Scabies is a skin infestation caused by mites Sarcoptes scabiei. It is a parasite capable of nesting under the skin and laying its eggs in tunnels that it specially digs. In recent years there has been an increase in cases in Italy due to a greater spread of travel towards some countries in South America, the islands of Central America and Africa considered at risk.
In reality, in recent weeks, news reports have been multiplying according to which cases are increasing significantly in Italy too. There should be no particular concern about the treatment because scabies is treated with effective products. Furthermore, a new therapy has recently been developed at the AOU Meyer – IRCCS in Florence.
What are the symptoms of scabies?
The main symptom is a widespread itching and insistent on the whole body. Scabies is recognized by some lesions on the skin:
scabies tunnel: it is the most characteristic lesion, which consists of a line of a few centimeters, of a greyish color and with a kind of vesicle at the end. Typically, this type of lesion appears between the fingers, on the wrists and rarely on the trunk.
Scabies nodules: they are small reddish protrusions that are typically located in the armpits and genital area. In children they may appear on the palms of the hands or soles of the feet.
Non-specific variable lesions: they are “scratching” lesions and other lesions that resemble those of eczema and urticaria.
How is it transmitted?
Scabies is transmitted via close contact with the infested person and, more rarely, coming into contact with the objects of the infected person. In adults, most of the time, contagion occurs sexually.
How is the diagnosis made?
The diagnosis of scabies occurs following a careful clinical examination. To confirm the infestation has occurred, this is carried out a small sample of skin is taken coming from the burrow area or nodules. Under the microscope it is possible to observe the presence or absence of the mite or its eggs.
Scabies: what are the treatments?
Today scabies can be treated easily and in a very short time. The standard treatment involves the application, all over the body, of a 5% permethrin ointment, which must be left to act for a whole night or for 8 or 12 hours. In most cases, a single application is sufficient or, even for those who are following the treatment as a precaution, to eliminate the risk of infestation. Out of caution it would be better to carry out a second application a week after the first.
The new treatment developed by Meyer of Florence
«Traditionally permethrin is used to treat scabies and in recent years oral ivermectin has been introduced as a second line: but our clinical experience has shown us that it was often no longer enough», he explains Cesare Filippeschi, dermatologist at the AOU Meyer – IRCCS in Florence. «From here, in dialogue with colleagues at Bambino Gesù, the intuition was born to treat patients suffering from scabies with a sulfur preparation at 17% concentrationhowever based on a “gentle vehicle”, an emollient and non-irritating cream.”
The Research Center has developed a specific protocol: the cream is applied in the evening and left on the skin for three days, without washing. In this way an occlusive barrier to sulfur is created. The treatment is repeated (not only on the patient but also on family members and cohabitants) the following week. The very encouraging results of the study were published in the journal International Journal of Dermatology.
Currently at Meyer this has become the treatment of choice for scabies. «This discovery is arousing interest from other national and international centers. Furthermore, it is a galenic preparation that has a reduced cost compared to other therapies on the market, and which once again reminds us that sometimes by rediscovering “old” molecules it is possible to develop effective therapies”, concludes Filippeschi.
Scabies: what to watch out for?
To avoid coming into contact with the underwear of the person who has contracted scabies, it is necessary that all of his personal effects (clothes, sheets, mattress, etc.) come placed in the open air for at least 24 hours. This measure is sufficient so that it is not necessary to boil the items.
Even if cases of contagion are very rare, it is necessary always wash the clothes we just bought. The clothes in the shops are in fact tried on by many people. It could happen that those who try them may have contracted scabies.
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