Domínguez L, Gorostiaga G, Rivelli V, Aldama A

Language: Spanish
References: 13
Page: 7-9
PDF size: 221.78 Kb.

ABSTRACT

Background: crusted scabies is a rare variant of scabies, which is a massive infestation by Sarcoptes scabiei var. hominis. It is characterized by hyperkeratotic plaques and crusts, which can be localized in one single area, or widespread.
Objectives: The study aims to determine the frequency of crusted scabies in our patients with scabies, establish its clinical features, predisposing factors and the presence or absence of pruritus.
Methods: An observational, descriptive, retrospective study of patients with crusted scabies at the Service of Dermatology, National Hospital of Paraguay from January 1990 to December 2006.
Results: Of 461 patients diagnosed with scabies, 22 had the crusted variety, (4.7%). The mean age at diagnosis was 34.5 years, affecting both sexes equally. Most patients had significant cutaneous involvement, leading to erythroderma in 5 cases. Pruritus was found in 13 patients. The main predisposing factors were: Down syndrome (6 cases), collagen vascular diseases (5 cases), diabetes mellitus (4 cases). The other patients had malnutrition, alcoholism, neoplasia, and in 2 no underlying pathology could be determined. 80% of patients had one or more family members with scabies. Since recent years the most common treatment has been oral ivermectin.
Conclusions: Crusted scabies is an uncommon condition in which a predisposing factor is usually present, we found it in 90% of cases. Itching was present in 59%.

REFERENCES

1. “Dermatosis parasitarias”. En: Sampaio S, Rivitti E. Dermatología. 2ª ed. Sao Paulo, Artes Médicas, 2000: 575-590.

2. Stone S, “Escabiosis y pediculosis”. En: Freedberg I, Eisen AZ, Wolff K, Austen KF, Goldsmith L. Dermatologia en Medicina General. 6ª ed. Buenos Aires, Panamericana, 2005: 2580-2588.

3. Rivelli V. “Dermatosis por ectoparásitos”. En: Aldama A, Rivelli V. Dermatología. 1ª ed. Asunción, EFACIM, 2009: 117-125.

4. Dauden TE, Oñate MJ. “Dermatosis causadas por Artrópodos, Helmintos y Protozoos”. En: Iglesias Diez L, Guerra Tapia A, Ortiz Romero PL. Tratado de Dermatología. 2ª ed. Madrid, Mc Graw-Hill Interamericana, 2004: 55-77.

5. Shapiro PE. “Granulomas no infecciosos”. En: Elder D, Elenitsas R, Jaworsky C, Johnson B. Lever. Histopatología de la Piel. 8ª ed. Buenos Aires, Intermédica, 1999: 289-308.

6. Galiana A, Bonasse J, Salmenton G. “Sarna costrosa: una forma inusual de escabiosis”. Arch Pediatr Urug 2003; 74(1): 22-25.

7. Barrón E, Gutiérrez Z, Castillo W, Rodríguez S. “Sarna costrosa (sarna noruega): reporte de cinco casos”. Dermatol Perú 1998; 8(1): 37-41.

8. Fajardo-Velázquez R, Urdez-Hernández E, Ysita-Morales A. “Brote intrahospitalario de escabiasis, a partir de un caso de sarna noruega”. Salud pública de México 2004; 46(3): 251-254.

9. Aldama A, Rivelli V, Correa J. “Sarna costrosa en pacientes no SIDA. Revisión de 10 casos”. Med Cután Iberolat 1998; 26(4): 190-196.

10. DePaoli R, Marks V. “Crusted (Norvegian) scabies: Treatment of nail involvement”. J Am Acad Dermatol 1998; 17(1): 136-138.

11. Shelley W, Shelley D, Burmeister V. “Staphylococcus aureus colonization of burrows in erythrodermic Norwegian scabies”. J Am Acad Dermatol 1988; 19(4): 673-678.

12. Cabrera H, Gatti C. Dermatología de Gatti-Cardama. Buenos Aires, El Ateneo, 2003: 282-292.

13. Elgueta A, Parada Y, Guzmán W, Molina P, González P. “Brote de sarna en un hospital terciario a partir de un caso de sarna costrosa”. Rev Chil infectol 2007; 24(4): 306-310.