Scabies and genetics, some relationship ? / Escabiosis y genetica, alguna relacion ?

**********************************
****** DATA-MÉDICOS *********
*********************************
ESCABIOSIS Y GENÉTICA, ALGUNA RELACIÓN ?.
SCABIES AND GENETCS, SOME RELATIONSHIP ?
**************************************
***** DERMAGIC-EXPRESS No 75 *******
** 14 OCTUBRE 1.999 / 14 OCTOBER 1999**
*********************************

EDITORIAL ESPAÑOL:
=====================
Hola Amigos de la red, el tema de hoy: LA ESCABIOSIS Y LA GENÉTICA, ALGUNA RELACIÓN ???. Si yo les dijese que existe una relación entre la vulgar y común SARNA y la predisposición a padecerla TENDRÍA que convencerlos.

Pues en algunas de estas REFERENCIAS BIBLIOGRÁFICAS, queda plasmado que se han hecho estudios donde se ha demostrado una susceptibilidad estadísticamente significativa entre los ANTÍGENOS DE HISTOCOMPATIBILIDAD (HLA) y la ESCABIOSIS, y en los dos estudios el antígeno asociado fue el MISMO.

En otros estudios, el papel inmunológico del organismo es factor importante en el comportamiento de la enfermedad, y sus manifestaciones clínicas. Al final un REPASO de las ya terapias conocidas LINDANO, CROTAMITON, PERMETRIN y el ultimo grito de la MODA el popular IVERMECTIN, medicina que gano el Premio Nobel de la Ciencia en al año 2015, por sus grandes efectos contra los parásitos.

Quien iba a pensar que tenemos una predisposición para que ese BICHITO se nos monte ???

En las 27 referencias, los hechos,,,

Saludos a todos !!!

Dr. José Lapenta R.,,,

EDITORIAL ENGLISH:
=====================
Hello friends of the internet, today's topic: SCABIES AND GENETICS, IS THERE ANY RELATIONSHIP? If I told you that there is a relationship between common scabies and a predisposition to suffer from it, I would have to convince you.

Well, in some of these BIBLIOGRAPHIC REFERENCES, it is evident that studies have been conducted demonstrating a statistically significant susceptibility between HLA antigens and SCABIES, and in both studies, the associated antigen was the SAME.

In other studies, the body's immunological role is an important factor in the behavior of the disease and its clinical manifestations. Finally, a REVIEW of the well-known therapies: LINDANE, CROTAMITON, PERMETHRIN, and the latest fashion, the popular IVERMECTIN, a drug that won the Nobel Prize in Science in 2015 for its significant effects against parasites.

Who would have thought we were predisposed to that BUG creeping up on us???

In the 27 references, the facts,,,

Greetings to ALL, !!

Dr. José Lapenta R.,,,

================================================================
DERMAGIC/EXPRESS(75)
================================================================
REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
================================================================
1.) Histocompatibility (HLA) antigens in Egyptians with two parasitic skin diseases (scabies and leishmaniasis).
2.) The immunology of scabies.
3.) HLA antigens in patients with scabies.
4.) Immunoglobulin and complement deposits in the skin and circulating immune complexes in scabies.
5.) The immunology of scabies.
6.) Serum IgE before and after treatment for scabies.
7.) Cutaneous histiocytosis with Langerhans cell features induced by scabies: a case report.
8.) Skin test and radioallergosorbent test characteristics of scabietic patients.
9.) In vitro demonstration of specific immunological hypersensitivity to scabies mite.
10.) A DNA fingerprinting system for the ectoparasite Sarcoptes scabiei.
11.) The behaviour of Sarcoptes scabiei var. hominis in human skin: an ultrastructural study.
12.) Immunohistopathological status of the skin in cases infested with three species of mites.
13.) Scabietic nodules: a dermatopathologic and immunofluorescent study.
14.) Immunologic cross-reactivity among various strains of Sarcoptes scabiei.
15.) Can house dust mite-triggered atopic dermatitis be alleviated using acaricides?
16.) Epiluminescence microscopy. A new approach to in vivo detection of Sarcoptes scabiei.
17.) [Ivermectin and tropical dermatoses]
18.) Success of a scabies control program in an Australian aboriginal community.
19.) Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies.
20.) The treatment of scabies with ivermectin.
21.) Epidemiology and control of scabies in an Egyptian village.
22.) Crusted scabies in two immunocompromised children: successful treatment with oral ivermectin.
23.) Treatment of scabies with ivermectin.
24.) Efficacy and tolerance of oral ivermectin in scabies.
25.) Norwegian scabies in a patient with acquired immunodeficiency syndrome.
26.) Ivermectin for Sarcoptes scabiei hyperinfestation.
27.) Crusted scabies of the scalp in dermatomyositis patients: three cases treated with oral ivermectin.
================================================================= =================================================================
1.) Histocompatibility (HLA) antigens in Egyptians with two parasitic skin diseases (scabies and leishmaniasis).
=================================================================
J Egypt Soc Parasitol 1990 Dec;20(2):565-72

Morsy TA, Romia SA, al-Ganayni GA, Abu-Zakham AA, al-Shazly AM, Rezk RA
Department of Parasitology, Faculty of Medicine, Ain Shams University, Egypt.
The frequency of human leucocytic antigens (HLA) were studied in 62 patients with scabies and 27 patients with cutaneous leishmaniasis to evaluate the role of HLA antigens as genetic markers in the pathogenesis of these parasitic skin diseases. A significant statistical association was proved between HLA-A11 antigen and scabies and between HLA-A11, -B5 and -B7 antigens and diffuse cutaneous leishmaniasis.

=================================================================
2.) The immunology of scabies.
=================================================================
Ann Allergy 1983 Dec;51(6):560-6

Dahl MV

Scabies is an inflammatory skin disease caused by the mite Sarcoptes scabiei. The mite itself provokes little dermatitis. The rash and itch associated with scabies is probably a manifestation of immune response. The immune response may help to limit the number of infesting organisms either directly by toxic products generated during the reaction or indirectly by evoking scratch. Critical studies using purified antigens from scabies mites in vivo and in vitro will be necessary in order to clarify the nature of the antigens involved and the role of different types of immune responses in producing clinical disease.

=================================================================
3.) HLA antigens in patients with scabies.
=================================================================
Br J Dermatol 1981 Mar;104(3):317-20

Falk ES, Thorsby E

Sixty patients with scabies were typed for thirty-three antigens of the HLA-A, -B and -C series. A significantly increased frequency was found for HLA-AII (28.3%), compared to healthy controls (10.4%). This deviation was only found in those of the patients without signs of atopic disease.

=================================================================
4.) Immunoglobulin and complement deposits in the skin and circulating immune complexes in scabies.
=================================================================
ARTICLE SOURCE: Acta Derm Venereol (Sweden), 1982, 62(1) p73-6
AUTHOR(S): Salo OP; Reunala T; Kalimo K; Rantanen T
PUBLICATION TYPE: JOURNAL ARTICLE

ABSTRACT: Sixteen patients with papulovesicular, 6 with nodular and one with a Norwegian scabies were studied. Direct immunofluorescence (IF) examination revealed C3 deposits in the skin lesions of 13 of the 18 patients.

Among them were all 6 cases with nodular scabies. C3 was found mostly in dermal vessel walls and 3 of the patients also showed IgM and 2 IgA deposits at the same site. No circulating immune complexes were found, with a solid-phase C1q radioimmunoassay (RIA), but HSV- and RSV-RIA methods detected IgM antibodies of rheumatoid factor type in 5 of the 15 sera examined.

These results suggest that local complement activation and perhaps also immune complex deposition may by important in the pathogenesis of the papular and nodular skin lesions of human scabies.

=================================================================
5.) The immunology of scabies.
=================================================================
ARTICLE SOURCE: Semin Dermatol (United States), Mar 1993, 12(1) p15-21
AUTHOR(S): Cabrera R; Agar A; Dahl MV
AUTHOR'S ADDRESS: Department of Dermatology, University of Chile School of Medicine, Santiago.

PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (52 references); REVIEW, TUTORIAL

ABSTRACT: Individuals with scabies react to bites by generating a cell-mediated immune response at the bite site. This elicits a very itchy papule that is often excoriated.

Sometimes ulcerated papules, vasculitis, and nodules develop as a result of other immunologic reactions in skin. Immunologic reactions mediated by antibodies of the immunoglobulin G (IgG), IgM, and especially, IgE classes may also be involved.

None of these reactions have been shown to eliminate all mites from the skin surface, but locally these reactions may prevent the epidemic multiplication of scabies' organisms on the skin surface, as observed in some patients with crusted scabies.

=================================================================
6.) Serum IgE before and after treatment for scabies.
=================================================================
ARTICLE SOURCE: Allergy (Denmark), Apr 1981, 36(3) p167-74
AUTHOR(S): Falk ES
PUBLICATION TYPE: JOURNAL ARTICLE

ABSTRACT: In 120 patients, treated for scabies infection, the serum IgE concentrations fell from high levels in 54 and normal levels in 66 to lower levels 12 months after treatment. The specific IgE antibodies to Dermatophagoides pteronyssinus (RAST) were also reduced 12 months after treatment. The decrease in both IgE concentrations and IgE antibodies was most conspicuous in non-atopic patients.

These findings confirm previous observations of specific immunological hypersensitivity to scabies mite, and that scabies infection stimulates the production of IgE antibodies.

=================================================================
7.) Cutaneous histiocytosis with Langerhans cell features induced by scabies: a case report.
=================================================================
ARTICLE SOURCE: Pediatr Dermatol (United States), Dec 1994, 11(4) p327-30
AUTHOR(S): Talanin NY; Smith SS; Shelley ED; Moores WB
AUTHOR'S ADDRESS: Division of Dermatology, Medical College of Ohio, Toledo 43699-0008.
INDEXING CHECK TAG(S): Case Report; Human; Male
PUBLICATION TYPE: JOURNAL ARTICLE

ABSTRACT: An infant with biopsy-proven scabies developed nodular lesions. Histopathology revealed atypical histiocytes with Langerhans cell features. Within six months after treatment all skin lesions gradually disappeared. We suggest that the nodules in scabies can be due to Langerhans cell proliferation.

=================================================================
8.) Skin test and radioallergosorbent test characteristics of scabietic patients.
=================================================================
Morgan MS; Arlian LG; Estes SA
Department of Biological Sciences, Wright State University, Dayton, Ohio 45435, USA. Am J Trop Med Hyg (UNITED STATES) Aug 1997 57 (2) p190-6 ISSN: 0002-9637
Contract/Grant No.: AI-17252--AI--NIAID
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9711

Subfile: AIM; INDEX MEDICUS

The scabies mite Sarcoptes scabiei and the Dermatophagoides house dust mites (HDM) are related phylogenetically and are the sources of several cross-reactive antigens. The purpose of this study was to investigate the immune response to S. scabiei and HDM in scabietic patients. Skin test sensitivity and serum IgE to both S. scabiei and HDM were determined for patients who had or previously had confirmed ordinary scabies.

A retrospective group included nine subjects who had received successful treatment three weeks to one year prior to the study. A prospective group included 16 subjects with active scabies. Allergic histories were obtained, serum was collected, and skin prick tests (SPTs) were performed at enrollment for all and periodically over the next 12 months for the prospective patients. None of the individuals in either group reported a known sensitivity to HDM. Six of the nine retrospective patients were SPT positive to both S. scabiei and HDM and two of these showed circulating IgE specific for these antigens.

At diagnosis, 13 of 16 patients with active scabies were SPT positive to S. scabiei and 12 of these were also SPT and/or radioallergosorbent test positive to HDM. Six patients had circulating IgE directed at both S. scabiei and HDM antigens while one subject had IgE to S. scabiei only and another had IgE directed at HDM only.

Twelve of the 15 subjects tested also showed IgE and/or IgG binding to one or more bands on Western blots of an S. scabiei- specific protein fraction.

This study indicated that approximately half of the patients with active scabies had S. scabiei- and HDM-specific circulating IgE while most patients cured of scabies lacked S. scabiei- and HDM-specific serum IgE. The data also suggested that antibodies to S. scabiei in scabietic patients also recognize HDM; however, some antibodies were directed at scabies-specific antigens.

=================================================================
9.) In vitro demonstration of specific immunological hypersensitivity to scabies mite.
=================================================================
ARTICLE SOURCE: Br J Dermatol (England), Oct 1980, 103(4) p367-73
AUTHOR(S): Falk ES; Bolle R
PUBLICATION TYPE: JOURNAL ARTICLE

ABSTRACT: An extract prepared from 200 adult female scabies mites was used for prick and intracutaneous testing in twelve patients with previous scabies infestation, as well as in six healthy controls and three persons with skin sensitivity to Dermatophagoides pteronyssinus who had never had scabies before.

Seven individuals who had had scabies less than a year prior to the testing had positive intracutaneous (immediate type) reactions, whereas all the five who had had scabies more than a year before had negative reactions. The prick tests were negative in all cases. No skin reactions could be evoked in the controls.

The passive transfer, or Prausnitz-Kustner, test was positive with the scabies mite extract and serum from three of five patients tested on one healthy individual, and with both of two sera tested on a second healthy individual. These findings indicate that immediate type hypersensitivity reactions may occur with scabies infection.

=================================================================
10.) A DNA fingerprinting system for the ectoparasite Sarcoptes scabiei.
=================================================================
Walton SF; Currie BJ; Kemp DJ
Menzies School of Health Research, Casuarina, Australia.
[email protected]
Mol Biochem Parasitol (NETHERLANDS) Apr 1997 85 (2) p187-96 ISSN: 0166-6851
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9709

Subfile: INDEX MEDICUS

We describe multiple hypervariable microsatellites that will provide a highly informative genetic marker system for the sarcoptid mite Sarcoptes scabiei. Eighteen positive clones containing the highly repetitive sequence (GA)n were isolated from a partial genomic library of S. scabiei.

Ten of these clones were characterised by sequencing and primers were designed from the unique sequences flanking eight microsatellite loci. Genomic DNA was subsequently extracted from individual mites and the repeat blocks were amplified by way of [gamma 33P] ATP end-labelled polymerase chain reaction. Fragment length polymorphisms were revealed in three of the loci when resolved on polyacrylamide sequencing gels.

The high levels of allelic variability demonstrated between individual mites enable these three loci to form a DNA fingerprinting system that will be suitable for epidemiological and taxonomic studies both within and between host species.

=================================================================
11.) The behaviour of Sarcoptes scabiei var. hominis in human skin: an ultrastructural study.
=================================================================
Fimiani M; Mazzatenta C; Alessandrini C; Paccagnini E; Andreassi L
Department of Dermatology, University of Siena, Italy.
J Submicrosc Cytol Pathol (ITALY) Jan 1997 29 (1) p105-13 ISSN: 0022-4782
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9706

Subfile: INDEX MEDICUS

The biology of Sarcoptes scabiei var. hominis is poorly understood because of the lack of an in vivo or in vitro propagation system. To obtain more information on the mite behaviour in its natural habitat we conducted an ultrastructural study of burrows in a number of patients with common scabies.

Scanning electron microscopy furnished attractive images of the tunnel, parasite body and eggs architecture and demonstrated the presence of holes in the tunnel roof probably representing aeration structures. Transmission electron microscopy showed a marked keratinocyte damage around burrowing mites, well evident ahead of the mite capitulum also. Faecal pellets containing keratinocyte micro-organelles (melanosomes and mitochondria) were documented in posterior midgut.

For the first time we disclosed the adhesion mechanism of eggs to the burrow floor. We showed that the typical finger-like projections of the outer layer of the egg shell gradually disappear where the eggs are in contact with the tunnel floor.

This allows the inner layer of the egg shell to fuse and stick with the damaged keratinocytes lining the tunnel floor. Our observation substantiates that Sarcoptes scabiei produces a proteolytic substance (salivary secretions?) that has a key role in its life cycle allowing burrowing, feeding and eggs-burrow adhesion.

=================================================================
12.) Immunohistopathological status of the skin in cases infested with three species of mites.
=================================================================
Yassien NA; Ghoraba HM; Doghaim NN; Afify EM
Department of Parasitology, Faculty of Medicine, Tanta University, Egypt.
J Egypt Soc Parasitol (EGYPT) Dec 1996 26 (3) p567-73 ISSN: 0253-5890
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9704

Subfile: INDEX MEDICUS

This study was performed on eighty patients with clinical manifestations of scabies. Sarcoptes scabiei adult or larva was isolated from 39 patients (48.8%). Dermanyssus gallinae (red poultry mite) and Dermatophagoides sp.

were isolated from 6 and 5 patients respectively. Punch biopsies were taken from the patients, stained with haematoxylin and eosin and direct immunofluorescence stain to study the immunopathological status of the skin infested with three species of mites.

The results declared that the pathological changes and the immunoglobulin deposition in the skin were nearly similar regardless of the type of the causative mite with the except of the presence of burrows in Sarcoptes scabiei.

=================================================================
13.) Scabietic nodules: a dermatopathologic and immunofluorescent study.
=================================================================
ARTICLE SOURCE: J Cutan Pathol (Denmark), Apr 1992, 19(2) p124-7
AUTHOR(S): Liu HN; Sheu WJ; Chu TL
AUTHOR'S ADDRESS: Department of Dermatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
PUBLICATION TYPE: JOURNAL ARTICLE

ABSTRACT: Mites and their eggs were thought to be rarely found in nodular lesions of scabies. However, serial sections from 27 scabietic scrotal papules or nodules revealed mite parts in 22% (6/27). This supports the contention that scabietic nodules may result from persisting antigens of mite parts.

In contrast to previous studies, vasculitis with fibrinoid degeneration was uncommon (3/27) in our series. This discrepancy may be due to the timing of the biopsies: 2 of 3 cases with vasculitis were associated with diffuse dense infiltration, and vasculitis may be a late event in the development of scabietic nodules.

The specificity of immunoreactant deposits along the epidermodermal junction (EDJ) in scabies is controversial. In our study, direct immunofluorescence (DIF) was performed on 13 scabietic nodules. Four (31%) showed immunoreactants at the EDJ and two on blood vessels.

Because of the relatively low positive rate, the low intensity of fluorescence, and 3 of 4 cases with positive immunoreactants having only a single class of immunoglobulin, the deposition may only be secondary to inflammation instead of a specific type II immunologic reaction to scabies.

=================================================================
14.) Immunologic cross-reactivity among various strains of Sarcoptes scabiei.
=================================================================
AU: Arlian-LG; Morgan-MS; Arends-JJ
AD: Department of Biological Sciences, Wright State University, Dayton, Ohio 45435, USA.
SO: J-Parasitol. 1996 Feb; 82(1): 66-72
ISSN: 0022-3395
PY: 1996
LA: ENGLISH
CP: UNITED-STATES

AB: Varieties of Sarcoptes scabiei from different hosts are highly host specific but they are morphologically indistinguishable. The purpose of this study was to investigate the immunologic cross-reactivity among several varieties of scabies mites using serum from a human scabies patient and from several other species of infested hosts. Homologous and heterologous crossed-immunoelectrophoretic (CIE) analysis of extracts prepared from var.

canis (dog) and var. suis (pig) mites yielded very similar antigen profiles. Serum from a human patient infested with var. hominis had circulating IgE that bound to antigens present in extracts prepared from each animal mite variety. Antigen homology was further confirmed by fused peaks on tandem CIE. Additionally, sodium dodecyl sulfate polyacrylamide gel electrophoresis/immunoblot analysis showed that the 2 extracts contained proteins that bound antibody in serum from a var. suis-infested pig, a var. canis-infested dog, var. canis-infested rabbits, and a var. hominis-infested human.

The results of this study clearly indicate that different varieties of scabies mites, though host specific, introduce some immunologically cross-reactive molecules into the host. However, each serum from the 4 scabies-infested hosts also contained antibody that was specific for proteins in extract from only 1 variety of mite.

These data indicated that each variety of scabies introduced some unique molecules into the host, each strain produced some similar molecules, or both, but different hosts responded immunologically to different sets of these.

=================================================================
15.) Can house dust mite-triggered atopic dermatitis be alleviated using acaricides?
=================================================================
Cameron MM
Department of Medical Parasitology, London School of Hygiene & Tropical Medicine, U.K. Br J Dermatol (ENGLAND) Jul 1997 137 (1) p1-8 ISSN: 0007-0963
Language: ENGLISH
Document Type: JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
Journal Announcement: 9711

Subfile: INDEX MEDICUS

House dust mite (HDM) allergens are the most important triggers for atopic dermatitis. Reducing exposure to these allergens may alleviate clinical symptoms. Chemicals with acaricidal activity have been used to treat upholstered furniture, carpets and bedding with the aim to reduce HDM allergen exposure.

These chemicals, by reducing HDM, can decrease the concentration of mite allergens in dust but improvements in clinical symptoms are not always apparent. Clinical improvement is more likely to occur if bedding has been treated rather than carpets and upholstery. Future control strategies should be aimed at treating bedding.

Permethrin is a very efficient killer of mites. It is used topically to treat scabies and head lice and is impregnated in bed nets to prevent mosquito bites.

Even when applied to the skin in high concentrations, it has a very low toxicity in humans and other mammals. Permethrin-impregnated bedding may prove to be the best control method in the treatment of HDM allergen-triggered atopic conditions. (93 References)

=================================================================
16.) Epiluminescence microscopy. A new approach to in vivo detection of Sarcoptes scabiei.
=================================================================
Argenziano G; Fabbrocini G; Delfino M
Clinic of Dermatology, Federico II University of Naples, Italy.
Arch Dermatol (UNITED STATES) Jun 1997 133 (6) p751-3 ISSN: 0003-987X
Language: ENGLISH
Document Type: CLINICAL TRIAL; JOURNAL ARTICLE
Journal Announcement: 9709

Subfile: AIM; INDEX MEDICUS

BACKGROUND: The usual methods of scabies diagnosis include microscopic identification of the mites and their eggs and feces in skin scrapings. In many cases, the results of microscopic examination can be negative owing to the low number of parasites present in the cornified layer.

Epiluminescence microscopy (ELM) is an in vivo technique that allows a detailed inspection of the skin, from the surface to the superficial papillary dermis. This is where the scabies mite lives. In this study, we evaluate the applicability and the usefulness of ELM for in vivo diagnosis of scabies.

OBSERVATIONS: Sixty-five (93%) of 70 cases of scabies showed small, dark, triangular structures at the sites examined with ELM. A subtle linear segment seen below the base of the triangle was made visible by the presence of small air bubbles. Together, both structures resembled a jet with contrail. On traditional microscopic examination of the scrapings, we verified that the triangular structure corresponded to the pigmented anterior section of the mite in all cases. The linear segment observed on ELM was thought to be the burrow of the mite along with its eggs and fecal pellets. The cases in which the results of a first ELM examination were negative demonstrated positive results on a second ELM examination carried out 20 days later.

CONCLUSION: Epiluminescence microscopy is a very useful tool for in vivo diagnosis of scabies because it permits Sarcoptes scabiei detection in only a few minutes, with no discomfort to the patient and with a very low number of false- negative results.

=================================================================
17.) [Ivermectin and tropical dermatoses] Ivermectine et dermatoses tropicales.
=================================================================
Caumes E
Service de maladies infectieuses et tropicales, Groupe hospitalier Pitie- Salp.ANG.etriere, Paris.
Bull Soc Pathol Exot (FRANCE) 1997 90 (1) p37-8
Language: FRENCH Summary Language: ENGLISH
Document Type:
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL English Abstract
Journal Announcement: 9710

Subfile: INDEX MEDICUS

Among tropical dermatoses, the main indications of ivermectine are tropical parasitoses such as filariasis and cosmopolitan diseases due to ectoparasites such as scabies.

The efficacy and tolerance of ivermectine in filariasis (onchocerciasis, lymphatic filariasis, loiasis) have been the topic of numerous articles and reviews. More recent studies showed that ivermectin was also efficient in the therapy of scabies, cutaneous larva migrans and larva currens. (17 References)

=================================================================
18.) Success of a scabies control program in an Australian aboriginal community.
=================================================================
Carapetis JR; Connors C; Yarmirr D; Krause V; Currie BJ
Menzies School of Health Research, Darwin, Northern Territory, Australia.
[email protected]
Pediatr Infect Dis J (UNITED STATES) May 1997 16 (5) p494-9 ISSN: 0891-3668
Language: ENGLISH
Document Type: JOURNAL ARTICLE
Journal Announcement: 9710

Subfile: INDEX MEDICUS

OBJECTIVE: To adapt, implement and evaluate a model of scabies control in an Australian Aboriginal community.

METHODS: After initially examining the population, we offered all residents treatment with 5% permethrin cream. Visits were made during the ensuing 25 months to rescreen and to treat new-cases of scabies and contacts.

RESULTS: The prevalence of scabies was reduced from 28.8% before the program to < 10% during the entire period (from 32.3% to < 10% in children) (P < 0.01 for each visit). The initial prevalence of pyoderma in children was 69.4%, which was reduced and maintained at approximately one-half that rate during the last 16 months (P < 0.004 for the last 4 visits). Residual pyoderma in children was significantly less severe and no longer scabies-related.

CONCLUSIONS: This simplified model of scabies control had a substantial effect on scabies prevalence and on pyoderma prevalence and severity which was sustained for > 2 years. It could prove useful for other communities with high rates of scabies and pyoderma.

=================================================================
19.) Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies.
=================================================================
Arch Dermatol 1999 Jun;135(6):651-5

Chouela EN, Abeldano AM, Pellerano G, La Forgia M, Papale RM, Garsd A, Balian MC, Battista V, Poggio N
Department of Dermatology, the Hospital General de Agudos Dr Cosme Argerich, Buenos Aires, Argentina. [email protected]

OBJECTIVE: To compare the therapeutic efficacy and safety of ivermectin and lindane for the treatment of human scabies. DESIGN: Randomized, prospective, controlled, double-blind, "double-dummy," and parallel clinical study.

SETTING: A single department of dermatology at a hospital in Buenos Aires, Argentina.

PATIENTS: Patients were outpatients, hospitalized patients, and those referred to our hospital from nursing homes and asylums. Fifty-three patients had clinical signs and symptoms compatible with scabies.

INTERVENTION: Patients received either a single oral dose of ivermectin (150-200 microg/kg of body weight) or a topical application of 1% lindane solution. Treatment was repeated after 15 days if clinical cure had not occurred.

MAIN OUTCOME MEASURES: Clinical healing and adverse effects. RESULTS: Of 53 patients, 43 (81%) completed the study, 19 in the group treated with ivermectin and 24 in the group treated with lindane. At day 15, 14 patients (74%; 95% confidence interval, 48.8%-90.8%) in the group receiving ivermectin showed healing of their scabies and 13 patients (54%; 95% confidence interval, 32.8%-74.4%) in the group treated with lindane were healed.

At 29 days, both treatments resulted in statistically equivalent therapeutic efficacy: 18 patients (95%; 95% confidence interval, 74.0%-99.9%) were healed with ivermectin and 23 patients (96%; 95% confidence interval, 78.9%, 99.9%) were healed with lindane (P<.02). Adverse effects from the treatments were few, mild, and transient. Results from laboratory tests showed no major abnormalities and no difference between treatments.

CONCLUSIONS: Ivermectin is as effective as lindane for the treatment of scabies. Ivermectin is simpler to use and, therefore, is a promising tool to improve compliance and to control
infestations.

=================================================================
20.) The treatment of scabies with ivermectin.
=================================================================
ARTICLE SOURCE: N Engl J Med (United States), Jul 6 1995, 333(1) p26-30
AUTHOR(S): Meinking TL; Taplin D; Hermida JL; Pardo R; Kerdel FA
PUBLICATION TYPE: CLINICAL TRIAL; JOURNAL ARTICLE

ABSTRACT: BACKGROUND. Ivermectin is an anthelmintic agent that has been a safe, effective treatment for onchocerciasis (river blindness) when given in a single oral dose of 150 to 200 micrograms per kilogram of body weight. Anecdotal reports of improvement in patients who suffered from infestation with the mite Sarcoptes scabiei suggest that the ectoparasitic disease scabies might be treated with ivermectin.

METHODS. We conducted an open-label study in which ivermectin was administered in a single oral dose of 200 micrograms per kilogram to 11 otherwise healthy patients with scabies and to 11 patients with scabies who were also infected with the human immunodeficiency virus (HIV), 7 of whom had the acquired immunodeficiency syndrome.

All patients received a full physical and dermatologic examination; scrapings from the skin of all patients tested positive for scabies. Patients were reexamined two and four weeks after treatment, when the scrapings for scabies were repeated. The patients used no other scabicides during the 30 days before ivermectin treatment or during the 4-week study period.

RESULTS. None of the 11 otherwise healthy patients had evidence of scabies four weeks after a single dose of ivermectin. Of the 11 HIV-infected patients, 2 had or = 10 scabies lesions before treatment, 3 had 11 to 49 lesions, 4 had or = 50 lesions, and 2 had heavily crusted skin lesions. In eight of the patients the scabies was cured after a single dose of ivermectin.

Two patients received a second dose two weeks after the first. Ten of the 11 patients with HIV infection (91 percent) had no evidence of scabies four weeks after their first treatment with ivermectin.

CONCLUSIONS. The anthelmintic agent ivermectin, given in a single oral dose, is an effective treatment for scabies in otherwise healthy patients and in many patients with HIV infection.

=================================================================
21.) Epidemiology and control of scabies in an Egyptian village.
=================================================================

Hegazy AA, Darwish NM, Abdel-Hamid IA, Hammad SM
Department of Dermatology, Faculty of Medicine, Mansoura University, Egypt.

BACKGROUND: Some studies have addressed the epidemiology of scabies among rural populations in developing countries; however, the epidemiology of scabies among the rural population in Egypt is unknown. We sought to determine the magnitude of scabies infestation in an Egyptian village and to evaluate the control measures after 1 year.

METHODS: This study was carried out on 3147 residents of Mit-Moaned village in Dakahlia govemorate, Egypt. It was a cross-sectional follow-up study where the same individuals examined in round I were re-examined in round III. The two rounds were separated by a period of 1 year, during which infested patients were followed up and new cases were discovered (round II). Patients and their household contacts received treatment with topical permethrin. Patients showing resistance to permethrin received a single oral dose of ivermectin.

RESULTS: In round III, the overall prevalence rate of scabies was reduced from 5.4% in round I to 1.1%.

The incidence of new cases among susceptible persons during round II was 1.1%. Scabies was significantly (P < 0.05) more prevalent among families of large size, high crowding index at night, low socioeconomic standards, and those receiving their water supply from a hand pump. Children younger than 10 years showed the highest prevalence.

CONCLUSIONS: Our data provide the first complete picture of the epidemiology of scabies in rural Egypt. The epidemiologic characteristics of the disease should be considered in the design of disease control programs for other villages with scabies epidemics.

Our findings revealed that good control was achieved with the following: increased awareness and better case finding, education of the staff at the rural health unit, improved hygiene measures, and massive treatment campaigns using effective drugs such as topical permethrin and oral ivermectin.

=================================================================
22.) Crusted scabies in two immunocompromised children: successful treatment with oral ivermectin.
=================================================================
Australas J Dermatol 1999 Feb;40(1):37-40

Patel A, Hogan P, Walder B
Department of Dermatology, Sydney Children's Hospital, Randwick, Australia.

Two immunodeficient children, aged 4 and 12 years, with crusted scabies were successfully treated with a single oral dose of ivermectin (200 micrograms/kg). One child had been diagnosed in infancy with an undefined congenital T cell immunodeficiency and the other with chronic mucocutaneous candidiasis.

Both had failed to respond to conventional topical therapy. In view of the excellent therapeutic response and absence of side-effects, ivermectin should be considered in the treatment of recalcitrant crusted scabies in children.

=================================================================
23.) Treatment of scabies with ivermectin.
=================================================================
Eur J Dermatol 1999 Mar;9(2):100-1

Offidani A, Cellini A, Simonetti O, Fumelli C
Clinica Dermatologica, Ospedale Umberto I, Piazza Cappelli 1, 60100 Ancona, Italy.

The authors report six new cases of patients suffering from severe infestation with the mite sarcoptes scabiei, treated with ivermectin, currently the only oral therapy available for this disease. Each patient received 200 mug/kg of ivermectin, taken as single dose.

No topical therapy was undertaken, except for topical treatment with emollient, as needed. The drug was very effective in all cases, easy to use, safe, and particularly useful in those patients with secondary eczematisation and escoriations, for whom the topical treatments are irritant and less well tolerated.

=================================================================
24.) Efficacy and tolerance of oral ivermectin in scabies.
=================================================================
J Eur Acad Dermatol Venereol 1998 Nov;11(3):247-51

Dourmishev A, Serafimova D, Dourmishev L
Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria. [email protected]

OBJECTIVE: The aim of this open-label study was to investigate the therapeutic effect and adverse reactions of oral ivermectin in scabies patients.

BACKGROUND: There is much confusion over reports of efficacy, adverse reactions and relapses after oral treatment of scabies with ivermectin.

METHODS: Nineteen patients, ten otherwise healthy outpatients with scabies, and nine inpatients with scabies and another skin disease (dermatomyositis, 3; pemphigus, 2; bullous pemphigoid, 1; pyoderma, 1; HIV, 1; Behcet's disease, 1) were treated with an oral dose of 0.2 mg/kg ivermectin (1% water solution) on days 1 and 8. The presence of live mites and ova in the patient's skin was investigated before, during and after the treatment.

RESULTS: None of the 19 patients with scabies had evidence of scabies after the second dose of ivermectin. In seven patients we noted the enhancement of pruritus 24-72 h after the first administration of ivermectin. In three patients the skin manifestation, vesicle-pustular rash increased between the second and the fourth day.
vCONCLUSION: The advantages of oral ivermectin treatment in scabies patients are: high therapeutic efficacy against Sarcoptes scabiei, good tolerance and influence of the drug on the whole skin surface and on clinical symptoms. The administration of the drug is easy and quick.

=================================================================
25.) Norwegian scabies in a patient with acquired immunodeficiency syndrome.
=================================================================
Dermatology 1998;197(3):306-8

Guggisberg D, de Viragh PA, Constantin C, Panizzon RG
Service de Dermatologie, Centre Hospitalier Universitaire Vaudois, Lausanne, et Departement Hospitalo-Universitaire Romand de Dermatologie et Venereologie (DHURDV), Lausanne/Geneve, Suisse.

We report the case of a 42-year-old man with symptomatic HIV infection (C3 CDC stage) who presented widespread hyperkeratotic skin lesions diagnosed as Norwegian scabies. The CD4 count was 87 cells/mm3. The patient has been the source of a nosocomial outbreak (20 individuals affected). He was treated successfully with combined topical treatment (permethrin 5% cream plus keratolytic agents) and oral ivermectin.

=================================================================
26.) Ivermectin for Sarcoptes scabiei hyperinfestation.
=================================================================
Int J Infect Dis 1998 Jan-Mar;2(3):152-4

Huffam SE, Currie BJ
Royal Darwin Hospital, Menzies School of Health Research, Darwin, Northern Territory, Australia.

OBJECTIVES: Crusted (Norwegian) scabies is an unusual variant of scabies caused by hyperinfestation with Sarcoptes scabiei. It has high morbidity, and secondary bacterial skin sepsis may result in life-threatening bacteremia.

An open label study of oral ivermectin was carried out in patients with crusted scabies refractory to topical therapy. METHODS: Patients with refractory crusted scabies were prescribed oral ivermectin, one to three doses of 200 mg/kg at 14-day intervals, combined with topical scabicide and keratolytic therapy. RESULTS: Of the 20 patients who received ivermectin, 8 had a complete initial clinical response, a partial response was achieved in 9, and minimal improvement occurred in 3.

Three doses of ivermectin were curative for 8 of 10 cases, but recurrence of scabies from presumed reinfestation occurred in at least half of these. CONCLUSION: The authors conclude that ivermectin is effective for crusted scabies; however, multiple doses may be required to achieve a cure, and recurrence 6 or more weeks after completing treatment is common.

=================================================================
27.) Crusted scabies of the scalp in dermatomyositis patients: three cases treated with oral ivermectin.
=================================================================
Int J Dermatol 1998 Mar;37(3):231-4

Dourmishev AL, Serafimova DK, Dourmishev LA, Mualla MA, Papaharalambous V, Malchevsky T
Department of Dermatology and Venereology, University of Medicine, Sofia, Bulgaria.

BACKGROUND: Cutaneous features in the scalp area among adult patients are rarely considered as a manifestation of scabies.

METHODS: Three patients with clinical and laboratory data of dermatomyositis with scalp involvement (fulfill three or four of Bohan and Peter's criteria), of 4 years, 8 months, and 3 years duration, were seen at our department between 1995 and 1996. For relapses of ordinary scabies, they were treated repeatedly with local scabicide with temporary effect.

After a symptom-free period during the treatment of dermatomyositis with corticosteroids and azathioprine, they developed diffuse redness with scales and crusts on the scalp areas. Light microscopy examination of material taken from these crusts showed an abundance of live mites.

RESULTS: All patients were successfully cured of scabies with a twice oral dose of 200 microg/kg ivermectin within 8 days.

CONCLUSIONS: Our patients with crusted scabies of the scalp and dermatomyositis prompted us to change our standard diagnostic and therapeutic regimens.

Fascinating features included mimicry of scabies in patients with dermatomyositis, location of parasites on the scalp, suppressed cell-mediated immunity and successful cure of mange by ivermectin.

===================================================================
DATA-MÉDICOS/DERMAGIC-EXPRESS No (75) 14/10/99 DR. JOSÉ LAPENTA R.
===================================================================