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Scabies outbreaks in residential and nursing care homes for elderly people are common, subject to diagnostic delay, and hard to control. We studied clinical features, epidemiology, and outcomes of outbreaks in the UK between 2014 and 2015. We did a prospective observational study in residential care homes for elderly people in southeast England that reported scabies outbreaks to Public Health England health protection teams. An outbreak was defined as two or more cases of scabies (in either residents or staff) at a single care home. All patients who provided informed consent were included; patients with dementia were included if a personal or nominated consultee (ie, a family member or nominated staff member) endorsed participation. Dermatology-trained physicians examined residents at initial clinical visits, which were followed by two mass treatments with topical scabicide as per local health protection team guidance. Follow-up clinical visits were held 6 weeks after initial visits. Scabies was diagnosed through pre-defined case definitions as definite, probable, or possible with dermatoscopy and microscopy as appropriate. 230 residents were examined in ten outbreaks between Jan 23, 2014, and April 13, 2015. Median age was 86·9 years (IQR 81·5–92·3), 174 (76%) were female, and 157 (68%) had dementia. 61 (27%) residents were diagnosed with definite, probable, or possible scabies, of whom three had crusted scabies. Physical signs differed substantially from classic presentations. 31 (51%) of the 61 people diagnosed with scabies were asymptomatic, and only 25 (41%) had burrows. Mites were visualised with dermatoscopy in seven (11%) patients, and further confirmed by microscopy in three (5%). 35 (57%) cases had signs of scabies only on areas of the body that would normally be covered. Dementia was the only risk factor for a scabies diagnosis that we identified (odds ratio 2·37 [95% CI 1·38–4·07]). At clinical follow-up, 50 people who were initially diagnosed with scabies were examined. No new cases of scabies were detected, but infestation persisted in ten people. Clinical presentation of scabies in elderly residents of care homes differs from classic descriptions familiar to clinicians. This difference probably contributes to delayed recognition and suboptimal management in this vulnerable group. Dermatoscopy and microscopy were of little value. Health-care workers should be aware of the different presentation of scabies in elderly people, and should do thorough examinations, particularly in people with dementia. Public Health England and British Skin Foundation.

Scabies is a neglected tropical disease caused by the ectoparasitic mite, Sarcoptes scabiei var. hominis (S. scabiei). Common scabies, the most prevalent clinical subtype of scabies, is characterized by pruritus, multiple skin lesions and low mite burden. In contrast, crusted scabies, an extremely contagious variant, is characterized by hyperkeratosis and high mite burden, with or without pruritus. Scabies can be diagnosed based on clinical manifestations, with confirmation obtained through microscopic identification of diagnostic features of S. scabiei. However, owing to the diversity and non-specific nature of its clinical manifestations and insufficient knowledge regarding early-stage clinical manifestations, the diagnosis of crusted scabies continues to be delayed. Herein, we present three cases of scabies with varying degrees of crusting and mite burden. Three patients with physical and microscopic results suggesting scabies were selected for this study. Case 1 had mild crusting and low mite burden, case 2 had severe crusting and high mite burden and case 3 had mild crusting and high mite burden. In this case report, ‘the initial stage of crusted scabies’ refers to the progression from common to crusted scabies. The discussion regarding the diagnostic characteristics of the initial stage of crusted scabies is expected to aid the early diagnosis of crusted scabies.

Scabies is a parasitic disease due to infestation of skin by the burrowing mite Sarcoptes scabiei. Scabies is a major public health problem and endemic in resource poor communities worldwide affecting over 100 million people. Associated bacterial infections cause substantial morbidity, and in severe cases can lead to renal and cardiac diseases. Mite infestation of the skin causes localised cutaneous inflammation, pruritus, skin lesions, and allergic and inflammatory responses are mounted by the host against the mite and its products. Our current understanding of the immune and inflammatory responses associated with the clinical manifestations in scabies is far outweighed by the significant global impact of the disease. This review aims to provide a better understanding of human immune responses to S. scabiei in ordinary and crusted scabies phenotypes.

Background Scabies is a contagious skin infestation caused by Sarcoptes scabiei var. hominis , presenting with a wide range of clinical manifestations. Nodular scabies is an uncommon variant that typically affects the genital region. When nodules appear in atypical locations, they may resemble other dermatoses and complicate diagnosis. Case presentation A 56-year-old woman presented with persistent, pruritic nodules on the chest, buttocks, and thighs that clinically resembled papular urticaria. She had previously been treated with topical corticosteroids and antihistamines without improvement, prompting a diagnostic biopsy. Histopathological examination confirmed the presence of Sarcoptes mites in the stratum corneum. The patient and her family were treated with 10% sulfur ointment applied once daily for three consecutive days per course, with two courses administered one week apart. The nodules gradually regressed after two courses, while pruritus and intermittent wheals persisted for four weeks and resolved completely within two months. Conclusion The case emphasizes the need to consider atypical scabies in the differential diagnosis of persistent nodular eruptions occurring in uncommon anatomical sites. Clinical trial number Not applicable.

Scabies is a debilitating parasitic skin disease caused by the obligate parasitic mite Sarcoptes scabiei, which inhabits the upper layers of the epidermis. In over 90% of affected individuals intense itching is the primary clinical symptom. This is accompanied by other delayed-type hypersensitivity responses. Persistent scratching due to the itch compromises skin integrity, facilitating the entry of pathogenic bacteria. Combined with immune-modulatory factors secreted by the mites, this creates a permissive environment for bacterial colonisation often leading to secondary complications. Effective treatment of scabies-associated itch could significantly reduce these complications and improve patients' quality of life. However, current antipruritic therapies are inadequate: in most cases, antihistamines provide little relief for scabies-related itch, and systemic corticosteroids are generally contraindicated. Thus, there is a critical need for targeted therapies, yet progress has been hindered by a limited understanding of the underlying pathobiology of scabies-induced pruritus. We investigated the expression of itch-associated mediators - encompassing both histaminergic and non-histaminergic pathways - using immunohistochemistry in a porcine scabies model. Skin biopsies were collected at multiple time points during the course of infection. We observed upregulated expression of key non-histaminergic itch receptors PAR-2 and MRGPRX2, as well as the mediator tryptase, following infection. Additionally, levels of the pruritogenic cytokine IL-31 and periostin, a molecule that may promote IL-4, IL-13 and IL-31 expression were elevated, as were substance P and its receptor NK-1R. In addition, the expression of histamine, the primary mediator of the histaminergic itch pathway, was also increased. Notably, reduced expression of β tubulin III across all time points suggests direct mite-induced neuroinflammation. Our findings may serve as a valuable basis for future drug development efforts focused on specific treatment of scabies-associated itch. Our data suggest that both the histaminergic and non-histaminergic pathways may be involved in scabies itch. Further research is needed to better understand the complex interplay between these pathways and to identify therapeutic targets for scabies-related itch.

The disease scabies is one of the earliest diseases of humans for which the cause was known. It is caused by the mite, Sarcoptes scabiei , that burrows in the epidermis of the skin of humans and many other mammals. This mite was previously known as Acarus scabiei DeGeer, 1778 before the genus Sarcoptes was established (Latreille 1802) and it became S. scabiei . Research during the last 40 years has tremendously increased insight into the mite’s biology, parasite-host interactions, and the mechanisms it uses to evade the host’s defenses. This review highlights some of the major advancements of our knowledge of the mite’s biology, genome, proteome, and immunomodulating abilities all of which provide a basis for control of the disease. Advances toward the development of a diagnostic blood test to detect a scabies infection and a vaccine to protect susceptible populations from becoming infected, or at least limiting the transmission of the disease, are also presented.

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.

Background Scabies is an infectious disease that affects the skin caused by the mite Sarcoptes scabiei and it transmitted through close personal contact. Even though it is easily treatable disease, its prevalence is high and continuous as neglected tropical disease of resource-poor settings, and particularly affects young age groups. Despite of these facts, studies conducted in Ethiopia regarding to the prevalence and associated factors for scabies infestation have been highly variable and didn’t well compiled. Due to that, the aim of this systematic review and meta-analysis was to estimates the overall prevalence of scabies and associated factors in all age groups in Ethiopia. Methods International databases (PubMed/PMC/Midline, EMBASE, CINAHL, Web of Science, Google Scholar, Google and Science Direct) were systematically searched from December 1, 2019, to January 18, 2020. All observational studies noted the prevalence of human scabies and associated factors in Ethiopia were included. Two authors (AG and G.T) independently extracted all necessary data using a standardized data extraction format. The data which is extracted each study were analyzed using STATA Version 14.1. Heterogeneity among the included studies was assessed through the Cochrane Q test statistics and I 2 test. Lastly, a random effects meta-analysis model was computed to fix overall prevalence and associated factors of scabies. Results Twelve studies were included in this meta-analysis after 410 articles retrieved. Of these, eight studies were analyzed for prevalence estimation. The overall prevalence of scabies infestation was 14.5% (95%CI: 1.5, 27.6%) in Ethiopia. Furthermore, the subgroup analysis revealed the highest prevalence was 19.6% in Amhara region. A person from a large family size (OR: 3.1, 95% CI: 1.76, 5.67), and sharing a bed (OR: 3.59, 95%CI: 2.88, 4.47) were significantly associated with scabies. Conclusion This study revealed the prevalence of scabies infestation was 14.5% in Ethiopia which was high. Persons from high family size and any contact with scabies case were factors associated with scabies.

Sarcoptic mange, caused by the Sarcoptes scabiei mite, is a highly transmissible skin condition affecting many mammalian species worldwide. South American camelids (SAC) have the highest reported prevalence of mange in South America, causing economic losses and posing a conservation threat to wild SAC. This study investigated mite diversity in SAC in Argentina and assessed relationships between known outbreak areas. Distinct epidemiologic scenarios were explored: the San Juan-La Rioja region, where a mange outbreak decimated wild SAC populations, and the Puna region of Jujuy, where domestic and wild SAC coexist and infections often occur. The mitochondrial gene cox1 and ten microsatellites were analysed from mites collected in five sampling events in Jujuy and four in San Juan-La Rioja between 2017 and 2023. A single cox1 haplotype was observed regardless of mite origin or host species. Comparison with partial cox1 sequences from other camelids worldwide showed little variation. Microsatellite markers revealed lower diversity in mites from San Juan-La Rioja compared to Jujuy. A single strain common to vicuñas and guanacos was identified in San Juan-La Rioja, while three strains were detected in Jujuy affecting vicuñas and/or domestic llamas. Some mites from Jujuy exhibited mixed genetic composition between the two regions, and results confirmed that domestic and wild SAC shared mite strains. This study enhances understanding of sarcoptic mange transmission among SAC species, contributing to vicuña and guanaco conservation and high-altitude livestock farming. Additionally, these findings provide support for the development of intersectoral management strategies to address this significant threat.

Wildlife that use anthropogenic resources often come into conflict with humans, e.g. due to damaged property, habituation or transmission of pathogens, amongst them Sarcoptes scabiei , the aetiological agent of sarcoptic mange, an emerging panzootic skin disease. This study examines the use of haystacks intended for supplementary feeding of European bison ( Bison bonasus ) by wolves ( Canis lupus ) with sarcoptic mange and the potential role of this behaviour in skin parasite transmission and human-wolf conflict. Hay samples from the beds used by wolves were found to harbour S. scabiei mites, even several days after the last use. Our data demonstrate an unforeseen link between wild ungulate supplementary feeding and wolf behaviour that may lead to conflict, namely approaching human settlements. However, no negative interactions were observed between wolves and humans or domestic animals. The presence of S. scabiei mites in haystacks provides a potential for its human-facilitated environmental transmission among wildlife and to domestic animals.