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Interventions for treating scabies

Scabies is a parasitic infection of the skin. It occurs throughout the world, but is particularly problematic in areas of poor sanitation, overcrowding, and social disruption, and is endemic in many resource‐poor countries. The global prevalence of scabies is estimated at 300 million cases, but the level of infection varies between countries and communities. The female mite burrows into the skin to lay eggs which then hatch out and multiply. The infection can spread from person to person via direct skin contact, including sexual contact. It causes intense itching with eruptions on the skin. Various drugs have been developed to treat scabies, and herbal and traditional medicines are also used. The review of trials attempted to cover all these. The authors identified 22 small trials involving 2676 people, with 19 of the trials taking place in resource‐poor countries. Permethrin appeared to be the most effective topical treatment for scabies, and ivermectin appeared to be an effective oral treatment. However, ivermectin is unlicensed for this indication in many countries. Adverse events such as rash, vomiting, and abdominal pain were reported, but the trials were too small to properly assess serious but rare potential adverse effects. No trials of herbal or traditional medicines were identified for inclusion.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Interventions for preventing the spread of infestation in close contacts of people with scabies

Scabies is a common parasitic infection. It is caused by a mite, Sarcoptes scabiei variety hominis, also known as the human itch mite, which depends on humans to survive. Crusted scabies (or Norwegian scabies) is caused by the same mite, but tends to occur in people whose immune system is not working so well, such as transplant patients on immunosuppressive therapy, people who misuse alcohol, or other debilitated people. Scabies infection spreads from person to person by skin contact. This is why it is more prevalent in areas with poor sanitation or overcrowding. In high‐income countries it tends to spread between family contacts, between people in residential care, or between patients and staff in hospitals. People may be infected with these mites for several weeks before developing symptoms. During this time it is possible to spread the infection to other people. Consequently people who are in contact with suspected cases of scabies infection are often given preventative treatments in an attempt to stop the development of symptoms. Preventive treatment also aims to prevent further spread of the infection and to prevent the person who was the source of infection from getting reinfected. This review is important, as before conducting this review we were unable to say if using preventive treatment helps or not.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pruritus (PDQ®): Health Professional Version

Expert-reviewed information summary about pruritus (itching of the skin) as a complication of cancer or its treatment. Approaches to the management and treatment of pruritus are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2011

Atopic Eczema in Children: Management of Atopic Eczema in Children from Birth up to the Age of 12 Years

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2007
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Teledermatology for Diagnosis and Management of Skin Conditions: A Systematic Review of the Evidence [Internet]

Telemedicine uses telecommunication technology to transfer medical information. Due to the visual nature of a skin examination, telemedicine, specifically, teledermatology, may be a valuable tool in the diagnosis and management of dermatologic diseases for patients in rural areas (including rural Veterans Affairs Medical Centers and Community Based Outpatient Clinics) who may not have ready access to a dermatologist. Teledermatology may also be useful in primary care settings to triage cases and limit unnecessary dermatology clinic referrals. Although not the focus of this review, teledermatology may also be used to provide follow-up care or monitoring after an in-person dermatology visit. The objectives of this evidence synthesis project were to systematically review and summarize the scientific literature addressing: 1) teledermatology for the diagnosis of skin conditions, 2) teledermatology for the management of skin conditions, 3) clinical outcomes when teledermatology is used, 4) the cost of teledermatology compared with usual care (in-person dermatology), and 5) key elements of, and barriers to, successful teledermatology implementation.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: January 2010
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Drug Class Review: Topical Calcineurin Inhibitors: Final Report [Internet]

Since December 2000, two topical calcineurin inhibitors have been approved for use in patients with atopic dermatitis in the United States and Canada. Since the approval of these agents, several case reports of malignancies (skin and lymphoma) have been reported to the United States Food and Drug Administration, causing a black box warning to be placed in each product's labeling. Several pharmacokinetic analyses, commentaries, and editorials have been published refuting the addition of the black box warning. In light of these findings, this comparative effectiveness review of 2 topical calcineurin inhibitors was commissioned to identify whether additional good-quality studies on safety have been published and to determine whether differences in efficacy and effectiveness exist between the 2 topical agents. The purpose of this review is to compare the effectiveness and harms of topical calcineurin inhibitors in persons with atopic dermatitis or eczema.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008
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Medical Encyclopedia

  • Scabies
    Scabies is an easily spread skin disease caused by a very small type of mite.
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Systematic Reviews in PubMed

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