Evaluation and Management of Pruritus and Scabies in the Elderly Population.

Pruritus is the most common dermatologic complaint in the geriatric population. Its growing prevalence coincides with the rapid growth of the elderly population (>65 years of age) in the United States. According to the US Census Bureau, 16.9% of the population, or more than 56 million adults 65 years and older, lived in the United States in 2022. Pruritus is a condition that accompanies a diverse array of underlying etiologic factors. The mechanism of normal itch impulse transmission has been recently elucidated. The itch sensation originates from epidermal/dermal receptors connected to unmyelinated, afferent C-fibers that transmit the impulse from the periphery.

Delusions of parasitosis and delusions of parasitosis by proxy in a mother and her children.

Delusions of parasitosis by proxy is an uncommon entity wherein an individual projects a delusional belief onto another person who lacks capacity to hold the same belief. We report a case of delusions of parasitosis by proxy in a mother who believed that she was infested with scabies and projected her fixed, delusional belief of scabies infestation onto her children. She subjected her children to numerous home remedies and medical treatments as well as removing them from school in an effort to cure them of the supposed infestation. Child maltreatment can be a concern in such cases with a low threshold for involving child protective services if harm to the children is suspected.

[Epidemiology of scabies in Germany: multisource analysis of primary and secondary data]. / Epidemiologie der Skabies in Deutschland: Multi-Source-Analyse von Primär- und Sekundärdaten.

BACKGROUND: Scabies is one of the most common and, in terms of burden of disease, one of the most significant skin diseases worldwide. In Germany, an increase in cases is currently being discussed, for which reliable data have been lacking until now. OBJECTIVES: The goal is to clarify the prevalence and treatment of scabies in Germany. MATERIALS AND METHODS: Multisource analyses of treatment data from a nationwide statutory health insurance company, the Federal Statistical Office and company skin screenings. RESULTS: In Germany, the number of cases of scabies has been rising since 2009 and especially since 2014. In the outpatient setting, there was an increase of 52.8% to around 128,000 treatment cases between 2010 and 2015. Currently, more than 11,000 inpatient cases are documented annually in Germany with scabies as the main diagnosis (ICD-10 B86). The increase between 2010 and 2016 was about 306%. The main outpatient specialist groups providing care are dermatologists and general practitioners, while in the inpatient sector treatment is provided by departments of dermatology, paediatrics and internal medicine. CONCLUSION: Due to the aforementioned development of prevalence and incidence, the need for care will remain at a high level in the future, which suggests an increased need for education and early detection.

Biomarkers as predictive tools to test the in vivo anti-sarcoptic mange activity of propolis in naturally infested rabbits.

The present study was designed to investigate the use of specific biomarkers, such as albumin, serum total protein, aspartate amino transferase (AST), globulin, alanine amino transferase (ALT), serum cortisol and alkaline phosphatase (ALP), as predictive tools for sarcoptic mange in rabbits. A total of 40 naturally infested rabbits were equally divided into four groups.Thirty infested rabbits were administered with three different treatments (propolis,ivermectin, and propolis with ivermectin) and were compared to10 infested un-treated rabbits. The impact of treatment was assessed via microscopic examination of skin scrapings, clinical signs, and blood measurements relating to the liver. The present study demonstrated that topical application of 10% propolis ointment resulted in complete recovery from clinical signs and complete absence of mites based on microscopic examination after 10-15 days of treatment. Moreover, AST, ALP, ALT, and cortisol were determined to be acceptable biomarkers to track the response of diseased rabbits to the therapeutic use of propolis.

Treatment of Scabies and Pediculosis in Health Education Publications and Folk Medicine of Eastern Croatia - Slavonija, Baranja, and Western Srijem County.

Scabies and pediculosis are common parasitic infestations of the skin and hair, manifesting with intense pruritus and effectively treated with modern medications. Because of the attached social stigma linking it with poverty and poor hygiene, patients will often attempt alternative folk-based remedies before confiding in their physicians. We conducted a comprehensive bibliographical study of historic folk literature and interviewed 70 individuals experienced in everyday application of folk medicine in order to categorize available remedies and provide a modern, scientific comment on their effectiveness and dangers. Compositions containing sulfur, copper sulfate, petroleum, coal, tar, and highly alkaline soaps and washing solutions undoubtedly have scabicidal and pediculicidal properties, but they are used either in high concentrations with greater possibility of intoxication and irritation or lower concentrations with questionable therapeutic benefit. These remedies, extracted from historical-cultural frameworks, are poorly adapted to modern standards and can lead to side-effects and complications. Physicians today have to be aware of the reasons their patients seek alternative remedies and know the substances and procedures they may use in self-healing, so as to be able to provide the help that may be needed if those complications occur.

HIV-Associated Psoriasis. / Psoriasis asociada al VIH.

Human immunodeficiency virus (HIV) prevalence is increasing worldwide as people on antiretroviral therapy are living longer. These patients are often susceptible to debilitating inflammatory disorders that are frequently refractory to standard treatment. Psoriasis is a systemic inflammatory disorder, associated with both physical and psychological burden, and can be the presenting feature of HIV infection. In this population, psoriasis tends to be more severe, to have atypical presentations and higher failure rates with the usual prescribed treatments. Management of moderate and severe HIV-associated psoriasis is challenging. Systemic conventional and biologic agents may be considered, but patients should be carefully followed up for potential adverse events, like opportunist infections, and regular monitoring of CD4 counts and HIV viral loads.

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

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.

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.

Evaluation and management of pruritus and scabies in the elderly population.

Pruritus is the most common dermatologic complaint in individuals older than 65 years. The elderly comprise a demographic that seeks medical attention for itch with greater frequency than other age groups. Managing pruritus in elderly patients represents a unique therapeutic challenge attributable to a range of circumstances that are of particular importance in this population. Topical steroid therapy must be administered carefully, and other forms of treatment, including phototherapy, may be difficult to maintain. The challenge of treating pruritus in the elderly might also stem from communication barriers that prevent definitive identification of the itch's underlying etiology or severity.

Scabies: molecular perspectives and therapeutic implications in the face of emerging drug resistance.

Limited effective treatments, coupled with recent observations of emerging drug resistance to oral ivermectin and 5% permethrin, raise concerns regarding the future control of scabies, especially in severe cases and in endemic areas where repeated community treatment programs are in place. There is consequently an urgent need to define molecular mechanisms of drug resistance in scabies mites and to develop and assess alternative therapeutic options, such as tea tree oil, in the event of increasing treatment failure. Molecular studies on scabies mites have, until recently, been restricted; however, recent advances are providing new insights into scabies mite biology and genetic mechanisms underlying drug resistance. These may assist in overcoming many of the current difficulties in monitoring treatment efficacy and allow the development of more sensitive tools for monitoring emerging resistance.

Sarcoptic mange in three alpacas treated successfully with amitraz.

Sarcoptic mange is a serious skin disease in alpacas that can result in high morbidity and even mortality. Three alpacas were presented with sarcoptic mange that had previously failed to respond to repeated topical applications of eprinomectin, and an injection of doramectin. They were moderately to severely pruritic, had extensive lesions of alopecia, erythema, scaling and crusting, and had lost weight. As no drug is currently licensed for the treatment of sarcoptic mange in alpacas in the UK, they were treated with a topical solution of amitraz (50 mL in 10 L) after initial bathing with antibacterial or keratolytic shampoos. The clinical signs completely resolved with no relapse over a 10-month follow-up period. In this small group of alpacas, amitraz was an effective and well-tolerated treatment for sarcoptic mange.

[Serological survey of Sarcoptes scabies var. suis infection using colostrum samples: preliminary results]. / Serologische Bestandesuntersuchung der Sarcoptes scabiei var. suis Infektion mit Kolostralmilchproben: vorläufige Resultate.

Pig mange was investigated serologically in colostral samples with ELISA using Chekit Sarcoptest. This test has already been using to investigate sera samples from swine in veterinary practice. A total of 684 sow colostral samples were collected from 24 mange free breeding units and 6 units with clinical manifestation of mange infestation. The specificity of the test was more than 99% and the mean seroprevalence 30% (range 6% to 100%). This simple method will allow in the future not only the rapid and certain diagnosis of pig mange but also the screening of pig breeding units after eradication of the disease.