SKABİYES; KLİNİK BULGULAR, TANI VE TEDAVİ

Skabiyes; Sarcoptes scabiei var. hominis’in etken olduğu cins, yaş ya da ırk ayrımı gözetmeksizin herkesi etkileyebilen bir ektoparazitozdur. Epidemiyolojik verilerin yetersizliğine rağmen son yıllarda birçok ülkede olduğu gibi ülkemizde de görülme sıklığının artmış olduğu bilinmektedir. Pratikte klasik öykü ve patognomonik deri lezyonları ile kolayca tanı konabilmekte iken özellikle immunsuprese ya da ek sistemik hastalığı olan erişkinlerde ve çocuklarda farklı klinik tabloları taklit edebilmektedir. Tanı sürecinin geciktiği ya da etkin ve yeterli tedavinin verilemediği durumlarda özellikle toplu yaşanılan yerlerde salgınlara neden olabilmektedir. Biz bu derlemeyi güncel çalışmalar ışığında skabiyes klinik bulgularını, tanı yöntemlerini ve tedavi seçeneklerini hatırlatmak amacıyla hazırladık.

Anahtar Kelimeler:

ektoparazit, skabiyes, tanı, tedavi

SCABIES; CLINICAL FINDINGS, DIAGNOSIS, AND TREATMENT

Scabies is an ectoparasitosis caused by Sarcoptes scabiei var. hominis that can affect all people regardless of sex, age and race. Although the data of epidemiological surveys are insufficient, it is known that prevalence is increased in the recent years in our country as well as the other countries. Typical anamnesis and pathognomonic skin findings are the mainstay of clinical diagnosis, but it can have different clinical manifestations especially in children and immunocompromised adults. When the diagnosis is delayed or the treatment is ineffective or inadequate, mass outbreaks can occur especially in places where people live together. We prepared this review with the aim to remind readers clinical findings, diagnostic methods and treatment options of scabies in the light of current studies.

Keywords:

ectoparasite, scabies, diagnosis, treatment,

PDF

___

Cassell JA, Middleton J, Nalabanda A, et al. Scabies outbreaks in ten care homes for elderly people: a prospective study of clinical features, epidemiology, and treatment outcomes. Lancet Infect Dis. 2018;18(8):894-902. doi:10.1016/S1473-3099(18)30347-5
Burgess I. Sarcoptes scabiei and scabies. Adv Parasitol. 1994;33:235-292. doi:10.1016/s0065-308x(08)60414-5
Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;2007(3):CD000320. doi:10.1002/14651858.CD000320.pub2
Sunderkötter C, Feldmeier H, Fölster-Holst R, et al. S1 guidelines on the diagnosis and treatment of scabies - short version. J Dtsch Dermatol Ges. 2016;14(11):1155-1167. doi:10.1111/ddg.13130
Arlian LG, Runyan RA, Achar S, Estes SA. Survival and infectivity of Sarcoptes scabiei var. canis and var. hominis. J Am Acad Dermatol. 1984;11(2Pt1):210-215. doi:10.1016/s0190-9622(84)70151-4
Mellanby K. Transmission of scabies. Br Med J. 1941;2(4211):405-406. doi:10.1136/bmj.2.4211.405
Arlian LG. Biology, host relations, and epidemiology of Sarcoptes scabiei. Annu Rev Entomol. 1989;34:139-161. doi:10.1146/annurev.en.34.010189.001035
Bernigaud C, Fernando DD, Lu H, et al. How to eliminate scabies parasites from fomites - a high throughput ex vivo experimental study. J Am Acad Dermatol. 2020;83(1):241-245. doi:10.1016/j.jaad.2019.11.069
Ishii N, Asai T, Asahina A, et al. Guideline for the diagnosis and treatment of scabies in Japan (third edition): Executive Committee of Guideline for the Diagnosis and Treatment of Scabies. J Dermatol. 2017. doi:10.1111/1346-8138.1389
Engelman D, Yoshizumi J, Hay RJ, et al. The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. Br J Dermatol. 2020. doi:10.1111/bjd.18943
Walton SF, Oprescu FI. Immunology of scabies and translational outcomes: identifying the missing links. Curr Opin Infect Dis. 2013;26(2):116-122. doi:10.1097/QCO.0b013e32835eb8a6
Chosidow O. Scabies and pediculosis. Lancet. 2000;355(9206):819-826. doi:10.1016/s0140 6736(99)09458-1
Scrace M, Koko K. An outbreak of acute post-streptococcal glomerulonephritis in remote Far North Queensland. Aust J Rural Health. 2006;14(4):160-163. doi:10.1111/j.1440-1584.2006.00795.x
Karimkhani C, Colombara DV, Drucker AM, et al. The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(12):1247-1254. doi:10.1016/S1473-3099(17)30483-8
Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: Scabies. J Am Acad Dermatol. 2020;82(3):533-548. doi:10.1016/j.jaad.2019.05.109
Tempark T, Lekwuttikarn R, Chatproedprai S, Wananukul S. Nail Scabies: An Unusual Presentation Often Overlooked and Mistreated. J Trop Pediatr. 2017;63(2):155-159. doi:10.1093/tropej/fmw058
Yoshizumi J, Harada T. 'Wake sign': an important clue for the diagnosis of scabies. Clin Exp Dermatol. 2009;34(6):711-714. doi:10.1111/j.1365-2230.2008.03010.x
Anderson KL, Strowd LC. Epidemiology, diagnosis, and treatment of scabies in a dermatology office. J Am Board Fam Med. 2017;30(1):78-84. doi:10.3122/jabfm.2017.01.160190
Uenotsuchi T, Moroi Y, Urabe K, Tsuji G, Takahara M, Furue M. The scybala (fecal pellets) of Sacroptes scabiei var. hominis are obviously stained with chlorazol black E. J Dermatol. 2004;31(6):511-512. doi:10.1111/j.1346-8138.2004.tb00546.x
Meletis G, Oustas E, Kemanetzi C, Botziori C. Is the simple saline mount Technique more effective than potassium hydroxide for the microscopic detection of Sarcoptes scabiei? J Parasitol. 2018;104(1):109. doi:10.1645/17-157
Jacks SK, Lewis EA, Witman PM. The curette prep: a modification of the traditional scabies preparation. Pediatr Dermatol. 2012;29(4):544-545. doi:10.1111/j.1525-1470.2012.01745.x
Clayman JL. Did they see mites? Arch Dermatol. 1990;126(7):966-967.
Katsumata K, Katsumata K. Simple method of detecting sarcoptes scabiei var hominis mites among bedridden elderly patients suffering from severe scabies infestation using an adhesive-tape. Intern Med. 2006;45(14):857-859. doi:10.2169/internalmedicine.45.1707
Neynaber S, Muehlstaedt M, Flaig MJ, Herzinger T. Use of Superficial Cyanoacrylate Biopsy (SCAB) as an alternative for mite identification in scabies. Arch Dermatol. 2008;144(1):114-115. doi:10.1001/archdermatol.2007.24
Micali G, Lacarrubba F, Verzi AE, Chosidow O, Schwartz RA. Scabies: Advances in noninvasive diagnosis. PLoS Negl Trop Dis. 2016;10(6):e0004691. doi:10.1371/journal.pntd.0004691
Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006;354(16):1718-1727. doi:10.1056/NEJMcp052784
Wong SS, Poon RW, Chau S, et al. Development of conventional and real-time quantitative PCR assays for diagnosis and monitoring of scabies. J Clin Microbiol. 2015;53(7):2095-2102. doi:10.1128/JCM.00073-15
Arlian LG, Feldmeier H, Morgan MS. The Potential for a blood test for scabies. PLoS Negl Trop Dis. 2015;9(10):e0004188. doi:10.1371/journal.pntd.0004188
Fraser TA, Carver S, Martin AM, Mounsey K, Polkinghorne A, Jelocnik M. A Sarcoptes scabiei specific isothermal amplification assay for detection of this important ectoparasite of wombats and other animals. Peer J. 2018;6:e5291. doi:10.7717/peerj.5291
Falk ES, Dale S, Bolle R, Haneberg B. Antigens common to scabies and house dust mites. Allergy. 1981;36(4):233-238. doi:10.1111/j.1398-9995.1981.tb01568.x
Salavastru CM, Chosidow O, Boffa MJ, Janier M, Tiplica GS. European guideline for the management of scabies. J Eur Acad Dermatol Venereol. 2017;31(8):1248-1253. doi:10.1111/jdv.14351
Porto I. Antiparasitic drugs and lactation: focus on anthelmintics, scabicides, and pediculicides. J Hum Lact. 2003;19(4):421-425. doi:10.1177/0890334403258133
Usha V, Gopalakrishnan Nair TV. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol. 2000;42(2 Pt 1):236-240. doi:10.1016/S0190-9622(00)90131-2
Dhana A, Yen H, Okhovat JP, Cho E, Keum N, Khumalo NP. Ivermectin versus permethrin in the treatment of scabies: A systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol. 2018;78(1):194-198. doi:10.1016/j.jaad.2017.09.006
Brownlee DJ, Holden-Dye L, Walker RJ. Actions of the anthelmintic ivermectin on the pharyngeal muscle of the parasitic nematode, Ascaris suum. Parasitology. 1997;115 ( Pt 5):553-561. doi:10.1017/s0031182097001601
Rosumeck S, Nast A, Dressler C. Ivermectin and permethrin for treating scabies. Cochrane Database Syst Rev. 2018;4(4):CD012994. doi:10.1002/14651858.CD012994
Gershanik J, Boecler B, Ensley H, McCloskey S, George W. The gasping syndrome and benzyl alcohol poisoning. N Engl J Med. 1982;307(22):1384-1388. doi:10.1056/NEJM198211253072206
Taniguchi H, Matsuo N, Ohtaki N. Topical phenothrin treatment in a case of crusted scabies with nail involvement. J Dermatol. 2017;44(4):e64-65. doi:10.1111/1346-8138.13626
Sunderkötter C, Aebischer A, Neufeld M, et al. Increase of scabies in Germany and development of resistant mites? Evidence and consequences. J Dtsch Dermatol Ges. 2019;17(1):15-23. doi:10.1111/ddg.13706
Mounsey KE, Holt DC, McCarthy J, Currie BJ, Walton SF. Scabies: molecular perspectives and therapeutic implications in the face of emerging drug resistance. Future Microbiol. 2008;3(1):57-66. doi:10.2217/17460913.3.1.57