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韩国疥疮诊断与治疗临床实践指南:第1部分。流行病学、临床表现及诊断——二次发表

Clinical practice guidelines for the diagnosis and treatment of scabies in Korea: Part 1. Epidemiology, clinical manifestations, and diagnosis - a secondary publication.

作者信息

Park Jin, Kwon Soon-Hyo, Lee Young Bok, Kim Hei Sung, Jeon Jie Hyun, Choi Gwang Seong

机构信息

Department of Dermatology, Jeonbuk National University Medical School, Jeonju, Korea.

Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Ewha Med J. 2024 Oct;47(4):e73. doi: 10.12771/emj.2024.e73. Epub 2024 Oct 31.


DOI:10.12771/emj.2024.e73
PMID:40704002
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12093540/
Abstract

Scabies is a skin disease caused by the parasite var. , which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient's age, health status, the number of mites, and the route of transmission. Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution imaging techniques.

摘要

疥疮是一种由疥螨变种寄生虫引起的皮肤病,主要通过直接皮肤接触或性接触传播,较少情况下通过接触受感染的污染物传播。在韩国,疥疮的发病率已从2010年的每年约50000例降至2021年的每年约30000例。然而,在养老院等居住设施中,尤其是老年人中,疥疮疫情仍时有发生。疥疮的临床表现因患者年龄、健康状况、螨虫数量和传播途径而异。典型疥疮的典型症状包括夜间剧烈瘙痒和特征性皮疹(隧道和红斑丘疹),好发于指间、内腕、脐周、腋窝和生殖器部位。相比之下,免疫功能低下或患有神经系统疾病的老年人可能表现为角化过度的鳞屑性病变或非典型分布,伴有轻度瘙痒或无瘙痒(结痂性疥疮)。疥疮的诊断基于临床症状以及旨在确定寄生虫存在的诊断测试结果。虽然密切接触史和特征性临床发现提示疥疮,但确诊需要检测到疥螨、虫卵或粪便。这可以通过皮肤样本的光学显微镜检查、非侵入性皮肤镜检查和其他高分辨率成像技术来实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/266e4e8e2ead/emj-47-4-72-g6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/8ff3ab31b1d5/emj-47-4-72-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/717c8f2d42ca/emj-47-4-72-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/a9ad80caf6e9/emj-47-4-72-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/1cda76098673/emj-47-4-72-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/d78d9c09aecc/emj-47-4-72-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/266e4e8e2ead/emj-47-4-72-g6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/8ff3ab31b1d5/emj-47-4-72-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/717c8f2d42ca/emj-47-4-72-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/a9ad80caf6e9/emj-47-4-72-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/1cda76098673/emj-47-4-72-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/d78d9c09aecc/emj-47-4-72-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9835/12093540/266e4e8e2ead/emj-47-4-72-g6.jpg

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本文引用的文献

[1]
Sight the Mite: A Meta-Analysis on the Diagnosis of Scabies.

Cureus. 2023-1-30

[2]
Erythroderma secondary to crusted scabies.

BMJ Case Rep. 2021-12-14

[3]
Estimation of scabies prevalence using simplified criteria and mapping procedures in three Pacific and southeast Asian countries.

BMC Public Health. 2021-11-10

[4]
Risk factors for scabies treatment resistance: a retrospective cohort study.

J Eur Acad Dermatol Venereol. 2022-1

[5]
Scabies itch: an update on neuroimmune interactions and novel targets.

J Eur Acad Dermatol Venereol. 2021-9

[6]
Diagnostic Accuracy of Dermoscopy for Scabies.

Korean J Parasitol. 2020-12

[7]
Gray-edged line sign of scabies burrow.

J Dermatol. 2021-2

[8]
A community-based validation of the International Alliance for the Control of Scabies Consensus Criteria by expert and non-expert examiners in Liberia.

PLoS Negl Trop Dis. 2020-10

[9]
Scabies: A comprehensive review and current perspectives.

Dermatol Ther. 2020-7

[10]
Trends in prevalence and incidence of scabies from 1990 to 2017: findings from the global Burden of disease study 2017.

Emerg Microbes Infect. 2020-12

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