Scholarlink

<p>In classic scabies, mite burden is typically low, whereas crusted scabies exhibits massive infestation. During recent surges in presentations, we observed immunocompetent patients with non-crusted scabies referred for persistent or relapsing symptoms after standard topical therapy, who appeared to carry higher burdens. We aimed to estimate the frequency of a pragmatic high-load scabies phenotype among patients presenting with apparent topical treatment failure and to summarize its clinical features and outcomes. In a prospective, multicenter cohort across 10 dermatology centers in Türkiye, we enrolled patients with suspected scabies who had persistent or relapsing symptoms despite standard therapy and fulfilled a predefined high-load phenotype (≥ 50 mite-confirmed burrows on dermoscopy). The primary endpoint was Day-28 dermoscopic clearance, defined as no mites/ova and no new burrows at index sites. At baseline, all burrows were counted under a shared standard operating procedure (SOP). High-load scabies was defined a priori as ≥ 50 burrows. Of 3,316 patients screened, 76 (2.3%) met the high-load definition. The cohort comprised 42 men (56.1%) and 34 women (43.9%) with a mean age of 30.24 years. Baseline burrow counts ranged 50–400 (mean 86). Age showed a moderate positive association with burrow count (Spearman’s ρ = 0.365, <i>p</i> &lt; 0.01), whereas sex and household high-load history were not associated (both <i>p</i> &gt; 0.05). In routine care, combined oral ivermectin plus topical therapy was associated with clinical clearance in 89% (<i>n</i> = 68/76) of these high-load cases. This observation reflects outcomes among patients presenting after apparent topical treatment failure and does not establish a causal role of mite burden in treatment failure or transmission. This multicenter cohort defines a pragmatic high-load scabies phenotype (≥ 50 dermoscopically counted burrows) that lies between classic and crusted disease. Routine dermoscopy allowed pragmatic burden stratification in this cohort; in patients meeting the ≥ 50-burrow definition, combined oral and topical therapy was associated with high clearance in routine care.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Beyond classic vs. crusted: the high-load non-crusted scabies phenotype in a prospective multicenter cohort

  • 期刊论文

  • 发表日期：

    2026年4月6日

查看全文
  • Aslan Yurekli,
  • Murat Durdu,
  • Gozde Simsek,
  • Selami Aykut Temİz,
  • Burak Akşan,
  • Sevgi Kulakli,
  • Fatma Etgü,
  • İlkay Can,
  • Sema Aytekİn,
  • Ülker Gül,
  • Özlem Su Küçük,
  • Suzan Demİr,
  • Emine Tuğba Alataş,
  • Tuğba Tehçİ,
  • Işıl Deniz Oğuz,
  • İlayda Muslu,
  • Melisa Özay

摘要

In classic scabies, mite burden is typically low, whereas crusted scabies exhibits massive infestation. During recent surges in presentations, we observed immunocompetent patients with non-crusted scabies referred for persistent or relapsing symptoms after standard topical therapy, who appeared to carry higher burdens. We aimed to estimate the frequency of a pragmatic high-load scabies phenotype among patients presenting with apparent topical treatment failure and to summarize its clinical features and outcomes. In a prospective, multicenter cohort across 10 dermatology centers in Türkiye, we enrolled patients with suspected scabies who had persistent or relapsing symptoms despite standard therapy and fulfilled a predefined high-load phenotype (≥ 50 mite-confirmed burrows on dermoscopy). The primary endpoint was Day-28 dermoscopic clearance, defined as no mites/ova and no new burrows at index sites. At baseline, all burrows were counted under a shared standard operating procedure (SOP). High-load scabies was defined a priori as ≥ 50 burrows. Of 3,316 patients screened, 76 (2.3%) met the high-load definition. The cohort comprised 42 men (56.1%) and 34 women (43.9%) with a mean age of 30.24 years. Baseline burrow counts ranged 50–400 (mean 86). Age showed a moderate positive association with burrow count (Spearman’s ρ = 0.365, p < 0.01), whereas sex and household high-load history were not associated (both p > 0.05). In routine care, combined oral ivermectin plus topical therapy was associated with clinical clearance in 89% (n = 68/76) of these high-load cases. This observation reflects outcomes among patients presenting after apparent topical treatment failure and does not establish a causal role of mite burden in treatment failure or transmission. This multicenter cohort defines a pragmatic high-load scabies phenotype (≥ 50 dermoscopically counted burrows) that lies between classic and crusted disease. Routine dermoscopy allowed pragmatic burden stratification in this cohort; in patients meeting the ≥ 50-burrow definition, combined oral and topical therapy was associated with high clearance in routine care.