Engelman D, Yoshizumi J, Hay R J, Osti M, Micali G, Norton S, Walton S, Boralevi F, Bernigaud C, Bowen A C, Chang A Y, Chosidow O, Estrada-Chavez G, Feldmeier H, Ishii N, Lacarrubba F, Mahé A, Maurer T, Mahdi M M A, Murdoch M E, Pariser D, Nair P A, Rehmus W, Romani L, Tilakaratne D, Tuicakau M, Walker S L, Wanat K A, Whitfeld M J, Yotsu R R, Steer A C, Fuller L C
Tropical Diseases, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Br J Dermatol. 2020 Nov;183(5):808-820. doi: 10.1111/bjd.18943. Epub 2020 Mar 29.
Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods.
To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings.
Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods.
The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library.
The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.
疥疮是一种常见的寄生性皮肤病，在全球范围内导致相当高的发病率。疥疮的临床和流行病学研究一直受到诊断方法缺乏标准化的限制。
制定可在各种环境中实施的普通疥疮诊断的共识标准。
通过与国际专家进行德尔菲研究制定共识诊断标准。从专家小组收集详细建议，以确定标准特征并指导其实施。然后将这些意见与对现有文献的全面综述以及扩大的国际专家小组的意见相结合，以制定详细的、基于证据的定义和诊断方法。
2020年国际疥疮控制联盟（IACS）疥疮诊断共识标准包括三个诊断确定性水平和八个子类别。确诊疥疮（A 级）需要直接观察到螨虫或其产物。临床疥疮（B 级）和疑似疥疮（C 级）依赖于对体征和症状的临床评估。制定了基于证据的显微镜检查、可视化以及临床症状和体征的共识方法，同时还建立了一个媒体库。
2020年IACS标准代表了一套实用且可靠的诊断特征和方法。通过选择适当的诊断水平和子类别，这些标准可在一系列研究、公共卫生和临床环境中实施。这些标准可能为疥疮诊断提供更高的一致性和标准化。现在需要进行验证研究、开发培训材料以及开发调查方法。关于这个主题已经知道了什么？疥疮的诊断受到缺乏准确、客观测试的限制。皮肤刮片显微镜检查可以确诊，但它不敏感、具有侵入性且通常不实用。诊断通常依赖于临床评估，尽管使用皮肤镜进行可视化检查越来越普遍。这些诊断方法尚未标准化，这妨碍了对临床研究和流行病学调查结果的解释以及疥疮控制策略的制定。这项研究增加了什么？通过与全球专家进行德尔菲研究，制定了普通疥疮的国际共识诊断标准。2020年国际疥疮控制联盟（IACS）标准将诊断分为三个诊断确定性水平（确诊、临床和疑似疥疮）和八个子类别，并且可以适用于一系列研究和公共卫生环境。包括详细的定义和图表以帮助培训和实施。2020年IACS标准可能有助于疥疮诊断的标准化。
