Chair of Microbiology, Department of Molecular Medical Microbiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Cracow, Poland.
Chair of Microbiology, Department of Infection Control and Mycology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Cracow, Poland.
Ann Parasitol. 2021;67(4):779-787. doi: 10.17420/ap6704.396.
Scabies is the skin infestation caused by Sarcoptes scabiei var hominis. It is one of the commonest dermatological infection which can affect people around the world. However, nails are relatively rarely involved, and the fingernails are mostly infected. The report a case of a 77-year-old woman, long-term pensioner of a nursing home, who had isolated toe subungual Sarcoptes infestation. In addition, the results of systematic review of toenails scabies was presented. Analysis of 21 subungual Sarcoptes infestation cases, revealed that patients in any age (median age 45+/-31.7-year-old) and sex can be affected. Most of the patients had concomitant diseases. Seventy-five percent of cases of nail involvement were treated with combined or sequential therapy. The most used drugs were ivermectin (IVR) and permethrin (PER) (each used in 47.6% cases), following γ-BHC (38.1%) and crotamiton (CRO) (23.8%). It seems that the crucial for adequate diagnosis in scabies affected nails is a precise anamnesis, early and accurate diagnosis that consists of examining not only skin lesions, but including assessing toenails, and differentiation of Sarcoptes infestation from other nail diseases as onychomycosis or psoriasis. Important to achieving a cure is at least frequent nail trimming, softening the nail plate with urea or in the difficult cases the mechanical removal of subungual plaque with using of a scabicide in the location allowing to penatrate it under the nail plate.
疥疮是由人疥螨引起的皮肤感染。它是世界范围内最常见的皮肤感染之一。然而，指甲相对较少受到影响，而且通常感染的是手指甲。报告了一例 77 岁的女性，长期居住在养老院的养老金领取者，患有孤立的脚趾甲下疥螨感染。此外，还介绍了对指甲疥疮的系统回顾结果。对 21 例甲下疥螨感染病例的分析表明，任何年龄（中位数年龄 45+/-31.7 岁）和性别的患者都可能受到影响。大多数患者有合并症。75%的指甲受累病例采用联合或序贯治疗。最常用的药物是伊维菌素（IVR）和扑灭司林（PER）（分别用于 47.6%的病例），其次是γ-林丹（38.1%）和克罗米通（CRO）（23.8%）。似乎在受疥疮影响的指甲中进行充分诊断的关键是详细的病史、早期和准确的诊断，不仅要检查皮肤病变，还要评估指甲，并将疥螨感染与其他指甲疾病（如甲真菌病或银屑病）区分开来。要实现治愈，至少要经常修剪指甲，用尿素软化指甲板，在困难情况下，使用杀疥剂机械去除甲下斑块，在允许杀疥剂渗透到指甲板下的位置进行操作。
