Skip to main content

Advertisement

SpringerLink
Log in

Diagnosis, Prevention, and Treatment of Scabies

  • Skin, Soft Tissue, Bone, and Joint Infections (N Safdar, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Scabies remains a public health problem, especially in developing countries, with a worldwide incidence of approximately 300 million cases each year. Prolonged skin-to-skin contact is necessary to allow the transmission of the causative mite, Sarcoptes scabiei. Classic scabies presents with burrows, erythematous papules, and generalized pruritus. Clinical variants include nodular scabies and crusted scabies, also called Norwegian scabies. The diagnosis is based mainly on history and physical examination, but definitive diagnosis depends on direct visualization of the mites under microscopy. Alternative diagnostic methods include the burrow ink test, video-dermatoscopy, newly serologic tests like PCR/ELISA, and specific IgE directed toward major mite components. Treatment of scabies consists of either topical permethrin or oral ivermectin, although the optimal regimen is still unclear.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. McCarthy J, Kemp D. Scabies: more than just an irritation. Postgrad Med J. 2004;80:382–7.

    Article  PubMed  CAS  Google Scholar 

  2. Montesu MA, Cottoni F, Bonomo GC, Cestoni D. Discoverers of the parasitic origin of scabies. Am J Dermopathology. 1991;13:425–7.

    Article  CAS  Google Scholar 

  3. Andrews RM, McCarthy J, Carapetis JR, et al. Skin disorders, including pyoderma, scabies, and tinea infections. Pediatr Clin N Am. 2009;56:1421–40.

    Article  Google Scholar 

  4. Chosidow O. Scabies. N Engl J Med. 2006;354:1718–27.

    Article  PubMed  CAS  Google Scholar 

  5. Tsutsumi M, Nishiura H, Kobayashi T. Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989–90. BMC Infect Dis. 2005;5:85.

    Article  PubMed  Google Scholar 

  6. Makigami K, Ohtaki N, Ishii N, et al. Risk factors for recurrence of scabies: a retrospective study of scabies patients in a long–term care hospital. J Dermatol. 2001;38:874–9.

    Google Scholar 

  7. Wang C-H, Lee S, Huang S, et al. Risk factors for scabies in Taiwan. J Microbiol Immunol Infect. 2012;45:276–80.

    Article  PubMed  Google Scholar 

  8. Arlian LG, Runyan RA, Achar S, et al. Survival and infestivity of Sarcoptes scabiei var. canis and var. hominis. J Am Acad Dermatol. 1984;11:210–5.

    Article  PubMed  CAS  Google Scholar 

  9. Mellanby K. The Transmission of Scabies. Br Med J. 1941; 405–406.

  10. Walton SF. The immunology of susceptibility and resistance to scabies. Parasite Immunol. 2010;32:532–40.

    PubMed  CAS  Google Scholar 

  11. • Walton S, Pizzutto S, Slender A. Increased allergic immune response to Sarcoptes scabiei antigens in crusted versus ordinary scabies. Clin Vaccine Immunol. 2010;17:1428–38. This study provides a description of the increased allergic reaction that is present in crusted scabies.

    Article  PubMed  CAS  Google Scholar 

  12. Walton SF, Beroukas D, Roberts-Thomson P, et al. New insights into disease pathogenesis in crusted (Norwegian) scabies: the skin immune response in crusted scabies. Br J Dermatol. 2008;158:1247–55.

    Article  PubMed  CAS  Google Scholar 

  13. Chosidow O. Scabies and pediculosis. Lancet. 2000;355:819–26.

    Article  PubMed  CAS  Google Scholar 

  14. Danielssen DC, Boeck W. Traite de la Spedalsked ou Elephantiasis des Grecs. Paris: J B Balliere; 1848.

    Google Scholar 

  15. Roberts LJ, Huffam SE, Walton SF, et al. Crusted scabies: clinical and immunological findings in seventy-eight patients and a review of the literature. J Infect. 2005;50:375–81.

    Article  PubMed  CAS  Google Scholar 

  16. Hulbert T, Larsen R. Hyperkeratotic (Norwegian) scabies with Gram-negative bacteremia as the initial presentation of AIDS. Clin Infect Dis. 1992;14:1164–5.

    Article  PubMed  CAS  Google Scholar 

  17. Woodley D, Saurat JH. The Burrow Ink Test and the scabies mite. J Am Acad Dermatol. 1981;4:715–22.

    Article  PubMed  CAS  Google Scholar 

  18. Lacarrubba F, Musumeci M, Caltabiano R, et al. High–magnification videodermatoscopy: a new noninvasive diagnostic tool for scabies in children. Pediatr Dermatol. 2001;18:439–41.

    Article  PubMed  CAS  Google Scholar 

  19. • Park JH, Kim CW, Kim SS. The diagnostic accuracy of dermoscopy for scabies. Ann Dermatol. 2012;24:194–9. This trial compares the efficacy of the skin scraping technique when videodermatoscopy is added for the diagnosis of scabies.

    Article  PubMed  Google Scholar 

  20. Leung V, Miller M. Detection of scabies: a systematic review of diagnostic methods. Can J Infect Dis Med Microbiol. 2011;22:143–6.

    PubMed  Google Scholar 

  21. Micali G, Lacarrubba F, Tedeschi A. Videodermatoscopy enhaces the ability of scabies treatment and allows optimal timing of drug application. Eur Acad Dermatol Venereol. 2004;18:153–4.

    Article  CAS  Google Scholar 

  22. Micali G, Tedeschi A, West D. The use of videodermatoscopy to monitor treatment of scabies and pediculosis. J Dermatol Treat. 2011;22:133–7.

    Article  Google Scholar 

  23. • Bezold G, Lange M, Schiener R, et al. Hidden scabies: diagnosis by polymerase chain reaction. Br J Dermatol. 2001;144:614–8. This study describes the use of polymerase chain reaction (PCR) to amplify Sarcoptes scabiei DNA in a patient presenting with clinically atypical eczema.

    Article  PubMed  CAS  Google Scholar 

  24. •• Jayaraj R, Hales B, Viberg L, et al. A diagnostic test for scabies: IgE specificity for a recombinant allergen of Sarcoptes scabiei. Diagn Microbiol Infect Dis. 2011;71:403–7. This study designed specific IgE antibodies to a major scabies antigen for the diagnosis of scabies.

    Article  PubMed  CAS  Google Scholar 

  25. Mahé A, Faye O, N’Diaye H, et al. Definition of an algorithm for the management of common skin diseases at primary health care level in sub-Saharan Africa. Trans R Soc Trop Med Hyg. 2005;99:39–47.

    Article  PubMed  Google Scholar 

  26. Currie BJ, McCarthy JS. Permethrin and Ivermectin for scabies. N Engl J Med. 2010;362:717–25.

    Article  PubMed  CAS  Google Scholar 

  27. Burkhart C, Morrell D, Goldsmith L. (2011). Chapter 65. Dermatological Pharmacology. In LL Brunton, BA Chabner, BC Knollmann, editors. Goodman & Gilman's the pharmacological basis of therapeutics, 12e.

  28. Buffet M, Dupin N. Current treatments for scabies. Fundam Clin Pharmacol. 2003;17:217–25.

    Article  PubMed  CAS  Google Scholar 

  29. McCarthy J, Loukas A, Hotez PJ (2011) Chapter 51. Chemotherapy of Helminth infections. In LL Brunton, BA Chabner, BC Knollmann, editors. Goodman & Gilman's the pharmacological basis of therapeutics, 12e.

  30. •• Strong M, Johnstone P. Interventions for treating scabies (Review). Cochrane Libr. 2010;10. This 2010 Cochrane review compares the efficacy of multiple treatment options for scabies.

  31. Usha V, Nair G. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. J Am Acad Dermatol. 2000;42:236–40.

    Article  PubMed  CAS  Google Scholar 

  32. • Sharma R, Singal A. Topical permethrin and oral ivermectin in the management of scabies: a prospective, randomized, double blind, controlled study. Indian J Dermatol Venereol Leprology. 2011;77:581–6. This randomized controlled trial included 120 patients and compared the efficacy of topical permethrin versus oral ivermectin.

    Article  Google Scholar 

  33. •• Goldust M, Rezaee E, Hemayat S. Treatment of scabies: comparison of permethrin 5% versus ivermectin. J Dermatol. 2012;39:545–7. This trial included 272 patients and compared the efficacy of topical 5% permethrin versus oral ivermectin.

    Article  PubMed  CAS  Google Scholar 

  34. •• Mohebbipour A, Saleh P, Goldust M, et al. Comparison of oral ivermectin vs. lindane lotion 1% for the treatment of scabies. Clin Exp Dermatol. 2013. doi:10.1111/ced.12079. This trial included 148 patients and compared the efficacy of oral ivermectin versus topical lindane.

    PubMed  Google Scholar 

  35. •• Goldust M, Rezaee E, Raghifar R. Comparison of oral ivermectin versus crotamiton 10% cream in the treatment of scabies. Cutan Ocul Toxicol. 2013. doi:10.3109/15569527.2013.768258. This trial included 320 patients and compared the efficacy of oral ivermectin versus topical crotamiton.

    PubMed  Google Scholar 

  36. •• Goldust M, Rezaee E, Raghifar R. The efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies. J Dermatolog Treat. 2013. doi:10.3109/09546634.2013.782093. This trial included 340 patients and compared the efficacy of topical ivermectin versus 10% malation.

    Google Scholar 

  37. Feldmeier H, Chhatwal GS, Guerra H. Pyoderma, group A streptococci and parasitic skin diseases – a dangerous relationship. Trop Med Int Health. 2005;10:713–6.

    Article  PubMed  Google Scholar 

  38. Lawrence G, Leafasia J, Sheridan J, et al. Control of scabies, skin sores and haematuria in children in the Solomon Islands: another role for ivermectin. Bull World Health Organ. 2005;011197:34–42.

    Google Scholar 

  39. McDonald M, Currie B, Carapetis J. Acute rheumatic fever: a chink in the chain that links the heart to the throat? Lancet Infect Dis. 2004;4:240–5.

    Article  PubMed  Google Scholar 

  40. Monsel G, Chosidow O. Management of scabies. Skin Ther Lett. 2012;17:1–4.

    Google Scholar 

  41. Taplin D, Porcelain SL, Meinking TL, et al. Community control of scabies: a model based on use of permethrin cream. Lancet. 1991;337:1016–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Luis Shimose declare that he has no conflict of interest.

Silvia Munoz-Price declare that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Miami, Miami, FL, USA

    Luis Shimose & L. Silvia Munoz-Price

  2. Department of Anesthesiology, University of Miami, Miami, FL, USA

    L. Silvia Munoz-Price

  3. Department of Public Health Sciences, University of Miami, Miami, FL, USA

    L. Silvia Munoz-Price

  4. Jackson Memorial Hospital, Miami, FL, USA

    Luis Shimose & L. Silvia Munoz-Price

  5. Park Plaza West L-302, 1611 N.W. 12th Avenue, Miami, FL, 33136-1096, USA

    L. Silvia Munoz-Price

Authors
  1. Luis Shimose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Silvia Munoz-Price
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Silvia Munoz-Price.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shimose, L., Munoz-Price, L.S. Diagnosis, Prevention, and Treatment of Scabies. Curr Infect Dis Rep 15, 426–431 (2013). https://doi.org/10.1007/s11908-013-0354-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11908-013-0354-0

Keywords

Search

Navigation