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Review
. 2024 Dec;63(12):1642-1656.
doi: 10.1111/ijd.17327. Epub 2024 Jun 23.

Clinical practice guidelines for the diagnosis and treatment of scabies

Soner Uzun  1 , Murat Durdu  2 , Aslan Yürekli  3 , Mehmet K Mülayim  4 , Melih Akyol  5 , Sevtap Velipaşaoğlu  6 , Mehmet Harman  7 , Ayşegül Taylan-Özkan  8 , Ekin Şavk  9 , Devrim Demir-Dora  10 , Levent Dönmez  11 , Umut Gazi  12 , Habibullah Aktaş  13 , Aysun Ş Aktürk  14 , Gülay Demir  15 , Fatih Göktay  16 , Mehmet S Gürel  17 , Neşe G Gürok  18 , Ayşe S Karadağ  16 , Özlem S Küçük  19 , Çağrı Turan  20 , Müge G Ozden  21 , Zeynep K Ural  22 , Orçun Zorbozan  23 , Kosta Y Mumcuoğlu  24
Affiliations
Review

Clinical practice guidelines for the diagnosis and treatment of scabies

Soner Uzun et al. Int J Dermatol. 2024 Dec.

Abstract

Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.

Keywords: diagnostics; elimination; infestations; neglected tropical diseases; prevention; scabies; treatment.

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Figures

Figure 1
Figure 1
Schematic (a), clinical (b), and dermoscopic appearance (c) of a scabies burrow
Figure 2
Figure 2
The most common symptoms of scabies on the skin are erythematous papules with excoriated tops due to scratching (prurigo papules). The most frequently affected areas are the wrists (a), belt area (b), around the breasts and areola in women (c), axillary regions and around the navel in both sexes (d), and the genital area in men, especially the glans penis (e) and scrotum (yellow arrows) (f). In some cases, ecthymatoid ulcerations may occur in the genital area (red arrow) (F)
Figure 3
Figure 3
Recommended algorithm for scabies diagnosis
Figure 4
Figure 4
Recommended treatment algorithm for scabies in Turkey
See this image and copyright information in PMC

References

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MeSH terms