[Increase of scabies and therapy resistance among German military personnel : An 8-year follow-up study in the Department of Dermatology of the Armed Forces Hospital Berlin, Germany (2012-2019)]

Abstract

Background: The diagnosis of scabies has become surprisingly frequent in Germany in recent years and the use of scabicides has risen significantly.

Objective: The aim of our survey was to determine whether this trend can also be detected among military personnel of the German Armed Forces (Bundeswehr).

Methods: The study was conducted as a retrospective single-center study over a period of 8 years from 2012 to 2019 in the Department of Dermatology of the Armed Forces Hospital Berlin, Germany. Data were generated from the hospital information system (KIS), which was searched for all scabies-coded diagnoses according to ICD10 code B86 both as outpatients and inpatients. Only first presentations with scabies diagnosis confirmed by dermoscopy or microscopy by a dermatologist were included. Inpatient treatment was required if a patient was not cured after at least three antiscabies treatment cycles in the outpatient setting.

Results: The data show that there has been a steady increase in the diagnosis of scabies in Bundeswehr personnel. Moreover, our data show that the number of unsuccessfully treated outpatients increased and required in-hospital treatment.

Conclusion: We observed an increase of scabies among German military personnel who represent a typical at-risk group. These results support the observations of an increased incidence of scabies in Germany in general and especially in an at-risk population. With the general increase in scabies cases, there are also increasing numbers of German military personnel who are refractory to treatment, which was largely attributed to inadequate treatment of contact persons and individual treatment errors. Nevertheless, the data also emphasize the low overall prevalence of scabies; therefore, all diagnoses should be confirmed by dermoscopy or microscopy after 14 days whenever possible to rule out the bias of overreporting due to false-positive cases diagnosed only by clinical examination.

Keywords: Dermoscopy; Epidemiology; Inpatient treatment; Ivermectin; Permethrin.