Severe Scabies: A French Multi-centre Study Involving 95 Patients with Crusted and Profuse Disease and Review of the Literature

Authors

  • Charbel Skayem Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
  • Askour Majda Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
  • Charlotte Gary Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
  • Francois Hemery Service d’Information Médicale, DSIGHM, APHP, Hôpital Henri-Mondor, Créteil, France
  • Emmanuel Mahé Dermatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
  • Frederic Caux Dermatology Department, APHP, Hôpital Avicenne, Bobigny, France
  • Nicolas Dupin Dermatology Department, APHP, Hôpital Cochin, Pavillon Tarnier, Paris, France
  • Patricia Senet Dermatology Department, APHP, Hôpital Tenon, Sorbonne Université, Paris, France
  • Alix Greder-Belan Service de Médecine Interne et Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier de Versailles, Hôpital Mignot, Le Chesnay, France
  • Brigitte Hillion Dermatology Department, Centre Hospitalier Marne la Vallée, Jossigny, France
  • Cecile Meni Dermatology Department, APHP, Hôpital Necker-Enfants malades, Paris, France
  • Philippe Saiag Dermatology Department, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
  • Guillaume Bellaud Infectious Diseases Department, APHP, Hôpital Tenon, Hôpitaux Universitaires Paris-Est, Paris, France
  • Alexandre Bleibtreu Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
  • Sylvie Lariven Infectious Diseases Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
  • Diane Bollens Infectious Diseases Department, APHP, Hôpital Saint-Antoine, Paris, France
  • Vincent Descamps Dermatology Department, APHP, Hôpital Bichat Claude Bernard, Paris, France
  • Jean-Michel Molina Infectious Diseases Department, APHP, Hôpital Saint-Louis, Paris, France
  • Olivier Bouchaud Infectious Diseases Department, APHP, Hôpital Avicenne, Bobigny, France
  • Daniel Vittecoq Infectious Diseases Department, APHP, CHU Bicêtre, Le Kremlin Bicêtre, France
  • Gia Do-Pham Service de Médecine Interne, Centre Hospitalier Intercommunal de Créteil, Créteil, France
  • Francoise Foulet Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
  • Francoise Botterel Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
  • Olivier Chosidow Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France
  • Charlotte Bernigaud Dermatology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Créteil, France

DOI:

https://doi.org/10.2340/actadv.v103.5351

Keywords:

scabies, Sarcoptes scabiei, parasitic, crusted scabies, pruritus, ivermectin, permethrin

Abstract

The aim of this multi-centre French retrospective study was to identify severe, i.e. crusted and profuse, scabies patients. Records were retrieved from 22 Dermatology or Infectious Diseases departments in the Ile-de-France from January 2009 to January 2015 to characterize epidemiology, demography, diagnosis, contributing factors, treatment features, and outcomes in severe scabies. A total of 95 inpatients (57 crusted and 38 profuse) were included. A higher number of cases was observed among elderly patients (>75 years), mostly living in institutions. Thirteen patients (13.6%) reported a history of previously treated scabies. Sixty-three patients (66.3%) had been seen by a previous practitioner for the current episode (up to 8 previous visits). Initial misdiagnosis (e.g. eczema, prurigo, drug-related eruptions, psoriasis) was documented in 41 patients (43.1%). Fifty-eight patients (61%) had already received 1 or more previous treatments for their current episode. Forty percent received corticosteroids or acitretin for an initial diagnosis of eczema or psoriasis. Median time from the onset of symptoms to the diagnosis of severe scabies was 3 months (range 0.3–22). Itch was present in all patients at diagnosis. Most patients (n=84, 88.4%) had comorbidities. Diagnostic and therapeutic approaches varied. Complications occurred in 11.5% of cases. To date, there is no consensus for diagnosis and treatment, and future standardization of is required for optimal management. 

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Additional Files

Published

2023-03-02

How to Cite

Skayem, C., Majda, A., Gary, C., Hemery, F., Mahé, E., Caux, F., … Bernigaud, C. (2023). Severe Scabies: A French Multi-centre Study Involving 95 Patients with Crusted and Profuse Disease and Review of the Literature. Acta Dermato-Venereologica, 103, adv00878. https://doi.org/10.2340/actadv.v103.5351