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Scabies in healthcare settings

Bouvresse, Sophiea; Chosidow, Oliviera,b

Current Opinion in Infectious Diseases: April 2010 - Volume 23 - Issue 2 - p 111–118
doi: 10.1097/QCO.0b013e328336821b
Skin and soft tissue infections: Edited by Roderick J. Hay

Purpose of review In industrialized countries, epidemics of scabies are mainly described within families or in institutions such as healthcare settings. Control of institutional scabies is associated with a considerable working and economic burden, but guidelines for the management are scarce.

Recent findings The prevalence of institutional scabies is probably underestimated. Identified risk factors for institutional scabies outbreaks include the institution type, extensive physical contact with patients and movement of patients, the existence of crusted scabies, a long diagnostic delay and failures in implementation of infection control or treatment plans.

Atypical clinical features (hyperinfestation, scabies in the elderly or in children) may be misdiagnosed.

Control of institutional scabies outbreaks relies on prompt recognition of the index case, constitution of an outbreak management team, determination of the extent of the outbreak and risk factors for spread, immediate implementation of infection control practices, adequate education of all involved persons, simultaneous treatment of cases and of all exposed individuals and concomitant environmental disinfection. Prolonged surveillance is imperative to eradicate scabies.

Summary The inclusion of institutionalized patients in randomized controlled trials would be beneficial as present data concerning scabicide effectiveness are obtained from trials that recruited individual participants and do not take into account a global strategy.

aDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France

bUniversité Pierre et Marie Curie, Paris, France

Correspondence to Olivier Chosidow, Department of Dermatology, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France Tel: +33 1 49 81 25 01; fax: +33 1 49 81 25 08; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.