Endomarketing para la adherencia al tratamiento de enfermedades dermatológicas estigmatizantes / Endomarketing for adherence to the treatment of stigmatizing dermatological diseases

Las enfermedades cutáneas son una amplia gama de afecciones que afectan la piel, de origen bacteriano, viral, fúngica, reacción alérgica, cáncer, parásito, hereditarias, ideopáticas; por sus sintomatologías pueden generar estigma. Por tal motivo, la Organización Mundial para la Salud, alienta a los Estados miembros a que se involucren en actividades de promoción para aumentar la concienciación con el fin de combatir la discriminación que perciben los pacientes con enfermedades dermatológicas estigmatizantes (EDE), tanto por la comunidad y en los establecimientos de salud, pudiendo repercutir negativamente en la adherencia del tratamiento. El objetivo de este estudio fue valorar el uso de endomarketing para la adherencia al tratamiento de EDE. Se realizó una investigación cuantitativa. Se les aplicó encuesta de endomarketing a 279 participantes; además con 147 pacientes con EDE se indago la percepción de actitudes estigmatizantes. Los resultados mostraron un alcance sobre el endomarketing de 0,62 en personal de atención directa y 0,45 para atención indirecta; los pacientes con mayor percepción de actitudes estigmatizantes fueron los que presentaban afecciones en piel tipo infecciosas, mayormente proveniente de la atención indirecta. Se infiere que el conocimiento sobre las EDE disminuye las expresiones de rechazos. Como alternativas para la formación del personal con una mayor satisfacción en el trabajo, competencia para gestionar y elevado sentido de espiritualidad corporativa, que garantice atención humanitaria a estos pacientes, se sugiere el uso de endomarketing, para conciliar los objetivos e intereses del recurso humano interno a las necesidades y expectativas de los pacientes con EDE(AU)

Skin diseases are a wide range of conditions that affect the skin, of bacterial, viral, fungal origin, allergic reaction, cancer, parasite, hereditary, idiopathic; due to their symptoms they can generate stigma. For this reason, the World Health Organization encourages Member States to engage in promotional activities to raise awareness in order to combat the discrimination perceived by patients with stigmatizing dermatological diseases (SDD), both for the community and in health establishments, which may have a negative impact on adherence to treatment. The objective of this study was to assess the use of endomarketing for adherence to DTS treatment. A quantitative investigation was carried out. An endomarketing survey was applied to 279 participants; In addition, with 147 patients with EDE, the perception of stigmatizing attitudes was investigated. The results showed a reach on endomarketing of 0.62 in direct attention personnel and 0.45 for indirect attention; The patients with the highest perception of stigmatizing attitudes were those who presented infectious-type skin conditions, mostly from indirect care. It is inferred that knowledge about DTS decreases the expressions of rejections. As alternatives for the training of personnel with greater job satisfaction, competence to manage and a high sense of corporate spirituality, which guarantees humanitarian attention to these patients, the use of endomarketing is suggested, to reconcile the objectives and interests of internal human resources. to the needs and expectations of patients with DTS(AU)

First description of sarcoptic mange in a wild coati (Nasua narica), in Ecuador, and cooccurrence of canine distemper virus / Primeira descrição da sarna sarcóptica em um coati selvagem (Nasua narica), no Equador, e coocorrência do vírus distemper canino

Abstract We present a case of Sarcoptes and canine distemper virus (CDV) infection in a white-nosed coati (Nasua narica) that was trapped in the dry tropical forest of Cerro Blanco reserve, located in the coastal region of Ecuador. Sarcoptic mange is a highly contagious and zoonotic disease with worldwide distribution that causes epidemics. Mange is produced by Sarcoptes mites that causes severe epidermal damage. Secondary infections and physiological constrictions without treatment can lead to death of the host. In addition, cooccurrence of canine distemper virus was detected via iiRT-PCR from serum samples. Physical analyses showed that 90% of the skin was affected by severe alopecia due to the sarcoptic mange infection. The presence of mites and histopathological analyses confirmed the diagnosis of infection. This coati was taken to a veterinary clinic and was fed every day, but it died after four days. This is the first report of sarcoptic mange and the first report of CDV in white-nosed coatis in South America. Further studies are needed in this region, to seek out other suspected cases, given the high capacity for disease transmission. Preventive actions to avoid epidemic and zoonotic episodes are needed.

Resumo Apresentamos um caso de Sarcoptes e infecção pelo vírus da cinomose canina (CDV) em um quati-do-nariz-branco (Nasua narica) que ficou preso na floresta tropical seca da reserva de Cerro Blanco, localizada na região costeira do Equador. A sarna sarcóptica é uma doença altamente contagiosa e zoonótica de distribuição mundial que causa epidemias. A sarna é produzida por ácaro do gênero Sarcoptes que causa graves danos epidérmicos. Infecções secundárias e constrições fisiológicas sem tratamento podem levar à morte do organismo. Além disso, a coocorrência do vírus da cinomose canina foi detectada, via iiRT-PCR, a partir de amostras de soro. As análises físicas mostraram que 90% da pele estava afetada por alopecia severa devido à infecção pelo ácaro da sarna sarcóptica. A presença de ácaros e análises histopatológicas confirmaram o diagnóstico de infecção. Esse quati foi levado a uma clínica veterinária e foi alimentado todos os dias, mas morreu após quatro dias. Esse é o primeiro relato de sarna sarcóptica e o primeiro relato de CDV em quatis-de-nariz-branco na América do Sul. São necessários mais estudos nessa região, para buscar outros casos suspeitos, dada a alta capacidade de transmissão da doença. Ações preventivas para evitar episódios epidêmicos e zoonóticos, são necessárias.

Sarna costrosa: revisión sobre aspectos clínicos de una ectoparasitosis desatendida y de presentación infrecuente / Crusty scabies: review of the clinical aspects of a neglected and infrequent ectoparasitosis

En esta revisión de la literatura se describen aspectos epidemiológicos, fisiopatológicos, clínicos y terapéuticos sobre una presentación atípica y grave de escabiosis, la sarna costrosa o noruega. Esta presentación de escabiosis destaca por afectar principalmente a personas con condiciones de inmunodepresión o sociales que las hacen susceptibles de una alta carga parasitaria, además se asocia a un peor pronóstico y a riesgo de complicaciones. Desde el punto de vista terapéutico, sus estrategias difieren del manejo de la escabiosis clásica.(AU)

This literature review describes epidemiological, pathophysiological, clinical and therapeutic aspects of an atypical and severe presentation of scabies, Norwegian or crusty scabies. This presentation of scabies stands out because it mainly affects people with immunosuppressive or social conditions that make them susceptibleto a high parasite load, it is also associated with a worse prognosis and risk of complications. From a therapeutic point of view, their strategies differ from the management of classic scabies.(AU)

Intervención educativa para la prevención de la escabiosis dirigida a representantes de preescolares de 5-6 años / Educational intervention for the prevention of scabiosis Aimed at representatives of preschoolers of 5-6 years / Intervenção educativa para a prevenção da escabiose dirigida a representantes de crianças pré-escolares de 5 a 6 anos

INTRODUCCIÓN: la escabiosis constituye un problema de salud pública en especial en los niños, es una infestación cutánea, altamente pruriginosa y contagiosa endémica en países en vías de desarrollo, afecta a todos los grupos socioeconómicos y a todas las edades es causa la alta morbilidad OBJETIVO: determinar la información sobre prevención de escabiosis que poseen los representantes de preescolares de 5-6 años de la comunidad de la Peña posterior a una intervención educativa MATERIALES Y MÉTODOS: investigación cuasi experimental de pre test y post test de las intervenciones educativas. El universo estuvo conformado por 143 representantes de preescolares, la muestra intencionada fue de 86 personas, el instrumento fue un cuestionario conformado por ítems de respuestas dicotómicas que se administró a los representantes antes de la intervención educativa y posterior a la misma. RESULTADOS: antes de la intervención existía muy baja información acerca de la prevención de la escabiosis lo que representaba el 67.4 %. Posterior a la misma se incrementa el número de representantes que mejoran su nivel de información hasta llegar a 73.2%. CONCLUSIÓN: El desarrollo y aplicación de la intervención educativa logro elevar los conocimientos sobre que es la escabiosis identificar cuáles son los factores de riesgo.

INTRODUCTION: scabies is a public health problem, especially in children. It is a highly pruritic and contagious skin infestation endemic in developing countries. It affects all socioeconomic groups and causes high morbidity at all ages. OBJECTIVE: to determine the information on the prevention of scabies that the representatives of preschool children aged 5-6 years from the Peña community have after an educational intervention. MATERIALS AND METHODS: quasiexperimental pre-test and post-test research of educational interventions. The universe was made up of 143 preschool representatives, the intended sample was 86 people, and the instrument was a questionnaire made up of items of dichotomous responses that were administered to the representatives before and after the educational intervention. RESULTS: before the intervention, there was very little information about the prevention of scabies, which represented 67.4%. After the same, the number of representatives that improve their level of information increases to 73.2%. CONCLUSION: the development and application of the educational intervention managed to raise the knowledge about what scabies is, to identify which are the risk factors.

INTRODUÇÃO: a escabiose constitui um problema de saúde pública principalmente em crianças, é uma infestação cutânea altamente pruriginosa e contagiosa, endêmica em países em desenvolvimento, afeta todos os grupos socioeconômicos e é causa de alta morbidade em todas as idades OBJETIVO: determinar as informações sobre prevenção de sarna que os representantes de crianças pré-escolares de 5-6 anos da comunidade La Peña têm após uma intervenção educativa MATERIAIS E MÉTODOS: pesquisa quase experimental de pré-teste e pós-teste de intervenções educativas. O universo foi constituído por 143 representantes da pré-escola, a amostra pretendida foi de 86 pessoas, o instrumento foi um questionário composto por itens de resposta dicotómicos que foi aplicado aos representantes antes e após a intervenção educativa. RESULTADOS: antes da intervenção havia muito pouca informação sobre a prevenção da escabiose, o que representava 67,4%. Depois disso, o número de representantes que melhoraram seu nível de informação aumentou para 73,2%. CONCLUSÃO: o desenvolvimento e aplicação da intervenção educativa foi capaz de aumentar o conhecimento sobre o que é sarna para identificar quais são os fatores de risco.

Digital dermoscopy: a complementary method in the diagnosis of scabies

Abstract Scabies is an ectoparasitosis caused by Sarcoptes scabiei var. hominis, characterized clinically by pruritic lesions in typical locations; the crusted form is a rare manifestation. The diagnosis is usually established based on the clinical picture, but dermoscopy can be an important complementary method, as it allows the observation of a brownish triangular structure with a hang-glider appearance. A case of crusted scabies is reported; the magnification of the images obtained by digital dermoscopy allowed the demonstration of a structure usually observed only with videodermoscopy.

Escabiose mascarada por mastocitose sistêmica / Scabies masked by systemic mastocytosis

Paciente do sexo feminino, com 59 anos de idade, portadora de mastocitose sistêmica há 20 anos. A mastocitose é doença rara, caracterizada pela proliferação excessiva e o subsequente acúmulo de mastócitos em órgãos e tecidos, principalmente na medula óssea, pele e no trato gastrointestinal. Há 1 mês, relatava história de novas lesões cutâneas caracterizadas por pápulas e placas eritemato-edematosas com escoriação e intenso prurido. Feito o raspado da pele com confirmação diagnóstica de escabiose.

A 59-year-old female patient had a diagnosis of systemic mastocytosis for 20 years. Mastocytosis is a rare disease characterized by excessive proliferation and accumulation of mast cells in organs and tissues, especially in the bone marrow, skin and gastrointestinal tract. She reported new skin lesions characterized by erythematous papules and plaques with excoriation and intense itching for one month. Skin scraping confirmed the diagnosis of scabies.

Éxito terapéutico con esquema de ivermectina oral en sarna costrosa / Therapeutic success with oral ivermectin regimen in crusted scabies

Se expone el caso de una paciente obesa inmunodeprimida que presentó una sarna costrosa. Luego de la sospecha clínica se confirmó el diagnóstico mediante acarotest. La paciente sufrió algunas complicaciones asociadas a su condición general, como sobreinfección de sus lesiones cutáneas, epistaxis e insuficiencia renal aguda, que fueron tratadas. La sarna costrosa fue tratada con ivermectina oral con dosis de 15 mg (200 ug/kilo de peso ideal según la talla), los días 1, 2, 7, 8 y 15, obteniendo una excelente respuesta terapéutica.

We present the case of an immunosuppressed obese patient who presented with crusted scabies. After clinical suspicion, the diagnosis was confirmed with skin scraping for the diagnosis of scabies. The patient presented some complications associated with her baseline condition, such as superinfection of her skin lesions, epistaxis and acute renal failure, which were treated. Crusted scabies was treated with oral ivermectin with a dose of 15 mg (200 ug/kg of ideal weight according to height), on days 1,2,7,8 and 15, obtaining an excellent therapeutic response.

Sarna costrosa en un paciente diabético / Crusted scabies in a diabetic patient

La sarna costrosa corresponde a una variedad muy rara y poco frecuente de escabiosis; una parasitosis humana causada por el ácaro Sarcoptes Scabiei (var. Hominis); se produce principalmente en pacientes inmunodreprimidos y se caracteriza por lesiones atípicas y extensas, sumamente contagiosas debido al compromiso inmunitario. Se presenta el caso clínico de un paciente de 68 años de edad con antecedentes de hipertensión arterial y diabetes mellitus tipo 2 con un mal control glucémico, que es atendido por el servicio de dermatología. Las lesiones se presentan como placas extensas pruriginosas, queratósicas, eritemato-escamosas de escamas gruesas y adherentes de seis meses de evolución en tronco, muslos y pliegues axilares, inguinales e interdigitales. La sospecha clínica de sarna costrosa fue confirmada por biopsia; el tratamiento se realizó con ivermectina con mejoría del cuadro clínico.

Crusted scabies corresponds to a very rare variety and little common scabies; a human parasitic disease caused by an acarid in this case Sarcoptes Scabiei (var. Hominis); it observed mainly among inmunosupressed patients and is characterized by atypical and extensive lesions, highly contagious due to their immune compromise. A case of a patient of 68 years old is described with a history of hypertension and diabetes mellitus type 2 with poor glycemic control, which is assist by the dermatology service. Lesions included extensive and pruritic badges, quetatotic, erythematous-squamous of thick and adherent scales of six months evolution in trunk, thighs and axillary, inguinal and interdigital folds. The clinical suspicion of crusted scabies was confirmed by biopsy; the treatment was performed with ivermectin with improvement of the clinical picture.

Brote de escabiosis en el Hospital Víctor Lazarte Echegaray, Trujillo, 2017 / Scabies outbreak at the Hospital Víctor Lazarte Echegaray, Trujillo, 2017

Objetivo: Describir las características de un brote de escabiosis y evaluar el impacto de las medidas de control.Materiales y métodos: Estudio epidemiológico descriptivo y prospectivo, realizado en un hospital de referencia, con 220 camas de hospitalización. Los datos se recolectaron a través de visitas diarias al Servicio de Medicina, entrevistas al personal asistencial y revisión de las historias clínicas. En la descripción del brote se consideran las variables epidemiológicas de persona, lugar y tiempo. Se aplicó estadística descriptiva, y se determinaron las frecuencias absolutas y relativas y la tasa de ataque. Se solicitó consentimiento informado a los pacientes y al personal asistencial, se les explicó sobre el beneficio de la investigación. La intervención consistió en medidas de aislamiento y precauciones de transmisión por contacto, se enfatizó el uso de guantes no estériles.Resultados: El brote ocurrió desde la semana epidemiológica 29 hasta la 37 del 2017. El caso primario fue un paciente varón de 93 años de edad con sarna noruega, hospitalizado por demencia de Alzheimer. El cuadro se presentó en 9 enfermeras, 7 médicos residentes, 6 técnicos de enfermería, 1 interno de medicina y 5 pacientes hospitalizados. Conclusiones: El brote fue de fuente propagada, con duración de 9 semanas epidemiológicas; y afectó enfermeras, médicos residentes, internos de medicina y a pacientes hospitalizados. La tasa de ataque fue del 40 %. Las medidas de prevención y control fueron aislamiento del caso primario y de los pacientes, higiene de manos antes y después de la atención, uso de guantes no estériles, uso de bata, artículos de uso clínico exclusivos para cada paciente, la ropa de los pacientes con sarna fue manipulada con guantes y en bolsas cerradas, limpieza de superficies, exclusión de la atención clínica de los trabajadores de la salud con sarna hasta las 24 horas de iniciado el tratamiento, y la vigilancia epidemiológica. El tratamiento médico consistió en loción de permetrina al 5 % por tres días. Se recomienda aplicar normas de bioseguridad en la atención de todos los pacientes, sobre todo cuando se hospitalizan con lesiones dermatológicas. Las medidas que se implementaron deben tenerse en cuenta en la prevención y control de este tipo de brote.

Objective: To describe the characteristics of a scabies outbreak and assess the effect of the control measures.Materials and methods: A descriptive and prospective epidemiological study was conducted at a reference hospital with 220 inpatient beds. Data was collected by visiting the Medicine Service on a daily basis, interviewing the healthcare personnel and examining the medical records. The description of the outbreak includes epidemiological variables such as subject, place and time. Descriptive statistics was used to determine the absolute and relative frequencies, as well as the attack rate. Patients and healthcare personnel were requested to sign an informed consent and received information about the benefits of the research. The intervention consisted of isolation measures and contact transmission-based precautions. The use of non-sterile gloves was emphasized.Results: The outbreak took place between the epidemiological weeks 29 and 37 in the year 2017. The index case was a 93-year-old male patient who had Norwegian scabies and was admitted to the hospital due to Alzheimer's disease. The scabies occurred in nine female nurses, seven residents, six nurse technicians, one intern y five inpatients. Conclusions: This propagated-source outbreak lasted nine epidemiological weeks; and affected nurses, residents, interns and inpatients. The attack rate was 40 %. The prevention and control measures were isolation of the index case and patients, hand hygiene before and after patient care, use of non-sterile gloves, use of scrubs, use of individual medical supplies for each patient, handling of clothing from scabies-infected patients in sealed bags and using gloves, surface cleaning, withdrawal of scabies-infected health workers from their duties until 24 hours of treatment onset, and epidemiological surveillance. Medical treatment was 5 % permethrin lotion for three days. Use of biosafety standards is recommended for patient care, especially when patients are admitted to the hospital with skin lesions. The implemented measures must be considered to prevent and control this type of outbreak.

Alternativas diagnósticas de escabiose felina / Diagnostic alternatives of feline scabies

A sarna notoédrica é uma doença altamente pruriginosa, causada pelo ácaro Notoedres cati. O diagnóstico consiste na observação do ácaro no material analisado, sendo o raspado cutâneo o método mais utilizado. Outras técnicas têm surgido como alternativas menos invasivas no diagnóstico de sarnas, sobretudo para demodicose em cães, como a de fita de acetato e o arrancamento de pelos, que vêm se mostrando tão sensíveis quanto o raspado cutâneo no diagnóstico de tal dermatopatia. Desse modo, o objetivo deste estudo foi comparar o raspado cutâneo com dois métodos alternativos para diagnóstico de sarna notoédrica em gatos: fita de acetato e arrancamento de pelo, sendo possível concluir que o método da fita é tão sensível quanto o raspado cutâneo, ambos apresentando 100% de sensibilidade. A técnica de arrancamento de pelo apresentou sensibilidade significativamente menor para o diagnóstico de Notoedres cati, resultado esperado, uma vez que esse parasita habita principalmente porções superficiais da derme. Assim, o método da fita de acetato pode ser utilizado de forma eficaz e segura para o diagnóstico de sarna notoédrica em gatos, além de ser menos estressante aos animais, mais rápido e simples do que o raspado cutâneo.(AU)

Notoedric mange is a highly pruritic disease caused by the Notoedres cati mite. The diagnosis consists of the observation of the mite in the material analyzed, skin scrapings is the most used method. Other techniques have emerged as less invasive alternatives in the diagnosis of mange, especially for demodicosis in dogs, such as acetate tape and hair removal, which have shown to be as sensitive as skin scrapings in the diagnosis of such dermatopathy. Thus, the objective of this study was to compare skin scaling with two alternative methods for the diagnosis of notohedral scabies in cats: acetate tape and hair collection, and it is possible to conclude that the acetate tape method is as sensitive as skin scraping, both presenting 100% sensitivity. The hair pulling technique showed significantly lower sensitivity for the diagnosis of Notoedres cati, an expected result, since this parasite inhabits mainly superficial portions of the dermis. Thus, the tape method can be used effectively and safely for the diagnosis of notodroid mange in cats, as well as being less stressful to animals, faster and simpler than skin scraping.(AU)

Escabiasis costrosa imitando una acrodermatitis continua de Hallopeau / Crusted scabies mimicking an acrodermatitis continua of Hallopeau

Resumen Introducción: La escabiasis costrosa (EC) es una variante poco común de sarcoptiosis clásica, altamente contagiosa. Las lesiones poseen una elevada concentración del ácaro Sarcoptes scabiei var hominis, lo que conlleva a un cuadro clínico más extenso que en la escabiasis clásica. Se observa principalmente en pacientes con algún tipo de inmunocompromiso y se relaciona con el síndrome de Down. Caso clínico: Se describe una paciente pediátrica con síndrome de Down quien presentó placas escamosas que afectaron la porción distal de los dedos, asociadas con distrofia ungueal e hiperqueratosis subungueal, por lo que se consideró acrodermatitis continua de Hallopeau como diagnóstico diferencial. Se realizó una biopsia tipo punch con lo que se llegó al diagnóstico de EC. La paciente recibió tratamiento sistémico con ivermectina vía oral y tratamiento tópico con crema hidratante y desonida al 0.1%. Mostró mejoría clínica notoria dos semanas después de finalizar el tratamiento. Conclusiones: La EC es una variante prevalente en pacientes inmunocomprometidos y con síndrome de Down que fácilmente puede confundirse con patologías inflamatorias con alteración de la queratinización epidérmica. Este caso se considera una presentación atípica debido a la afección localizada en los dedos de las manos asociada con distrofia ungueal. El estudio histopatológico fue necesario para realizar el diagnóstico y descartar diagnósticos diferenciales.

Abstract Background: Crusted scabies (CS) is an uncommon, highly contagious, variant of classic scabies. Elevated concentrations of the mite Sarcoptes scabiei var. hominis are found in the skin lesions, which lead to a more exaggerated clinical picture than in classic scabies. This disease is mainly observed in patients with any kind of immunosuppression and relates to Down syndrome. Case report: A pediatric female patient with Down syndrome, who presented a crusty white plaque associated with nail dystrophy and subungual hyperkeratosis affecting the distal portion of the fingers is described. Because of these findings, the diagnosis of acrodermatitis continua of Hallopeau was considered. A punch biopsy was performed, attaining the diagnosis of CS. She received systemic treatment with oral ivermectin, topical treatment with emollient cream and desonide 0.1%. Notorious clinical improvement was observed two weeks after finalizing treatment. Conclusions: CS is variant of scabies prevalent in immunocompromised patients and Down syndrome that can be easily confused with inflammatory pathologies with abnormal epidermal keratinization. This case is considered as an atypical presentation of the disease because of local affection of the fingers and nail dystrophy. The histopathological study was necessary to obtain the diagnosis and rule out differential diagnosis.

Métodos diagnósticos da escabiose / Diagnostic methods for scabies

Escabiose é infecção cutânea contagiosa causada pela penetração do ácaro Sarcoptes scabiei var. hominis na epiderme. A suspeita diagnóstica é feita pela história, distribuição clínica das lesões e sua aparência, porém sua confirmação se dá com a identificação do parasita. Apresentamos os aspectos dos métodos diagnósticos da escabiose, desde a identificação por microscopia óptica de raspados cutâneos de lesão ou pelo uso de fita adesiva sobre as lesões, à identificação com uso do dermatoscópio, ferramenta presente na maioria dos consultórios dermatológicos e que, mesmo em mãos inexperientes, possui sensibilidade e especificidade aceitáveis.

Scabies is a contagious cutaneous infection, caused by burrowing of the mite Sarcoptes scabiei var. hominis in the epidermis. The clinical suspicion is due to the history, clinical distribution of lesions and its aspect; however, the confirmation is with the detection of the parasite. We present the features of the diagnostic methods for scabies, from its detection through direct microscopy of skin scrapings from a lesion or with the use of an adhesive tape on the lesions, to its detection using the dermatoscope, a tool available in most dermatology clinics, which, even in unexperienced hands, has acceptable sensitivity and specificity.

Escabiosis: lesiones pruriginosas altamente contagiosas / Scabies: highly contagious pruritic lesions

La escabiosis es una infestación producida por Sarcoptes scabiei, caracterizada por lesiones generalizadas pruriginosas. El diagnóstico es eminentemente clínico. Síntomas compatibles en varios miembros de la misma familia se consideran diagnósticos. El tratamiento consiste en la aplicación de Permetrina al 5% en la superficie cutánea.

Scabies is an infestation produced by Sarcoptes scabiei. Itchy generalized lesions characterized this pathology. The diagnosis is clinical. Compatible symptons presented in some members of the same family are considered diagnostic. The treatment is based in the application of Permetrine 5% in all the cutaneous area.

Atypical crusted scabies in a patient with chronic liver disease caused by hepatitis B and D viruses

Abstract: Crusted scabies is a less common variant of scabies that is highly contagious, difficult to treat and involves infestation by Sarcoptes scabiei var. hominis. The classical clinical presentation includes crusted, scaly and generally non-pruritic lesions usually located on the head, neck, palmar, plantar and periungual region. It was first described in Norway in 1848 in patients with leprosy who presented with crusted lesions. In this study, we report the case of a patient with crusted scabies with florid clinical manifestations and chronic liver disease due to hepatitis B and delta virus infection.

Norwegian scabies in a patient treated with Tripterygium glycoside for rheumatoid arthritis

Abstract: We report an 80-year-old male patient with severe rheumatoid arthritis who was treated with tripterygium glycoside, an immunosuppressive agent made from the extract of a Chinese medicinal herb called Tripterygium wilfordii Hook F. The patient had no apparent skin lesions before the treatment, but he developed aggressive hyperkeratotic lesions with rapid progression after using tripterygium glycoside. He was repeatedly diagnosed with eczema, but treatment failed to achieve efficacy. Interestingly, a microscopic examination of the lesions revealed numerous scabies mites and eggs. Thus, we confirmed the diagnosis of Norwegian scabies infection. Treated with crotamiton 10% cream and 10% sulfur ointment for one month, the patient's clinical symptoms disappeared.

Crusted scabies due to indiscriminate use of glucocorticoid therapy in infant

Abstract Crusted or Norwegian scabies is a parasitic infectious disease caused by Sarcoptes scabiei var. hominis that mainly affects immunocompromised individuals and those with neurological patients. We report a case of crusted scabies in a 4-month-old infant who had been treated erroneously for atopic dermatitis with high doses of corticosteroids. This initial misdiagnosis associated with the abusive use of corticosteroid facilitated the evolution of scabies to crusted scabies and its main complications of secondary infection and sepsis.