Korean J Dermatol.  2024 May;62(4):218-227.

Clinical Characteristics of Hospitalized Patients Diagnosed with Scabies: A Retrospective Study

• Kim YC
• Kim HN
• Woo B
• Kim KE
• Baek YS
• Jeon J

Abstract

Background
Scabies, a common contagious skin disease caused by ectoparasites, is a significant public health concern in healthcare facilities, including tertiary hospitals.
Objective
This study aimed to assess the clinical characteristics of hospitalized patients who were diagnosed with scabies. We focused on determining whether patient-related factors such as height, weight, underlying diseases, mobility, mental alertness, cognitive impairment, catheter insertion, and the presence of caregivers influenced the failure of the initial diagnosis or treatment.
Methods
We retrospectively analyzed the medical records of 81 patients who were diagnosed with scabies during hospitalization between January 2011 and June 2023.
Results
Of the 81 patients, 45 (55.6%) were male, with a mean age of 76.5 years. The most common primary diagnosis was an infectious disease (66.7%). The main suspected routes of infection were care facilities (63.5%) for patients who already had pruritic skin lesions before admission, and contact with caregivers (80.0%) for patients who developed new skin lesions after admission. The initial consultation failed to diagnose scabies in 19.8% of the patients, and among those, 62.5% had not undergone initial microscopic examination. Patients who were initially misdiagnosed had significantly longer hospitalizations and scabies treatment durations. Among the patients who underwent follow-up microscopic examination after the initial treatment, 60.0% showed positive results. Overall, 54.2% of the patients experienced initial treatment failure. Patient-related factors did not significantly differ between patients with and without initial diagnostic failure and between patients with and without initial treatment failure.
Conclusion
Dermatologists should consider performing microscopic examinations more frequently in hospitalized patients to improve diagnostic accuracy. Considering the high treatment failure rate, follow-up microscopic evaluation is recommended after initial treatment.

Keyword

Inpatients; Scabies