Department of Dermatology, Nicolina Medical Center, Iasi, Romania.
Apollonia University, Iasi, Romania.
Eur J Pediatr. 2024 Jun;183(6):2527-2536. doi: 10.1007/s00431-024-05535-1. Epub 2024 Mar 27.
Scabies is a human ectoparasitosis caused by Sarcoptes scabei var. hominis. World-wide around 300 million patients are affected. Infants and children have the highest incidence rates. Poverty and overcrowding are social factors contributing to a higher risk of transmission and treatment failure. The leading symptom of the infestation is itch. Complications are bacterial infections that are responsible for mortality. Diagnosis is clinical. Non-invasive imaging technologies like dermoscopy can be used. Polymerase chain reaction (PCR) is less sensitive and specific than microscopy of skin scrapings. Treatment of choice is topical permethrin 5%. Ivermectin is the only oral drug FDA-approved for scabies. It should be used in cases non-responsive to topical therapy and in case of high number of infested patients in addition to topical therapy. Pseudo-resistance to treatment is not uncommon. New drugs are on the horizon. What is Known: • Pruritus is the leading symptom causing sleep disturbances and scratching with the risk of secondary bacterial infections. • Treatment failure is related to inappropriate application of topical drugs and asymptomatic family members. What is New: • COVID-19 pandemic and migration are contributing to an increased incidence of scabies. • New compounds to treat scabies are on the horizon.
疥疮是人感染疥螨所致的一种人兽共患寄生虫病。全世界约有 3 亿患者。婴幼儿发病率最高。贫困和过度拥挤是增加传播和治疗失败风险的社会因素。感染的主要症状是瘙痒。细菌感染是导致死亡的并发症。诊断主要依靠临床。非侵入性成像技术，如皮肤镜检，可以用于诊断。聚合酶链反应（PCR）的敏感性和特异性不如皮肤刮片显微镜检查。首选的治疗方法是局部使用 5%的扑灭司林。伊维菌素是美国食品药品监督管理局唯一批准用于治疗疥疮的口服药物。当局部治疗无效时，或在除局部治疗外还有大量感染者时，应使用伊维菌素。假性药物耐药并不少见。新的药物正在研发中。已知情况：瘙痒是导致睡眠障碍和搔抓的主要症状，搔抓会增加继发细菌感染的风险。治疗失败与局部药物使用不当和无症状的家庭成员有关。新进展：COVID-19 大流行和移民导致疥疮发病率增加。治疗疥疮的新化合物正在研发中。
