An overview of the epidemiology, transmission, pathogenesis and treatment of scabies

Abstract

Summary: Scabies is a well-known, yet a poorly understood neglected tropical disease (NTD). Although less common in the UK, scabies epidemics regularly occur abroad, in tropical, less developed communities (LDCs). Cases are prevalent in communities which tend to live with overcrowding, poor sanitation and limited access to healthcare facilities and medication; this environment provides the perfect breeding ground for the growth and the transmission of scabies. The body has a delayed response to infestation, this is due to the scabies mite’s ability to disrupt the complement cascade and delay the onset of the adaptive arm of the immune response Relevance: Contrary to popular belief, anyone can become infested with scabies. Although not usually life-threatening, scabies can cause unpleasant symptoms, as well as worsen existing skin conditions, which can reduce a person’s quality of life. Prompt diagnosis is challenging in LDCs. When failed to be diagnosed, scabies may lead to serious complications such as secondary skin sepsis, as well as allowing further transmission. Scabies is highly contagious; clinicians should be aware how to spot and treat scabies early on, and additionally know to offer treatment to other members that the patient has been in close contact with. Take Home Messages: Management for scabies is relatively simple and involves the application of topical medication, such as Permethrin. Despite this, there are still many barriers to treating epidemics in LDCs, such as a lack of access to treatment and healthcare professionals, a lack of awareness from clinicians about the condition’s clinical manifestations, as well as lack of infrastructure to definitively diagnose the condition. Despite progress in management of the condition, the pathophysiology and transmission of the condition are only partly understood, and the rise of resistance to current scabicides is indicative of the need for newer treatments, especially within resource poor communities.