The Relationship between Scabies and Stroke: A Population-Based Nationwide Study

Abstract

Background: Scabies is a commonly occurring infectious skin infestation that substantially impacts the quality of life, while stroke, which consists of a neurological deficit resulting from a lack of blood flow to the brain, carries sizable economic costs. The pathophysiologic mechanisms underlying both diseases involve inflammatory processes that are mediated by the immune system; however, no prior research has been conducted to explore the relationship between the two conditions. Methods: This population-based nationwide study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan for a total of 6628 scabies patients, who comprised a scabies group, and a randomly selected cohort of 26,509 matching patients, who served as a control group. More specifically, the medical records for the patients in both groups were checked for seven years to identify any new cases of stroke within that seven-year follow-up period. The hazard ratio (HR) of stroke for the follow-up period was then calculated using Cox proportional hazards regressions, while comorbidities and demographic characteristics were likewise analyzed. Results: During the follow-up period, 2892 patients, or 8.7%, of the overall total of 33,137 patients included in the study were newly diagnosed with a stroke. Of those newly diagnosed stroke patients, 833 were from the scabies group, and 2059 were from the control group, accounting for 12.6% and 7.8%, respectively, of the individuals in each group. With a crude hazard ratio of 1.67, the patients in the scabies group had a significantly higher risk of subsequent stroke than those in the control group, although the adjusted hazard ratio (aHR) for the scabies patients, which was determined by adjusting for covariates, was only 1.32 (95% confidence interval (CI): 1.21–1.43). Conclusions: The results of the study indicated an elevated risk of stroke among scabies patients, an association that might be contributed to by immunopathological factors. This information could serve as a reminder to clinicians to remain alert to any indications of neurological impairment in patients previously infected with scabies.

Crusted scabies triggering autonomic dysreflexia in a patient with spinal cord injury

“…7 Similarly, another populationbased study showed an elevated risk of stroke in patients with a history of scabies during a 7-year follow-up period; however, patients with scabies also had a higher incidence of metabolic syndrome, which is a well-established risk factor for stroke alone. 8 More research is needed to elucidate the pathogenesis to better counsel patients with scabies, like the patient described in our case, about their imminent and long-term risks.…”

Scabies Infestation and Risk of Acute Myocardial Infarction: A Population-Based Cohort Study

“…Our results supported our hypothesis that scabies infections may influence the progression of atherosclerosis and lead to subsequent AMI. Previous studies have shown that patients with scabies have an elevated risk of stroke, which is also a result of atherosclerosis [6]. Scabies is a skin infestation caused by the mite Sarcoptes scabiei; it is not only a simple, itchy skin disease but can activate many serious downstream systemic and life-threatening diseases [22].…”

“…Previous studies have identified scabies-related complications, including chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) [2,4,5]. A nationwide study reported an increased risk of stroke in patients with scabies and suggested that this association may be due to immunopathological factors [6]. Immune and inflammatory responses are the basic pathophysiological mechanisms underlying scabies infections [7].…”

A Survey on Scabies Inpatients in South Korea Based on Health Insurance Claims Data from 2010 to 2019

“…The most common symptom is severe itching due to skin lesions, which causes patients to scratch the lesions, resulting in secondary bacterial infections. In addition, it has been reported that there is a high risk of glomerulonephritis [ 2 ], chronic kidney disease [ 3 ], and stroke [ 4 ] after a major infection. Scabies mite infection spreads rapidly through direct skin contact, not only via patients but also via asymptomatic carriers [ 5 ].…”