Title : Neglected tropical disease case report: Impetiginized scabies
Abstract:
Scabies is a highly contagious skin condition caused by the Sarcoptes scabiei mite infestation, leading to intense itching, particularly at night. It is declared a neglected skin disease by the World Health Organization due to its significant health burden, especially in developing countries. This neglected tropical disease presents significant challenges in diagnosis and management, often leading to misdiagnosis, treatment failure, and outbreaks within communities. This case report explores a particularly severe manifestation of scabies known as impetiginized scabies, characterized by secondary bacterial infection, poses additional challenges in diagnosis and management. We presented a case of one-year-old male patient. The patient experienced with a two-week history of progressively worsening intense pruritus, particularly exacerbated at night, leading to impaired sleep. Despite previous treatments with topical and systemic medications, the symptoms persisted, prompting referral to a tertiary dermatovenereology clinic. Dermatological examination revealed erythematous papules, pustules, and crusted lesions primarily affecting interdigital spaces, hands, feet, and trunk. Upon examination, skin scrapings revealed the presence of Sarcoptes scabiei mites, confirming the diagnosis of scabies. Additionally, Gram staining identified gram-positive cocci, indicative of secondary bacterial infection. The patient was diagnosed with impetiginized scabies and initiated on a comprehensive management plan. Management strategies included patient and family education on scabies transmission, hygiene measures, and treatment adherence. Topical permethrin 5% cream was prescribed for the patient, applied once nightly for eight hours and repeated after one week, in addition to topical Fusidic Acid cream for active lesions. Systemic cetirizine was administered for symptomatic relief of pruritus. This case underscores the clinical complexities of scabies, especially when complicated by secondary bacterial infection, and highlights the significance of accurate diagnosis and comprehensive management. Furthermore, it emphasizes the need for improved public health measures, including hygiene promotion, environmental decontamination, and access to effective treatments, to mitigate the burden of scabies, particularly in resource-limited settings. This presentation aims to enhance healthcare providers' understanding of impetiginized scabies, facilitate early recognition, and optimize patient outcomes through evidence-based management strategies.
Audience Take Away Notes:
- Understanding the clinical manifestations of impetiginized scabies: Attendees will gain insight into the varied presentations of impetiginized scabies, including typical and atypical features, facilitating early recognition and diagnosis in clinical practiceImplementing effective treatment strategies: The presentation will elucidate evidence-based treatment options for impetiginized scabies, such as topical permethrin, oral antibiotics, and antihistamines, empowering healthcare professionals to make informed decisions in managing this condition
- Enhancing interdisciplinary collaboration: By emphasizing the importance of an interdisciplinary approach involving dermatologists, primary care providers, pharmacists, and nurses, the audience will learn how effective teamwork can optimize patient outcomes and mitigate the spread of scabies within communities
- Promoting community-wide initiatives for prevention: Attendees will explore the socio-economic determinants of scabies prevalence and learn about practical interventions to improve hygiene practices and raise awareness, ultimately contributing to the prevention of scabies outbreaks and reducing the disease burden
- This presentation aligns with the objectives outlined by the World Health Organization (WHO) to address neglected tropical diseases (NTDs), including scabies. By providing insights into the clinical manifestations, treatment strategies, and community-based interventions for impetiginized scabies, the presentation contributes to WHO's broader mission of eliminating NTDs as a public health concern. By raising awareness, promoting interdisciplinary collaboration, and advocating for sustainable prevention and control measures, this presentation actively supports WHO's efforts to reduce the global burden of neglected tropical diseases and improve health equity worldwide
Healthcare professionals can directly apply the knowledge gained from this presentation in their clinical practice by:
- Recognizing and accurately diagnosing impetiginized scabies based on clinical features and microscopic examination
- Selecting appropriate treatment modalities, including topical permethrin, oral antibiotics, and antihistamines, tailored to individual patient characteristics and disease severity
- Collaborating with interdisciplinary team members to implement comprehensive management strategies and promote community-wide initiatives for scabies prevention
Impact on Attendees' Job Performance: This presentation equips healthcare professionals with practical skills and evidence-based strategies to effectively manage impetiginized scabies, thereby improving patient care outcomes, reducing the incidence of complications, and enhancing community health
Potential for Further Research or Teaching: The insights and findings presented offer valuable contributions to both research and teaching endeavors, serving as a foundation for future studies exploring novel treatment modalities, diagnostic approaches, and community-based interventions for scabies control
Practical Solutions and Design Efficiency: The presentation provides a practical solution to the challenges associated with diagnosing and managing impetiginized scabies, offering clear guidance on treatment protocols, interdisciplinary collaboration, and community engagement initiatives. Implementing these strategies can streamline clinical workflows, improve diagnostic accuracy, and optimize patient care delivery
Overall Benefits:
- Improved patient outcomes through early recognition, accurate diagnosis, and timely treatment of impetiginized scabies
- Enhanced interdisciplinary collaboration among healthcare professionals, leading to more efficient and comprehensive patient care
- Contribution to public health efforts by promoting community-wide initiatives for scabies prevention and control
- Potential for further research and teaching in the field of dermatology, infectious diseases, and public health, driving innovation and knowledge dissemination
