-associated lesions. 1 During the first COVID-19 wave, chilblain-like lesions (CLLs) were the most reported dermatological manifestation. [2][3][4] Although SARS-CoV-2 infection polymerase chain reaction and serology testing were negative for most cases, this unexpected outbreak of chilblains like lesions remained remarkable. 5 To date, it is unclear whether CLL outbreak reported during the first COVID-19 pandemic is related to media release of this particular sign right after the wave or whether observed CLLs are truly associated with COVID-19 disease. 6 Therefore, we aimed
The aim of this multi-centre French retrospective study was to identify severe, i.e. crusted and profuse, scabies patients. Records were retrieved from 22 Dermatology or Infectious Diseases departments in the Ile-de-France from January 2009 to January 2015 to characterize epidemiology, demography, diagnosis, contributing factors, treatment features, and outcomes in severe scabies. A total of 95 inpatients (57 crusted and 38 profuse) were included. A higher number of cases was observed among elderly patients (>75 years), mostly living in institutions. Thirteen patients (13.6%) reported a history of previously treated scabies. Sixty-three patients (66.3%) had been seen by a previous practitioner for the current episode (up to 8 previous visits). Initial misdiagnosis (e.g. eczema, prurigo, drug-related eruptions, psoriasis) was documented in 41 patients (43.1%). Fifty-eight patients (61%) had already received 1 or more previous treatments for their current episode. Forty percent received corticosteroids or acitretin for an initial diagnosis of eczema or psoriasis. Median time from the onset of symptoms to the diagnosis of severe scabies was 3 months (range 0.3–22). Itch was present in all patients at diagnosis. Most patients (n=84, 88.4%) had comorbidities. Diagnostic and therapeutic approaches varied. Complications occurred in 11.5% of cases. To date, there is no consensus for diagnosis and treatment, and future standardization of is required for optimal management.
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