Anderson Kathryn L, Strowd Lindsay C
From the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC.
J Am Board Fam Med. 2017 Jan 2;30(1):78-84. doi: 10.3122/jabfm.2017.01.160190.
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.
A retrospective chart review of patients diagnosed with scabies within the past 5 years was performed.
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%).
Our findings suggest that more accurate and faster diagnostic methods are needed to limit unnecessary treatment and expedite appropriate therapy for scabies.
疥疮是一种被忽视的皮肤病，在美国，人们对其当前的发病率和治疗模式知之甚少。本研究的目的是调查一家门诊皮肤科诊所中疥疮患者的人口统计学数据、治疗类型、治疗成功率和误诊率。
对过去5年中被诊断为疥疮的患者进行回顾性病历审查。
共识别出459份病历，其中428份符合纳入标准。还报告了人口统计学数据、诊断方法、治疗选择、误诊率、治疗失败情况以及疥疮后的瘙痒情况。儿童是被诊断出患有疥疮的最大年龄组，占38%。男性（54%）被诊断出患有疥疮的人数多于女性。大多数诊断是通过在光学显微镜下观察虫卵、粪便或螨虫做出的（58%）。在诊断时，45%的患者曾被其他医生误诊。外用氯菊酯是最常用的治疗方法（69%），其次是外用氯菊酯和口服伊维菌素联合使用（23%）、口服伊维菌素（7%）以及其他治疗方法（1%）。
我们的研究结果表明，需要更准确、快速的诊断方法来限制不必要的治疗，并加快对疥疮的适当治疗。
