Reemerging skin disease caused by arthropods I: scabies

Baik Kee Cho

doi:10.5124/jkma.2011.54.5.511

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Cho: Reemerging skin disease caused by arthropods I: scabies

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(5): 511-520.

Published online: 11 May 2011

DOI: https://doi.org/10.5124/jkma.2011.54.5.511

Reemerging skin disease caused by arthropods I: scabies

Baik Kee Cho, MD

Department of Dermatology, Yeoido St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.

Corresponding author: Baik Kee Cho, bkcho@catholic.ac.kr

Received 7 February 2011 Accepted 23 February 2011

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Scabies is one of the most common world-wide arthropod-born diseases in both humans and animals caused by the "itch" mite Sarcoptes scabiei. The incidence of scabies has shown a tendency to increase for the last several years in Korea. The previous peak incidence in Korea was between the early 1970s and early 1980s. A substantial part of the cyclic resurgence of scabies has been considered the result of inexperience and indifference of medical doctors toward the disease. The recent resurgence is presumed to be derived from not only indifference of the doctors but also an increase in elderly patients admitted to nursing homes and eldercare hospitals. Scraping using mineral oil for scabies patients is a very simple and effective method for definite diagnosis. A new diagnostic method using a dermoscope is also effective, especially for very young patients. Lindane and crotamiton are two available antiscabietic preparations in Korea. Crotamiton is less effective, while infants and pregnant women should not use lindane. In conclusion, medical personnel should be alert coping with the resurgence of scabies, and it is strongly suggested that other antiscabietic drugs such as permethrin, ivermectin, etc. should be made available for resistant patients in the near future in the Republic of Korea.

Keywords: Scabies, Sarcoptes scabiei, Nursing homes, Lindane, Crotamiton

Figures and Tables

Figure 1

Dorsal surface of female Sarcoptes scabiei showing names of the characteristic morphological features.

Figure 2

Ventral surface of male Sarcoptes scabiei showing church bell-shaped male genitalia between 4th legs.

Figure 3

Dorsal surface of Saroptes canis without bare area (A) and Sarcoptes scabiei with bare area (B).

Figure 4

A larva and eggs of Sarcoptes scabiei.

Figure 5

Burrows on finger, finger web(A), wrist and palm (B).

Figure 6

Erythematous papules with burrow on the penis and scrotum.

Figure 7

Burrows and eczematous changes on the sole of a 80-year-old female patient.

Figure 8

Crusted scabies showing hyperkeratotic patches on the glans penis and pubic area in a 71-year-old man.

Figure 9

Crusted scabies showing seborrheic dermatitis-like yellowish hyperkeratotic patches on the scalp in a 86-year-old man admitted in an eldercare hospital (courtesy of Professor Moo Kyu Suh, Dongguk University).

Figure 10

Nodular scabies in a 9-month-old boy (courtesy of Professor Moon Bum Kim, Pusan National University).

Figure 11

Clinical and electronmicroscopic findings of canine scabies of a dog.

Figure 12

Procedures of scraping for scabies using mineral oil.

Figure 13

Scybala and a vellus hair (A), and scybala and an egg (B) of Sarcoptes scabiei.

Figure 14

Dermoscopic findings of scabies showing hang glider sign with "condensation trail" (courtesy of Dr. Ju Hyuk Park, Hallym University).

Figure 15

Histopathologic findings of scabies showing a burrow containing a female itch mite and an egg (H&E, ×200).

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