Clinical characteristics and treatment outcomes of adult patients with scabies infection: A retrospective cohort study

Abstract

© 2019, SEAMEO TROPMED Network. All rights reserved. Scabies infestations are relatively common. We aimed to identify the clinical manifestations, factors associated with infestation and treatment outcomes by treatment type among adults presenting to the treatment hospital in order to guide future scabies management efforts at the treatment hospital. We retrospectively reviewed the charts of patients aged ≥13 years diagnosed with scabies infestation treated at Siriraj Hospital, Bangkok, Thailand during 2011-2015. A total of 157 patient charts were reviewed. Four patients were excluded from the analysis due to incomplete data. The mean age of the 153 remaining subjects was 43.5 years; 69.9% were males. The most common signs and symptoms were pruritus (86.9%), rash (86.9%) and papules (70.1%). The most commonly affected sites were the web spaces between fingers and toes (60.1%) and the genitalia (59.5%). Four treatment regimens were prescribed: oral ivermectin monotherapy (17.6%), topical benzyl benzoate monotherapy (34.6%) and a combination of oral ivermectin, topical benzyl benzoate (26.1%) and other treatments (21.7%). Of the 107 patients who returned for follow-up, oral ivermectin gave a cure rate of 85%, the combination treatment gave a cure rate of 76% and topical benzyl benzoate alone gave a cure rate of 71.8%, there was no significant difference in cure rates among these three treatment groups (p=0.635). There was no significant difference in median time to cure among the 3 treatment regimens (p=0.231). Our study found no factors associated with cure. Therefore, no treatment regimen tested is preferred above the other regimens tested. Further studies regarding cost, patient acceptability of treatment and patient compliance with treatment are needed to determine if there are other factors that could significantly affect the recommended treatment regimen.