Are sexually transmitted infections associated with scabies?

Abstract

Sexually transmitted infections (STIs) have been previously reported to be associated with scabies in sexually active people. The UK national guidelines on STIs recommend screening for other STIs in patients with scabies attending a genitourinary medicine (GUM) clinic. However, there is a paucity of literature on this association, which we reviewed. We looked at the sexual behaviour and the coincidence of STIs in patients with scabies attending a GUM clinic and in inmates from a young offender institution (YOI) attending between 1 January 1998 and 31 December 1999. A total of 47 patients with scabies were identified in the GUM clinic population during this period and 15 patients in the YOI group. Consecutive new and rebooked sex-matched patients served as a control group. Among the GUM clinic attendees 36% of patients with scabies had multiple sexual partners in the preceding 3 months compared with 21% in the control group (P=0.11). Thirty-four per cent of patients with scabies had a previous history of STI vs 17% in the control group (P=0.058). The number of patients with coexistent STIs was not significantly different in both groups (49% vs 44%, P=0.68). The number of patients in the YOI group was too small for a statistical analysis. This study showed that patients with scabies had comparable rates of STIs as with the GUM clinic population. It therefore supports the national guidelines in recommending screening for other STIs in patients with scabies.

European guideline for the management of scabies

“…19 In sexually active patients, STI screening (including HIV test) is recommended {level of evidence Ib; grade A recommendation}. 23 General principles of treatment ( Fig. 1) Ten new clinical trials on scabies treatment have been published since the previous guideline in 2010.…”

“…Dermoscopic examination can identify skin burrows, mites (the ‘delta’ sign at the end of the burrow represents the anterior body of the adult female mite), eggs and can orientate the site of skin scrapings . In sexually active patients, STI screening (including HIV test) is recommended {level of evidence Ib; grade A recommendation} …”

Crusted scabies in a patient with systemic disorders – evaluation of ivermectin treatment results

“…It should be remembered that a negative result of the study does not exclude the diagnosis of scabies [25,26]. In patients with crusted scabies diagnosis for immunodeficiency disorders and sexually transmitted diseases should be made [27].…”

“…Należy jednak pamiętać, że ujemny wynik badania nie wyklucza rozpoznania świerzbu [25,26]. U chorych ze świerzbem hiperkeratotycznym powinno się także przeprowadzić diagnostykę w kierunku niedoborów odporności i chorób przenoszonych drogą płciową [27].…”

Management of scabies in 2019

“…Ensuite, de multiples IST ont été rapportées chez des patients infectés par la gale ainsi que dans leurs antécédents, même si le risque précis est peu clair. Les abrasions génitales de la peau et des muqueuses dues aux parasites pourraient prédisposer aux autres IST 50 . La gale a été davantage rapportée chez des personnes ayant de multiples partenaires sexuels.…”