Retrospective Evaluation of Misdiagnosed Scabies Cases: Clinical and Epidemiological Features and Resemblance to Other Dermatological Conditions

Fatmagül Gülbaşaran; Özlem Özbağcivan; Samet Öner; Onur Çapkan

Article Details

Retrospective Evaluation of Misdiagnosed Scabies Cases: Clinical and Epidemiological Features and Resemblance to Other Dermatological Conditions

Authors:

Fatmagül Gülbaşaran | Özlem Özbağcivan | Samet Öner | Onur Çapkan

Publisher:

Dokuz Eylul University

Main Topics:

Dermatoloji

Journal:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.37 Issue 3, pp.281-290

Document Type:

Article

Publication Date:

1/2024

Document Language:

English

Document ID (Org No.):

2001310543

pISSN:

2602-3148

Keywords:

Abstract:

 Background and Aim: Diagnosing scabies, a skin condition caused by mites, can be challenging due to its resemblance to other skin problems. Avoiding misdiagnoses could result in a significant reduction in treatment delays and complications. Our objective was to investigate scabies cases that initially posed diagnostic challenges. Methods: This retrospective study focused on scabies patients who were initially misdiagnosed despite routine clinical examinations and underwent histopathological examinations with different preliminary dermatological diagnoses. Inclusion criteria were in accordance with the 2020 International Alliance for the Control of Scabies Diagnosis Criteria. The study retrospectively compiled clinical, histopathological, and demographic characteristics, providing data on the challenges and delays in diagnosing scabies cases that mimic other dermatological conditions. Results: In a cohort of 27 scabies cases with diagnostic challenges, the majority were females 63 with a mean age of 64.815.9 years. Pre-admission, 66.7 of the patients used systemic antihistamines, 52.4 used immunosuppressants, and 42.9 used topical scabies treatment. Secondary xerosis cutis and contact dermatitis were noted in 11.1 and 7.4 of cases. The most frequently considered differential diagnoses by dermatologists included prurigo subacuta 29.6, dermatitis herpetiformis 18.5 , lymphomatoid papulosis 14.8, and vesicularbullous pemphigoid 11.1 . Conclusion: Previous treatments; prolonged infestations leading to severe secondary dermatological problems including prurigo subacuta, contact dermatitis, and xerotic eczema; atypical distribution of lesions; female prurigo; and elderly with prolonged pruritic atypical dermatoses or vesicularbullous presentations should be kept in mind as clinical scenarios that may contribute to a delay in the diagnosis of scabies.

 Background and Aim: Diagnosing scabies, a skin condition caused by mites, can be challenging due to its resemblance to other skin problems. Avoiding misdiagnoses could result in a significant reduction in treatment delays and complications. Our objective was to investigate scabies cases that initially posed diagnostic challenges. Methods: This retrospective study focused on scabies patients who were initially misdiagnosed despite routine clinical examinations and underwent histopathological examinations with different preliminary dermatological diagnoses. Inclusion criteria were in accordance with the 2020 International Alliance for the Control of Scabies Diagnosis Criteria. The study retrospectively compiled clinical, histopathological, and demographic characteristics, providing data on the challenges and delays in diagnosing scabies cases that mimic other dermatological conditions. Results: In a cohort of 27 scabies cases with diagnostic challenges, the majority were females 63 with a mean age of 64.815.9 years. Pre-admission, 66.7 of the patients used systemic antihistamines, 52.4 used immunosuppressants, and 42.9 used topical scabies treatment. Secondary xerosis cutis and contact dermatitis were noted in 11.1 and 7.4 of cases. The most frequently considered differential diagnoses by dermatologists included prurigo subacuta 29.6, dermatitis herpetiformis 18.5 , lymphomatoid papulosis 14.8, and vesicularbullous pemphigoid 11.1 . Conclusion: Previous treatments; prolonged infestations leading to severe secondary dermatological problems including prurigo subacuta, contact dermatitis, and xerotic eczema; atypical distribution of lesions; female prurigo; and elderly with prolonged pruritic atypical dermatoses or vesicularbullous presentations should be kept in mind as clinical scenarios that may contribute to a delay in the diagnosis of scabies.

 Background and Aim: Diagnosing scabies, a skin condition caused by mites, can be challenging due to its resemblance to other skin problems. Avoiding misdiagnoses could result in a significant reduction in treatment delays and complications. Our objective was to investigate scabies cases that initially posed diagnostic challenges. Methods: This retrospective study focused on scabies patients who were initially misdiagnosed despite routine clinical examinations and underwent histopathological examinations with different preliminary dermatological diagnoses. Inclusion criteria were in accordance with the 2020 International Alliance for the Control of Scabies Diagnosis Criteria. The study retrospectively compiled clinical, histopathological, and demographic characteristics, providing data on the challenges and delays in diagnosing scabies cases that mimic other dermatological conditions. Results: In a cohort of 27 scabies cases with diagnostic challenges, the majority were females 63 with a mean age of 64.815.9 years. Pre-admission, 66.7 of the patients used systemic antihistamines, 52.4 used immunosuppressants, and 42.9 used topical scabies treatment. Secondary xerosis cutis and contact dermatitis were noted in 11.1 and 7.4 of cases. The most frequently considered differential diagnoses by dermatologists included prurigo subacuta 29.6, dermatitis herpetiformis 18.5 , lymphomatoid papulosis 14.8, and vesicularbullous pemphigoid 11.1 . Conclusion: Previous treatments; prolonged infestations leading to severe secondary dermatological problems including prurigo subacuta, contact dermatitis, and xerotic eczema; atypical distribution of lesions; female prurigo; and elderly with prolonged pruritic atypical dermatoses or vesicularbullous presentations should be kept in mind as clinical scenarios that may contribute to a delay in the diagnosis of scabies.

 Arka Plan ve Amaç: Akarların neden olduğu bir deri hastalığı olan skabiyezin uyuz tanısı, diğer dermatolojik hastalıklara benzemesi nedeniyle zor olabilir. Yanlış teşhislerden kaçınmak, tedavi gecikmelerinde ve komplikasyonlarda önemli bir azalmaya neden olabilir. Amacımız başlangıçta tanısal zorluklar yaratan uyuz vakalarını araştırmaktı. Yöntem: Bu retrospektif çalışma, rutin klinik muayenelere rağmen başlangıçta yanlış tanı konulan ve farklı dermatolojik ön tanılarla histopatolojik inceleme yapılan uyuz hastalarına odaklandı. Dahil etme kriterlerinde, 2020 Uluslararası Uyuz Kontrolü İttifakı Tanı Kriterlerine uyuldu. Çalışma klinik, histopatolojik ve demografik özellikleri retrospektif olarak derleyerek, diğer dermatolojik durumları taklit eden uyuz vakalarının teşhisindeki zorluklara ve gecikmelere veri sundu. Bulgular: Tanı güçlüğü çeken 27 uyuz vakasından oluşan bir kohortta çoğunluğu kadın 63 ve yaş ortalaması 64,815,9 yıl idi. Başvuru öncesi hastaların 66,7si sistemik antihistaminik, 52,4ü immünsupresan ve 42,9u topikal uyuz tedavisi kullanmıştı. Vakaların sırasıyla 11,1inde ve 7,4ünde sekonder kserozis kutis ve kontakt dermatit kaydedildi. Dermatologlar tarafından en sık dikkate alınan ayırıcı tanılar prurigo subakuta 29,6, dermatitis herpetiformis 18,5, lenfomatoid papüloz 14,8 ve vezikülerbüllöz pemfigoid 11,1 idi. Sonuç: Önceki tedaviler; prurigo subakuta, kontakt dermatit ve kserotik egzama gibi şiddetli sekonder dermatolojik sorunlara yol açan uzun süreli enfestasyonlar; lezyonların atipik dağılımı; kadın prurigosu; ve uzamış kaşıntılı atipik dermatozları veya vezikülerbüllöz prezentasyonları olan yaşlılar, skabiyez tanısının gecikmesine katkıda bulunabilecek klinik senaryolar olarak akılda tutulmalıdır.

Article Details

Retrospective Evaluation of Misdiagnosed Scabies Cases: Clinical and Epidemiological Features and Resemblance to Other Dermatological Conditions

Authors:

Fatmagül Gülbaşaran | Özlem Özbağcivan | Samet Öner | Onur Çapkan

Publisher:

Dokuz Eylul University

Main Topics:

Dermatoloji

Journal:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.37 Issue 3, pp.281-290

Document Type:

Article

Publication Date:

1/2024

Document Language:

English

Document ID (Org No.):

2001310543

pISSN:

2602-3148

Scabies

pruritus

differential diagnosis

histopathological analysis

immunofluorescence microscopySkabiyez

pruritus

ayırıcı tanı

histopatolojik analiz

immünfloresan mikroskopi

Issues

Article Details

Authors: Fatmagül Gülbaşaran | Özlem Özbağcivan | Samet Öner | Onur Çapkan

Publisher: Dokuz Eylul University

Main Topics: Dermatoloji

Journal: Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.37 Issue 3, pp.281-290

Document Type: Article

Publication Date: 1/2024

Document Language: English

Document ID (Org No.): 2001310543

pISSN: 2602-3148

Issues

Authors:

Fatmagül Gülbaşaran | Özlem Özbağcivan | Samet Öner | Onur Çapkan

Publisher:

Dokuz Eylul University

Main Topics:

Dermatoloji

Journal:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.37 Issue 3, pp.281-290

Document Type:

Article

Publication Date:

1/2024

Document Language:

English

Document ID (Org No.):

2001310543

pISSN:

2602-3148