Epidemiology, Diagnosis, and

Treatment of Scabies in a
Dermatology Office
Pembimbing :
dr. Bowo Wahyudi, Sp.KK

Disusun Oleh :
Ghani Muhammad Sardjono

KEPANITERAAN KLINIK ILMU KULIT & KELAMIN

FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH JAKARTA
RSUD BANJAR
TAHUN 2018
Introduction
• Scabies is a common pruritic skin infestation caused by Sarcoptes scabiei
mite, with estimate world wide annual prevalence is 300 million
• 2009, WHO declared scabies as a neglected skin disease
• Few knowledge of the current incidence, treatment patterns for scabies in
the US
• Aim: examine demographic data, treatment types, success of treatments,
misdiagnosis rate of scabies in southeastern US
Methods
• Study: Retrospective study
• Location: Wake Forest Baptist Medical Center
• Sample: Inclusion: Clinic records, from the last 5 past years patients
diagnosed with scabies
• Exclusion: patient were not treated for scabies
• Data management: Microsoft Excel
• Total sample: 428 patients
Result
Result
Result
Result
Result
Discussion
• Epidemiology discussion:
• This study shows slight more exposure of scabies among males
compared to females (54% vs 46%) -> Pannel et al. found scabies
more common in females
• This study shows that the majority patient with scabies live at home
 literature studying patient with scabies live in long term facilities
Discussion
• Diagnosis discussion:
• Most method is microscopy examination (58%)
• History and physical examination were the second and third methods
• High sensitive method diagnosed via skin biopsy (2%)
Discussion
• Misdiagnosis discussion:
• 45% misdiagnosis were made by primary care providers, and
emergency department providers
• Dupuy A, Dehen L, Bourrat E, et al. found dermoscopy can decrease
the false-negative diagnosis rate compared to skin scrapings
• US Department of Health and Human Services found specific
serologic test for S.scabiei with 100% sensitivity and 93,75% specifity
Discussion
• Success treatment discussion:
• percentage treatment: 69% using permethrin, 7% using ivermectin,
23% using both, 1% using topical precipitated sulfur
• This study shows that 18% patient need retreatment, mostly from
pediatric group
• Another study found failure in treatment caused by S.scabiei
resistance to topical permethrin and oral ivermectin
• 34% patient in this study had postscabetic complaints
Study limitations
• Study performed at a single outpatient dermatology site
• Misdiagnosis rate may be overestimated
• Patients requiring retreatment may be underestimated
• The retrospective design of the study doesn’t allow for comparisons
of diagnostic modalities
Conclusions

Scabies is a common skin condition in outpatient clinics in

devloped countries. Patients often misdiagnosed by primary care
providers. According to scabies circumstance in US, a faster and more
accurate diagnostic methods such as dermoscopy is needed to
diagnose scabies in order to expedite appropriate therapy.