Epidemiological and Clinical Study of Scabies over the Last 4 Years in the North-west Gyeonggido Province: Focus on the Treatment Effect and Comparison between Inpatients and Outpatients

Kim, Soo Jin; Haw, Sik; Park, Hai Jin; Kim, Seong Hyun

Abstract

BACKGROUND
Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. The incidence of scabies decreased during the past 20 years, but it has been increasing with the increase in the number of elderly people and nursing hospitals in Korea.
OBJECTIVE
This study was performed to evaluate and compare the clinical aspects and etiologic factors between outpatients and inpatients diagnosed with scabies. Also, we tried to investigate the clinical efficacy of topical therapies for the treatment of scabies.
METHODS
We conducted a retrospective analysis of the medical records of 200 patients who were diagnosed with scabies with a mineral oil test or skin biopsy between September 2009 and August 2013.
RESULTS
Of 200 patients, 91 (45.5%) were men and 109 (54.5%) were women. The mean age of the patients was 59.2+/-26.6 years (men: 54.9+/-27.6 years/women: 62.8+/-25.2 years), and 61% of patients were aged >60 years. There was no seasonal variation in occurrence. Common primary lesions were papules and burrows in both inpatients and outpatients. Also, hyperkeratotic lesions were more commonly observed in inpatients (60%) than in outpatients (16.4%). The majority of the suspected routes of infection were transmissions through the nursing homes or hospitals (outpatients: 37.6%, inpatients: 71.4%). The mean time to diagnosis was 59+/-85.1 days (outpatients: 62.97+/-92.11 days, inpatients: 40.6+/-32.2 days) and to complete treatment was 31.87+/-49.2 days (outpatients: 35.3+/-53.14 days, inpatients: 14.8+/-13.87 days).
CONCLUSION
We confirmed that nursing homes or hospitals are sources of herd infection. Therefore, dermatologists should educate the medical team and caregivers who work in nursing homes and hospitals about the clinical aspects and treatments of scabies.