Epidemiology, Diagnosis, and Treatment of Scabies in a Dermatology Office

Abstract

Background: Scabies is a neglected skin disease, and little is known about current incidence and treatment patterns in the United States. The purpose of this study was to examine demographic data, treatment types, success of treatment, and misdiagnosis rate of scabies in an outpatient dermatology clinic.Methods: A retrospective chart review of patients diagnosed with scabies within the past 5 years was performed.Results: A total of 459 charts were identified, with 428 meeting inclusion criteria. Demographic data, diagnostic method, treatment choice, misdiagnosis rate, treatment failure, and itching after scabies are also reported. Children were the largest age group diagnosed with scabies, at 38%. Males (54%) were diagnosed with scabies more than females. The majority of diagnoses were made by visualizing ova, feces, or mites on light microscopy (58%). At the time of diagnosis, 45% of patients had been misdiagnosed by another provider. Topical permethrin was the most common treatment used (69%), followed by a combination of topical permethrin and oral ivermectin (23%), oral ivermectin (7%), and other treatments (1%).Conclusion: Our findings suggest that more accurate and faster diagnostic methods are needed to limit unnecessary treatment and expedite appropriate therapy for scabies. (J Am Board Fam Med 2017; 30:78 -84.)

Changes in incidence and age distribution of scabies: A retrospective cohort study in a tertiary hospital

“…Scabies has been reported more frequently in the pediatric age group, and in terms of sex, some studies have found male patients to be more frequent in contrast to some others [5,6]. Female patients were found more frequently in studies conducted in our country [7].…”

Epidemiological study of patients infected with scabies caused by Sarcoptes scabiei in Al-Najaf Governorate, Iraq

“…Diagnosis of scabies is depend on many clinical and physical parameters include; the presence of mite Sarcoptes scabiei or it products, strong itching and skin inflammation [11]. Scabies infect both male and female in different age groups, and it is common in tropical climate countries, in poor people who live in rural areas [12,13]. In Iraq, there is no recent studies focus on the prevalence of scabies in urban and rural areas.…”

Laboratory Diagnosis of Scabies Using a Simple Saline Mount: A Clinical Microbiologist's Report

“…Patients suffering from various skin disorders usually present themselves at the department of dermatology [5]. Dermatological manifestations can result from various causes that include common diaper rash, chemical-induced dermatitis, immunological conditions, genetic causes, and drug reactions [6].…”

“…Dermatologists usually perform a clinical diagnosis, identify the specific areas of skin lesions and collect skin scrapings or biopsies for further confirmation of pathological and microbiological causes. It was previously reported that there is a 45% chance of misdiagnosing scabies with other skin conditions [5]. …”

“…Although routine microscopic examination of skin scrapings for the presence of mites is considered as the gold standard for the diagnosis of scabies, the procedural errors and lack of communication between a dermatologist and microbiologists will result in false negative reports. A previous study has observed that a combination of dermatoscopy and light microscopic methods could improve scabies diagnosis and that there is need of a low cost, easily performed, and accurate technique [5]. This technical report describes the experience of a clinical microbiologist with the use of a simple saline mount of skin scrapings in the diagnosis of scabies.…”