Crusted scabies; a 2-year prospective study from the Northern Territory of Australia

Crusted scabies; a 2-year prospective study from the Northern Territory of Australia Journal Article

PLOS Neglected Tropical Diseases

• Author(s): Hasan, Tasnim, Krause, Victoria L., James, Christian, Currie, Bart J.
• Published: 2020
• Publisher: Public Library of Science
• Volume: 14

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Abstract: Undiagnosed crusted scabies patients can be index cases in outbreaks of scabies in residential facilities such as nursing homes and can undermine the success of scabies mass drug administration programs, but literature about this debilitating disease is very limited. The study describes a large cohort of patients with crusted scabies who have been treated according to established local guidelines. While the success of the initial clinical response supports the guideline-based treatment regimen for crusted scabies, with only one patient dying with scabies-related sepsis, the subsequent mortality remains high, reflecting the large burden of comorbidities in the cohort. In addition, there was a high rate of recurrent crusted scabies, attributed to new infection with scabies once the cured patients return to their scabies-endemic communities. Crusted scabies can be successfully treated using robust guidelines including multiple doses of ivermectin together with topical therapy. However, community-based initiatives such as support for ‘scabies free zones’ are needed to prevent re-infection and recurrent disease in those individuals who are susceptible to developing crusted scabies. Undiagnosed crusted scabies is a threat to the success of scabies mass drug administration programs and will continue to drive scabies outbreaks in residential facilities.

• Urls: https://doi.org/10.1371/journal.pntd.0008994