Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study. / Características clínicas y epidemiológicas de pacientes diagnosticados de escabiosis en España: oportunidades de mejora. Estudio transversal multicéntrico CLINI-AEDV.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had typical scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of the cases of scabies studied, the patient had already received treatment. In those cases, we observed several remediable shortcomings that could explain why some of these treatments had failed. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

[Translated article] Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use.

Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.

[Translated article] Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had clinical features of classic scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of scabies cases, the patient has already received treatment. In those cases, we observe several remediable shortcomings that could explain why some of these treatments fail. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use. / Escabiosis en España: tendencias del interés público y consumo de ectoparasiticidas.

Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.

Epidemic Scabies: New Treatment Challenges in an Ancient Disease. / Epidemia de escabiosis: los nuevos retos de una enfermedad ancestral.

Scabies, which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications -such as spinosad or, especially, moxidectin- offer hope for bringing this disease under control.

Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis. / Recomendaciones de expertos de la Academia Española de Dermatología (AEDV) para el manejo de las ectoparasitosis de transmisión sexual. Escabiosis y pediculosis púbica.

Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.

[Treatment of scabies]. / Tratamiento de la escabiosis.

Scabies affects more than 200 million people around the world, and causes a significant socioeconomic impact. Prolonged skin-to-skin contact is the primary mode of transmission. Fomite-mediated transmission is uncommon, although it can be significant in crusted scabies. Topical therapy with permethrin 5% is recommended as first-line treatment. It can be indicated during pregnancy and lactation, and appears to be safe in children <2 months. However, a decrease in the effectiveness of this drug has recently been reported. Another first-line therapeutic alternative is oral ivermectin. It can be administered during lactation, and new evidence suggests that it is safe in children >15kg. Diverse systematic reviews and meta-analysis have concluded that oral ivermectin is as effective and safe as topical permethrin. Mass drug administration of oral ivermectin is an excellent option for the management of scabies in communities with high prevalence, or for scabies outbreaks in institutions.

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)

Aspectos epidemiológicos de la escabiosis infantil en el servicio de Miscelánea. Hospital Pediátrico Docente. Bayamo / Epidemiological aspects of childhood scabiosis in the Miscellaneous service. Pediatric Teaching Hospital. Bayamo / Aspectos epidemiológicos da escabiose infantil no serviço Diversos. Hospital Pediátrico de Ensino. Bayamo

RESUMEN Introducción: la llamada «Escabiosis o Sarna¼ es una infestación producida por el acaro Sarcoptes scabiei, caracterizada por lesiones generalizadas pruriginosas. Objetivo: describir su comportamiento a través de las variables sociodemográficas edad y sexo; área de salud, condiciones socioeconómicas, mes de aparición; localización de las lesiones, y principales signos y síntomas que motivaron la consulta. Método: se realizó un estudio descriptivo, longitudinal, ambipectivo, a niños ingresados en el servicio de miscelánea con el diagnóstico de escabiosis en el periodo de agosto de 2018 a febrero de 2019, El universo estuvo constituido por 240 casos con piodermitis y la muestra fueron 192 casos con escabiosis. Se utilizaron estadígrafos descriptivos (frecuencias absolutas y relativas), los datos se procesaron a través del programa profesional estadístico SPSS 22.0 para Windows. Resultados: el 69.7% correspondían al grupo de edad menores de 1 año, del sexo masculino el 52,6%, el área de salud Policlínico Rene Vallejo con 27,3%, el 45,8% de las condiciones socioeconómicas fueron malas, el 35,4% de las lesiones fueron en el cuero cabelludo, el 100% manifestó prurito, erupciones mucocutáneas típicas y malestar general, el mes que predomino fue el mes de enero con 115 pacientes para un 59,8%. Conclusiones: predominó el grupo de edad menor de 1 año, el sexo masculino, el policlínico René Vallejo aportó el mayor número de los casos, las condiciones socioeconómicas fueron malas, las manifestaciones que predominaron fueron el prurito, la erupción mucocutánea y el malestar general y el mes de aparición fue en enero.

ABSTRACT Introduction: the so-called «Escabiosis or Scabies¼ is an infestation produced by the Sarcoptes scabiei mite, characterized by widespread pruritic lesions. Objective: to describe their behavior through the sociodemographic variables age and sex; health area, socioeconomic conditions, month of appearance; location of the lesions, and main signs and symptoms that motivated the consultation. Method: a descriptive, longitudinal, ambipective study was conducted on children admitted to the miscellaneous service with the diagnosis of scabiosis in the period from August 2018 to February 2019, The universe consisted of 240 cases with pyodermitis and the sample were 192 cases with scabiosis. Descriptive statisticians (absolute and relative frequencies) were used, the data was processed through the statistical professional program SPSS 22.0 for Windows. Results: 69.7% corresponded to the age group under 1 year old, 52.6% male, the Rene Vallejo Polyclinic health area with 27.3%, 45.8% of the socioeconomic conditions were bad, the 35.4% of the lesions were in the scalp, 100% manifested pruritus, typical mucocutaneous eruptions and malaise, the month that prevailed was the month of January with 115 patients for 59.8%. Conclusions: the age group under 1 year predominated, the male sex, the polyclinic René Vallejo contributed the largest number of cases, the socioeconomic conditions were bad, the predominant manifestations were pruritus, mucocutaneous eruption and general malaise. The month of appearance was in January.

RESUMO Introdução: a chamada «escabiose ou sarna¼ é uma infestação produzida pelo ácaro Sarcoptes scabiei, caracterizada por lesões pruriginosas generalizadas. Objetivo: descrever seu comportamento através das variáveis ​​sociodemográficas idade e sexo; área de saúde, condições socioeconômicas, mês de aparecimento; localização das lesões e principais sinais e sintomas que motivaram a consulta. Método: foi realizado um estudo descritivo, longitudinal e ambipativo, em crianças internadas no serviço diverso com diagnóstico de escabiose no período de agosto de 2018 a fevereiro de 2019. O universo foi constituído por 240 casos de piodermite e a amostra foi 192 casos com escabiose. Foram utilizados estatísticos descritivos (frequências absolutas e relativas), os dados foram processados ​​através do programa profissional estatístico SPSS 22.0 for Windows. Resultados: 69,7% corresponderam à faixa etária abaixo de 1 ano, 52,6% do sexo masculino, área de saúde da Policlínica Rene Vallejo com 27,3%, 45,8% das condições socioeconômicas eram ruins, 35,4% das lesões estavam no couro cabeludo, 100% apresentaram prurido, erupções mucocutâneas típicas e mal-estar, o mês que prevaleceu foi janeiro, com 115 pacientes em 59,8%. Conclusões: a faixa etária abaixo de 1 ano predominou, o sexo masculino, a policlínica René Vallejo contribuiu com o maior número de casos, as condições socioeconômicas foram ruins, as manifestações predominantes foram prurido, erupção mucocutânea e mal-estar geral. O mês de aparição foi em janeiro.

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.

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.

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.

Serie parasitosis en dermatología: escabiosis / Series parasitosis in dermatology: scabies

La escabiosis es una ectoparasitosis pruriginosa producida por el ácaro Sarcoptes scabiei, variedad hominis, específica del ser humano. Si bien su distribución es universal, con frecuencia es subdiagnosticada por asociarla únicamente a hacinamiento y malos hábitos de higiene. Se transmite por contacto directo con una persona afectada o a través de fómites, por lo que es muy común el contagio de los convivientes. Presentamos un caso de escabiosis en una paciente anciana evaluada por prurito generalizado. (AU)

Scabies is a human specific pruritic ectoparasitosis produced by the mite Sarcoptes scabiei var. hominis. Although it has a worldwide distribution, it is often underdiagnosed because it is only associated with overcrowding and poor hygiene. It is transmitted by a direct contact with an affected person or through fomites. The transmission to cohabitants is very common. We present a case of scabies in an elderly patient with generalized pruritus. (AU)

Sarna Costrosa (NORUEGA) en Hospital II Lima Norte. A propósito de un caso / Crustal Sarna (NORWAY) in North Lima Hospital II. About a case

Se presenta el caso de una paciente femenina de 68 años de edad, con antecedentes de hipertensión arterial, DM tipo 2, enfermedad renal reagudizada, con hiperqueratosis en manos, que ingresa al servicio de emergencia del Hospital II Lima Norte- Essalud por presentar trastorno de conciencia. Las lesiones clínicas evocan una forma poco frecuente de escabiosis, denominada sarna costrosa o noruega; una de las características de esta patología es su alto grado de contagio, frecuente en pacientes inmunosuprimidos y con alteraciones neurológicas.

Presents the case of a female patient 68 years old, with a history of hypertension, type 2 diabetes, renal disease exacerbation with hyperkeratosis in the hands, entering Hospital emergency Lima Norte ­ ESSALUD with disorder of consciousness. Clinic injuries evoke a rare form of scabies called Norwegian scabiesor crusted; one of the characteristics of this pathology is often a high degree of infection in immunosuppressed patient with neurological disorders.

Diagnóstico por Teledermatologia em paciente do Alto Rio Solimões: um caso de escabiose crostosa / Diagnosis by Teledermatology of a patient from the Alto Solimões River: a case of Crusted Scabies / Diagnóstico por Teledermatología en paciente del Alto Río Solimões: un caso de Escabiosis Costrosa

A Teledermatologia estuda o uso das tecnologias de telecomunicação e informática na assistência dermatológica sem a atuação presencial do especialista. Neste trabalho, é relatado o processo diagnóstico de um caso de escabiose crostosa (sarna norueguesa) em paciente idoso da região do Alto Rio Solimões, por meio de recursos de Teledermatologia. Além disso, os autores discutem os avanços dessa tecnologia que possibilita a assistência a distância para comunidades ribeirinhas e indígenas, sobretudo em áreas isoladas da Amazônia Legal, nas quais inúmeras doenças são negligenciadas e subdiagnosticadas.

Teledermatology uses telecommunication technology and informatics on dermatologic practice without the presence of a specialist. This paper describes the diagnostic process of a Crusted Scabies (Norwegian Scabies) case in an elderly patient from the Alto Solimões River region using teledermatology resources. Moreover, the authors discuss the progress of these technologies, which allow healthcare assistance for those living in remote indigenous and riverine communities, particularly in isolated areas of the Legal Amazon where many diseases are neglected or underdiagnosed.

La Teledermatología usa las tecnologías de las telecomunicaciones y de la informática para dar asistencia dermatológica sin la presencia de un especialista. Este artículo describe el proceso de diagnóstico de un caso de escabiosis costrosa (sarna norueguesa) en un paciente anciano de la región del Alto Rio Solimões, a través de recursos de la Teledermatología. Además, los autores discuten los avances de estas tecnologías que permiten llevar asistencia médica a las comunidades costeras e indígenas remotas, especialmente a aquellas de zonas aisladas del Legal Amazon, en las cuales numerosas enfermedades son negligenciadas y subdiagnosticadas.

Ectoparasitosis de importancia en Chile: Epidemiología y terapia / Ectoparasitosis of clinical importance in Chile

Several parasitic diseases affect the skin and appendages in humans, the most common are head lice and scabies. Both diseases have worldwide distribution with geographical variations. In Chile, the reported prevalence of head lice is 20-25 percent and of scabies 1-5 percent. Other ectoparasites include fleas and mite, causing transient parasitosis related to human and animal contact. These parasites are associated with various factors such as poor personal hygiene, promiscuity, long hair, crowding, and sharing of combs, among others. Various effective pharmacological therapies are available, which base on several active compounds. Important therapeutic options include topical treatments with pyrethroids, lindane, crotamiton, and malathion as well as oral medications such as ivermectin, which is used in case of drug intolerance, poor treatment response, infections with multiple parasites or concomitant bacterial infections. For some drugs, resistance has been reported in patients received multiple dosis.

Existen varias enfermedades parasitarias capaces de comprometer piel y fanéreos en el humano, siendo los más frecuentes la pediculosis y la escabiosis. Ambas enfermedades tienen distribución mundial variable según la localidad. En Chile, se describe una prevalencia de pediculosis capitis cercana a 20-25 por ciento y de escabiosis, entre 1 y 5 por ciento. Otras ectoparasitosis son la pulicosis y la acarosis, parasitosis transitorias relacionadas al contacto humano y animal. Estos agentes se asocian a diversos factores entre los que se encuentran escasa higiene personal, promiscuidad, uso de cabello largo, hacinamiento, intercambio de peines, entre otros. Las terapias farmacológicas disponibles son variadas y eficaces. Hay diversos compuestos activos entre los que destacan tratamientos tópicos como derivados piretroides, lindano, crotamitón y malatión; y medicamentos orales como ivermectina, utilizada en casos de mala tolerancia, escasa respuesta a tratamiento tópico, infestación múltiple o infección bacteriana concomitante. Se ha descrito resistencia a algunos compuestos en pacientes que han recibido múltiples dosis.

Riesgo de contagio y prevención de brotes hospitalarios por Sarcoptes scabiei / Contagion risk and prevention of nosocomial outbreaks due to Sarcoptes scabiei

Introducción. Los brotes por Sarcoptes scabiei son frecuentes en todo tipo de instituciones sanitarias, iniciándose sobre todo a partir de pacientes con sarna noruega. En forma cada vez más contundente, se recomiendan medidas agresivas y precoces, incluso en casos equívocos. Materiales y métodos. Este artículo describe un brote en el que se actuó de forma rotunda, pero sólo cuando se había demostrado la transmisión hospitalaria. Objetivos. Describir y valorar las consecuencias de esta decisión. Resultados y discusión. Ocurrió un brote pequeño pero, dada la levedad de las consecuencias de la infestación y que se evitó desde un inicio la dispersión de casos por toda la institución, los autores consideran que una demora en la aplicación de medidas agresivas, si permite valorar inequívocamente el riesgo y es de corta duración, favorece un uso más juicioso de los recursos.

Introduction. Sarcoptes scabiei outbreaks are common in all types of health institutions, starting mostly from patients with Norwegian scabies. Recommendations for action are growing stronger, such as early and aggressive action even in unclear cases. Materials and methods. This article describes an outbreak where aggressive action was taken, but only when nosocomial transmission was demonstrated. Objectives. To describe and assess the consequences of this decision. Results and discussion. A small epidemic occurred, but given the lightness of the infestation consequences and that the spread of cases across the institution was avoided from the beginning, the authors believe that a delay in the implementation of aggressive measures favors a more judicious use of resources, if it allows to assess the risk unambiguously and is short termed.

Sarna humana: el ácaro y sus circunstancias / Human Scabies: The Mite And Its Circumstances

La sarna humana, dermatosis milenaria, nos sigue sorprendiendo en la actualidad por su capacidad para producir diversas manifestaciones clínicas, cuyo reconocimiento puede ser dificultoso para el clínico generalista y aún para el dermatólogo experimentado. Es una enfermedad frecuente, cuyas manifestaciones dependen del delicado interjuego que existe entre el huésped, el parásito y el medio ambiente. Realizamos una descripción de variedades poco frecuentes de escabiosis y la ilustramos a través de nueve casos.

At the present time, human scabies, millenarian disease, surprised us because of its ability to produce diverse clinical manifestations, whose recognition still can be difficult for clinical and for the experienced dermatologist. It is a common disease, whose clinical expression depends on the delicate interplay between the host, the parasite and the environment. We present a description of rare varietes of scabies, illustrated with nine clinical cases.

Intervención educativa comunitaria sobre escabiosis en el ámbito de la Atención Primaria / Community educational intervention about escabiosis in the Primary Health Care realm

Objetivo: Ofrecer una alternativa de educación sobre escabiosis, adaptada a las condiciones locales y a las necesidades sentidas por las madres. Métodos: Se describe la metodología utilizada en una intervención educativa sobre escabiosis, dirigida al primer nivel de atención. El estudio se realizó en el Policlínico de Primero de Enero. En la primera etapa se practicó una encuesta para evaluar el nivel de conocimientos, actitudes y prácticas de las madres con relación a la escabiosis. A partir de este resultado, se desarrolló la metodología educativa, para la cual se elaboró un material de apoyo docente (folleto), y dos actividades para dar sostenibilidad al programa educativo, uno dirigido a la promoción de medidas de protección y prevención y otro destinado a la identificación de conductas de riesgo. Ocho meses después se aplicó la misma encuesta para conocer el nivel de conocimientos con relación al inicial. Resultados: Antes de la aplicación de la metodología educativa, un grupo importante de madres tenía deficiente higiene y bajo nivel de conocimientos con relación a la escabiosis. Después de la capacitación mejoraron los conocimientos, se modificaron hábitos y prácticas; las mujeres reconocieron la utilidad de la higiene personal y ambiental en la prevención de complicaciones durante los episodios activos de escabiosis. Conclusiones: A pesar del corto tiempo transcurrido entre la aplicación de la experiencia educativa y la encuesta final, los hallazgos encontrados después de su aplicación demuestran que el programa aplicado puede mejorar los conocimientos de la población con relación a la escabiosis y sus complicaciones.

Purpose: to provide an educative alternative about escabiosis, adapted to the local conditions and the necessities felt by mothers. Methods. The methodology used in an educational intervention on escabiosis is described, being directed to the first attention level. This study was conducted in Primero de Enero Polyclinic. In the first stage, a survey was carried out, to evaluate the level of knowledge, attitudes etc. Stemming from the results, an educational methodology was developed, for which a teaching aid was created (a pamphlet), plus two activities to provide sustainability for the educational program. Mothers were polled again Eight months later, by means of the same survey, in order to know their acquisition of knowledge up to now. Results. Before the new methodology was applied, a number of mothers had insufficient hygiene habits and low level of knowledge with regards to escabiosis. After doing this training, women recognized the usefulness of developing appropriate personal and environmental hygiene habits to prevent complications during its occurrence. Conclusions. In inspire of the short period of time elapsed from the implementation of the educational intervention and the last survey, it showed its effectiveness to improve people knowledge in regards of escabiosis, as well as the main complications that may occur.