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Evaluation of 1,094 children diagnosed with scabies in Turkey: a 5-year retrospective observational study
Zeynep Üze Okay1, Berker Okay1, Emanet Çelebi1
1University of Health Sciences, Haseki Training and Research Hospital, Department of Pediatrics, Sultangazi, Istanbul, Turkey.
Insights
This study analyzed 1,094 children with scabies, finding variant scabies (crusted and nodular) linked to underlying conditions and hospitalization. Early identification and household management are crucial for preventing scabies re-infection.
Area of Science:
- Pediatrics
- Dermatology
- Infectious Diseases
Background:
- Scabies is a common parasitic skin infestation, particularly affecting vulnerable populations like infants and children in disadvantaged households.
- Understanding scabies phenotypes, associated factors, and outcomes is crucial for effective management.
Purpose of the Study:
- To describe scabies phenotypes, associated factors, treatment patterns, complications, and re-attendance rates in diagnosed children.
- To identify factors associated with variant scabies and hospitalization.
- To inform clinical evaluation and management strategies for pediatric scabies.
Main Methods:
- A single-center retrospective observational cohort study of 1,094 children diagnosed with scabies between March 2018 and March 2023.
- Classification of patients into classic, crusted, or nodular scabies phenotypes.
- Logistic regression analysis to determine factors associated with variant scabies and hospitalization.
Main Results:
- Most scabies cases (67.6%) occurred in fall and winter.
- Variant scabies (crusted and nodular) was observed in 10.1% of patients.
- Underlying disease and younger age were associated with variant scabies and hospitalization; secondary bacterial infections, particularly Staphylococcus aureus, were common in hospitalized children.
- Re-attendance within one year was significantly more frequent in variant scabies cases (p < 0.001).
Conclusions:
- Crusted scabies requires thorough evaluation for underlying conditions and secondary infections.
- Nodular scabies may represent a distinct hypersensitivity-related phenotype.
- Proactive household-level management and follow-up are recommended to reduce scabies recurrence.
Abstract:
Scabies is a common health concern, particularly among infants and children from socioeconomically disadvantaged households. This single-center retrospective observational cohort study describes scabies phenotypes, associated factors, treatment patterns, complications, and 12-month scabies-related re-attendance among diagnosed children between March 2018 and March 2023. Data from 1,094 children living in Turkey were extracted from medical records. Patients were classified as having classic, crusted, or nodular scabies for descriptive analyses; crusted and nodular scabies were combined as variant scabies only for selected regression models. Logistic regression was used to identify factors associated with variant scabies and hospitalization. Most cases occurred in fall and winter (67.6%). Crusted and nodular scabies were identified in 93 (8.5%) and 18 (1.6%) patients, respectively. Underlying abnormalities were reviewed separately for crusted and nodular scabies. Among hospitalized children, 61.5% had variant scabies, and clinically suspected secondary bacterial infection was documented in 77 of 78 hospitalized patients. Cultures were obtained from all hospitalized children; among culture-positive cases, Staphylococcus aureus was the most frequently isolated organism. Among children who re-attended within one year, permethrin was the most frequently documented treatment (92.3% of documented treatments). Underlying disease and younger age were independently associated with variant scabies, whereas underlying disease, variant scabies, and younger age were independently associated with hospitalization. Re-attendance was more frequent in variant scabies (p < 0.001). Crusted scabies warrants careful evaluation for underlying abnormalities and secondary infection, while nodular scabies should be interpreted as a distinct hypersensitivity-related phenotype. These findings support proactive household-level management and follow-up.
