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Scabies is an infestation of the skin by the mite Sarcoptes scabiei. It manifests with pruritic erythematous papules and excoriations, in addition to the pathognomonic burrows. Multiple drugs can be used for treatment, but resistance to conventional therapy is increasing throughout the years. This paper will review the mechanisms of resistance proposed in the literature and some of the potential solutions to this problem.

Scabies is an itchy skin disease caused by the burrowing mite, Sarcoptes scabiei . During their lifespan, female mites invade the stratum corneum and create tunnels in which they reside, move, feed, deposit fecal pellets, and lay eggs. Globally, more than 200 million people are estimated to be affected by scabies annually. Currently, using scabicidal agents is the only approved method for treating scabies. However, resistance to commonly used agents such as permethrin and ivermectin has been observed in scabies mites. Therefore, the development of vaccines for scabies, either as a preventative measure or for treatment, is crucial to control such neglected diseases. Since the host could evolve a protective immune response that could prevent re-infestation by scabies mites, vaccine development is theoretically possible. This review aims to provide a comprehensive overview of the ongoing challenges regarding the currently available control measures for scabies. It also explores the promising path of scabies vaccine development, highlighting the current state of research and challenges that need to be addressed to develop new and innovative measures for both treating and preventing scabies infections.

Various kinds of pets have been known to contract the ectoparasite Sarcoptes scabiei . Current acaricides are becoming less effective because of the resistance developed by the mite besides their adverse effects on the general activity and reproductive performance of domestic pets. For this reason, the present study aims to discover a novel and safe approach using silver and gold nanoparticles to fight Sarcoptic mange in rabbits as well as to explain their mechanism of action. 15 pet rabbits with clinical signs of Sarcoptic mange that were confirmed by the microscopic examination were used in our study. All rabbits used in this study were assessed positive for the presence of different developing stages of S. scabiei . Three groups of rabbits (n = 5) were used as follows: group (1) didn’t receive any treatment, and group (2 and 3) was treated with either AgNPs or GNPs, respectively. Both nanoparticles were applied daily on the affected skin areas via a dressing and injected subcutaneously once a week for 2 weeks at a dose of 0.5 mg/kg bwt. Our results revealed that all rabbits were severely infested and took a mean score = 3. The skin lesions in rabbits that didn’t receive any treatments progressed extensively and took a mean score = of 4. On the other hand, all nanoparticle-treated groups displayed marked improvement in the skin lesion and took an average score of 0–1. All NPs treated groups showed remarkable improvement in the microscopic pictures along with mild iNOS, TNF-α, and Cox-2 expression. Both nanoparticles could downregulate the m-RNA levels of IL-6 and IFγ and upregulate IL-10 and TGF-1β genes to promote skin healing. Dressing rabbits with both NPs didn’t affect either liver and kidney biomarkers or serum Ig levels indicating their safety. Our residual analysis detected AgNPs in the liver of rabbits but did not detect any residues of GNPs in such organs. We recommend using GNPs as an alternative acaricide to fight rabbit mange.

This letter comments on the article “The treatment of sarcoptic mange in wildlife: a systematic review” published in Parasites & Vectors 2019, 12:99, and discusses the limitations in the use of endectocides for scabies control in free-ranging wildlife. The ecological impact and drug resistance to ivermectin are also discussed. In our view, scabies control in free-ranging wildlife should be based preferably on population management measures, and whether to apply individual treatments to free-ranging populations should be considered very carefully and avoided where not absolutely warranted.

A key limitation of current synthetic treatments of scabies is their focus on eliminating the mites rather than addressing the body’s immune response or tissue healing, potentially fostering drug resistance and prolonging recovery. Melatonin, with its anti-inflammatory, antioxidant, and antimicrobial properties, presents a potential solution. Consequently, this research seeks to assess the value of melatonin supplementation as complementary therapy in Sarcoptes scabiei mite infestation. The study included 25 male crossbreed rabbits, divided into five groups of five rabbits each: group I (a negative control); group II (a positive control); group III (infected and treated with melatonin); group IV (infected and treated with ivermectin); and group V (infected and treated with melatonin and ivermectin). Clinical and parasitological assessments were conducted from day 0 till day 28 post-treatment. Serum and tissue samples were collected at the end of day 28 post-treatment for subsequent histopathological, biochemical, and immunological analyses. Our research indicated that combining melatonin with ivermectin (group V) significantly accelerated clinical improvement compared to using ivermectin alone (group IV). Melatonin also lessened the side effects of ivermectin seen in group IV and effectively alleviated itching in group V. Skin analysis of group V revealed nearly full healing and the absence of mites, unlike group IV, which still showed inflammation and dead mites. Supporting these findings, blood tests in group V demonstrated a significant improvement in biochemical and immunological markers compared to group IV. Infestation with Sarcoptes mites disrupts the balance between oxidants and antioxidants and triggers systemic inflammation. Supplementing melatonin can help restore this balance and reduce inflammation, thereby accelerating cure in affected rabbits. Therefore, melatonin is suggested as an adjunct therapy with ivermectin, particularly in severe scabies cases, and future research should explore optimal dosages and treatment regimens. Graphical Abstract

Sarcoptes scabiei causes a fatal disease (mange) in bare-nosed wombats (BNWs) ( Vombatus ursinus) across their range and can threaten isolated populations with extinction. Repeated dosing of moxidectin (Cydectin®) at a dosage rate of 0.5 mg/kg is effective at treating individual BNWs but is difficult to administer on a population basis where treatment success has varied. This paper documents the temporary (~20 month) eradication of mange from a semi-isolated population of BNWs using repeated dosing of Cydectin® administered by burrow flaps. Treated BNWs were marked with nontoxic paint and selected burrows were monitored with camera traps demonstrating that 64–96% of wombats in the population were treated with each dosage. Treatment success was attributed to the installation of burrow flaps on all burrows in the treated area. This treatment program shows that isolated high-density populations can be successfully treated for S. scabiei infection with repeated dosages of Cydectin® (0.5 mg/kg) and questions the need for higher dosages that have been advocated. Mange returned to the population of BNWs after 20 months possibly as the result of migration of an infected BNW from a nearby population, suggesting mange affected populations may require periodic retreatment. Monitoring of burrow entrances confirmed that burrows provide habitat used by many species of birds, reptiles, and mammals, and suggest burrows could be occasional sites of mange spillover among species. Camera trap monitoring also showed when BNWs in this population leave and return to their burrows; how many BNWs enter a burrow and explore the burrow entrances each night; and how these parameters are impacted by season and mange status; variables that are valuable to know when treating populations of BNW for mange.

Canine sarcoptic mange, caused by Sarcoptes scabiei , is a highly contagious and intensely pruritic skin disease in dogs. It is prevalent worldwide and has zoonotic potential. Therefore, effective treatment is important to safeguard animal welfare and public health. The present clinical field study aimed to confirm the efficacy of NexGard ® Plus, an oral combination of afoxolaner, moxidectin and pyrantel pamoate, in treating dogs naturally infested with S. scabiei . It was a blinded, randomised, single-centre, negative-controlled efficacy study. Twenty naturally infested dogs were allocated into two groups: a group treated on Day 0 and Day 26/28 at the label dose, and an untreated control group. Skin scrapings were conducted similarly, once between Day −6 to 0, then on Days 26/28 and 56 for mite counts. Assessments of clinical signs were conducted at the same time intervals. In the treated group, mite infestations were reduced by 97% after the first treatment and were eliminated (100%) after the second treatment ( p  < 0.0005), while all dogs in the untreated control group remained infested for the whole study. Treated dogs had no pruritus, papules or crusts and clear evidence of hair regrowth by Day 56, unlike the dogs in the control group. This study demonstrated the elimination of S. scabiei mites and significant improvement of sarcoptic mange clinical signs in naturally infested dogs treated with the oral combination of afoxolaner, moxidectin and pyrantel. La gale sarcoptique canine, causée par Sarcoptes scabiei , est une dermatose très contagieuse et extrêmement prurigineuse chez le chien. Elle est répandue dans le monde entier et présente un potentiel zoonotique. Un traitement efficace est donc essentiel pour préserver le bien-être animal et la santé publique. La présente étude clinique de terrain visait à confirmer l’efficacité de NexGard ® Plus, une association orale d’afoxolaner, de moxidectine et de pamoate de pyrantel, dans le traitement des chiens naturellement infestés par S. scabiei . Il s’agissait d’une étude d’efficacité monocentrique, randomisée, en double aveugle et contrôlée par un placebo. Vingt chiens naturellement infestés ont été répartis en deux groupes : un groupe traité aux jours 0 et 26/28 à la dose recommandée, et un groupe témoin non traité. Des prélèvements cutanés ont été effectués de la même manière, une première fois entre le jour −6 et le jour 0, puis aux jours 26, 28 et 56 pour le dénombrement des acariens. L’évaluation des signes cliniques a été réalisée aux mêmes intervalles. Dans le groupe traité, l’infestation par les acariens a diminué de 97% après le premier traitement et a été totalement éliminée (100 %) après le second ( p < 0,0005), tandis que tous les chiens du groupe témoin non traité sont restés infestés pendant toute la durée de l’étude. Les chiens traités ne présentaient ni prurit, ni papules, ni croûtes, et une repousse des poils était clairement visible au jour 56, contrairement aux chiens du groupe témoin. Cette étude a démontré l’élimination des acariens S. scabiei et une amélioration significative des signes cliniques de la gale sarcoptique chez les chiens naturellement infestés traités par l’association orale d’afoxolaner, de moxidectine et de pyrantel.

Background One of the most relevant parasitic mites is Sarcoptes scabiei , which causes sarcoptic mange, commonly known as scabies. This condition is highly contagious and leads to intense itching and skin lesions in dogs. Otodectes cynotis , the “ear mite,” is immensely relevant as well, being the primary cause of external otitis in domestic carnivores, causing severe ear itching. The treatment and control of both these forms of mange rely on the use of antiparasitic compounds, such as fluralaner, which acts by paralyzing and killing arthropods. This study aimed to determine the acaricidal efficacy of WellPet™ (Ourofino Saúde Animal Ltda.), a new commercial palatable tablet based on fluralaner, at a dose range of 10–22.5 mg/kg, against S. scabiei and O. cynotis mites parasitizing naturally infested domestic dogs. Methods Two clinical studies evaluate the acaricide efficacy against each mite species in naturally infested animals. Each study utilizes 14 animals each, divided into a Control Group ( n  = 7), treated with a reference product on the basis of sarolaner (a palatable tablet based on sarolaner, 2.0–4.0 mg/kg—Zoetis Indústria de Produtos Veterinários Ltda.), and a treated group ( n  = 7) treated with WellPet™ (a palatable tablet based on fluralaner, 10–22.5 mg/kg—Ourofino Saúde Animal Ltda.). Acaricidal efficacy is assessed in both trials through mite counts and evaluation of lesions resulting from the diseases. Results Against Sarcoptes scabiei , WellPet™ provided a significant reduction in mite counts from day 14 ( p  = 0.022) onward, reaching 100% efficacy by day 28 without need for retreatment. The control group showed significant reduction from day 7 ( p  = 0.045) onward, but required retreatment to reach 100% efficacy by day 44. In the Otodectes cynotis trial, the WellPet™ group showed significant reduction starting from day 3 ( p  = 0.036), with 94.1% efficacy by day 14 and 100% from day 21 onward. The control group showed significant reduction starting from day 7 ( p  = 0.022) and reached 100% efficacy by day 14. Conclusions The WellPet™ product, a novel ectoparasiticide based on fluralaner, proved to be highly effective in the treatment of both sarcoptic and otodectic mange, with results similar to those of sarolaner, the only isoxazoline, at the time of these trials, registered in Brazil for controlling these mites. The main advantage observed for WellPet™ is the ability to achieve complete cure of sarcoptic mange with a single dose, thereby simplifying disease management. For otodectic mange, both products were highly effective. Further trials must still be conducted to corroborate these initial findings, but in summary, data presented here indicates that WellPet™ is an effective and practical treatment option for sarcoptic and otodectic mange in dogs with a single administration. Graphical Abstract

Oxidative stress, characterized by an overproduction of reactive oxygen species that overwhelm the body’s physiological defense mechanisms, is a key factor in the progression of parasitic diseases in both humans and animals. Scabies, a highly contagious dermatological condition caused by the mite Sarcoptes scabiei var. hominis, affects millions globally, particularly in developing regions. The infestation leads to severe itching and skin rashes, triggered by allergic reactions to the mites, their eggs, and feces. Conventional scabies treatments typically involve the use of scabicidal agents, which, although effective, are often associated with adverse side effects and the increasing threat of resistance. In light of these limitations, there is growing interest in the use of medicinal plants as alternative therapeutic options. Medicinal plants, rich in bioactive compounds with antioxidant properties, offer a promising, safer, and potentially more effective approach to treatment. This review explores the role of oxidative stress in scabies pathogenesis and highlights how medicinal plants can mitigate this by reducing inflammation and oxidative damage, thereby alleviating symptoms and improving patient outcomes. Through their natural antioxidant potential, these plants may serve as viable alternatives or complementary therapies in the management of scabies, especially in cases where resistance to conventional treatments is emerging.

Background Sarcoptic mange causes significant animal welfare and occasional conservation concerns for bare-nosed wombats ( Vombatus ursinus ) throughout their range. To date, in situ chemotherapeutic interventions have involved macrocytic lactones, but their short duration of action and need for frequent re-administration has limited treatment success. Fluralaner (Bravecto®; MSD Animal Health), a novel isoxazoline class ectoparasiticide, has several advantageous properties that may overcome such limitations. Methods Fluralaner was administered topically at 25 mg/kg ( n = 5) and 85 mg/kg ( n = 2) to healthy captive bare-nosed wombats. Safety was assessed over 12 weeks by clinical observation and monitoring of haematological and biochemical parameters. Fluralaner plasma pharmacokinetics were quantified using ultra-performance liquid chromatography and tandem mass spectrometry. Efficacy was evaluated through clinical assessment of response to treatment, including mange and body condition scoring, for 15 weeks after topical administration of 25 mg/kg fluralaner to sarcoptic mange-affected wild bare-nosed wombats ( n = 3). Duration of action was determined through analysis of pharmacokinetic parameters and visual inspection of study subjects for ticks during the monitoring period. Methods for diluting fluralaner to enable ‘pour-on’ application were compared, and an economic and treatment effort analysis of fluralaner relative to moxidectin was undertaken. Results No deleterious health impacts were detected following fluralaner administration. Fluralaner was absorbed and remained quantifiable in plasma throughout the monitoring period. For the 25 mg/kg and 85 mg/kg treatment groups, the respective means for maximum recorded plasma concentrations (C max ) were 6.2 and 16.4 ng/ml; for maximum recorded times to C max , 3.0 and 37.5 days; and for plasma elimination half-lives, 40.1 and 166.5 days. Clinical resolution of sarcoptic mange was observed in all study animals within 3–4 weeks of treatment, and all wombats remained tick-free for 15 weeks. A suitable product for diluting fluralaner into a ‘pour-on’ was found. Treatment costs were competitive, and predicted treatment effort was substantially lower relative to moxidectin. Conclusions Fluralaner appears to be a safe and efficacious treatment for sarcoptic mange in the bare-nosed wombat, with a single dose lasting over 1–3 months. It has economic and treatment-effort-related advantages over moxidectin, the most commonly used alternative. We recommend a dose of 25 mg/kg fluralaner and, based on the conservative assumption that at least 50% of a dose makes dermal contact, Bravecto Spot-On for Large Dogs as the most appropriate formulation for adult bare-nosed wombats. Graphical abstract