Experts warn against scabies, which is a skin disease caused by microscopic scabies that nest in the upper layer of the skin and causes intense itching. Prof. Dr. Burhan Engin, Prof. Dr. Haluk Çokuğraş and Prof. Dr. Hikmet Tekin Nacaroğlu spoke about the frequency of scabies cases in recent days. Experts gave information about the symptoms, diagnosis and treatment processes of scabies and warned about what to do. It was noted that there has been an increase in the number of cases recently, and warnings were made to citizens.
Cerrahpaşa Faculty of Medicine, Department of Skin and Venereal Diseases, Lecturer Prof. Dr. Burhan Engin said, “We can say that there has been an increase again for 2-3 months. We started to see him frequently in the daily outpatient clinic. We have many patients who have been treated and whose cases have flared up again. There is an increase in this period, we will see if it will continue in the summer. We can say that there is a risk in every environment where there is close contact. The patient, who was previously diagnosed with scabies, subsequently uses the drug many times, sometimes taking it himself. “The drug can also cause skin irritation and eczema, which can be confused with scabies,” he said.
“There has been an increase again for 2-3 months, we have started to see them frequently in the polyclinic”
Speaking about the scabies cases they have encountered recently, Dermatology Specialist Prof. Dr. Burhan Engin said, “Actually, this increase has been around for a long time. There was an increase both during the pandemic period and before the pandemic. In the last few months, it seemed like there was a downward trend, we started to see fewer cases that were at least resistant. We can say that there has been an increase again in the last 2-3 months. We started to see him frequently again in the daily outpatient clinic. In fact, the majority of resistant cases are cases where the treatment has not been fully applied or the scabies have not completely disappeared, cases with vague itching, and cases that have received treatment before.
For example; Some come, they started 3 months ago, some started 1 year ago, they used treatments. Scabies medications approved and paid for by the state are used orally. We have many patients who come to us like this, as if they had had this attack before, they or their family members were treated, the itching seemed to subside, and the case flared up again. Our biggest problem here is; improper treatment. The clothes he wears, his social environment, and his home environment also need to be disinfected. Scabies most commonly occurs in more hidden, closed areas of the body, such as the genital and abdominal areas. Especially when you ask patients, they say it but they don’t express it in the other way, they may be a little more hesitant. “Patients can hide this situation a little longer and postpone it, so it is important for them to contact the physician,” he said.
“THE PATIENT SHOULD USE MEDICATION ON HIS OWN”
Prof. Dr. said that the person diagnosed with scabies should also consult a specialist with whom he/she is in contact and his/her close circle. Dr. Engin continued his words as follows:
“Whether family members have similar complaints or not, sometimes they do not have any complaints, and family members say, ‘I have no complaints, so I do not need to use it.’ But we know this; family members and people in contact with it are also infected. Afterwards, lesions may appear, and sometimes they may not. Just because it doesn’t come out doesn’t mean it doesn’t carry it. It’s not like ‘I’m very clean, scabies won’t infect me’. The scabies mite is important here. This can be in social life, at work, at home, it can also be transmitted to people who are very careful about their hygiene. We can say that contamination may occur and close contact is important, but there is an increase in this period, let’s see if this will continue in the summer.
We can say that there is a risk in every environment where there is close contact. We used to use mixed creams before and the patient applied them to their entire body. We also apply them to some patients. It seems to be a little easier to eradicate scabies with medications. We see cases of scabies almost every day. It is very important that they comply with the treatment. We also started to see the following; The patient, who was previously diagnosed with scabies, then uses the medicine many times, sometimes taking it himself. That medicine can also cause skin irritation and eczema, which can be confused with scabies. We see many cases like this. I recommend that they listen to their doctors carefully and treat them accordingly, and not take too much medication on their own, because eczema can be triggered along with scabies. Then, when the drug is given again and again, this enters a vicious circle.”
“THERE ARE SERIOUS CASES OF SCABE IN OLD AND SMALL CHILDREN TOO”
Pediatric Allergy and Immunology Specialist Prof. said that they frequently encounter scabies cases in children. Dr. Haluk Çokuğraş said, “Unfortunately, since the end of this pandemic, there have been very serious cases of scabies, especially in older and younger children, for 2 years. Some of these can actually be confused with food allergies, but they shouldn’t be confused at all. Scabies is a very itchy disease, allergic diseases can also be itchy. Scabies is particularly common in areas such as the hands, between the fingers, and around the navel. If you look carefully, the scabies bug has some tunnels under the skin; Tunnels are formed in which the patient moves and walks, and diagnosis can be made by seeing them. An itch occurs during the movement of the insect, it is a really serious itch. It increases even more at night, we need to question this; Is there anyone else in the house who is itchy?
Indeed, such cases occur, the child has been diagnosed with food and milk allergy, but the whole family at home is itchy. If you don’t ask, they won’t tell you, you have to ask. It’s a very annoying disease, the worst part is; These scabies cases that have existed for the last 2 years are quite resistant cases. There are many cases that are resistant to classical treatments, of course, our dermatologist friends are mostly interested in this. When something like this happens, it is necessary to pay close attention to hygiene conditions. Laundry and bedding must be boiled, and the medicines given must be used very accurately and properly. Unfortunately, there is an increase in scabies cases in our country, as in the rest of the world. Of course, contamination may occur when other people use the clothes used by these people. Domestic transmission is very important. “It can happen through wearing and taking off in shopping places, places where clothes are sold, but of course the real contamination happens at home and sometimes in schools,” he said.
“OTHER THAN ALLERGY, THE SCABE EPIDEMIC MUST NOT COMES TO MIND”
Pediatric Allergy and Immunology Specialist Prof. says that scabies can sometimes be confused with other diseases. Dr. Hikmet Tekin Nacaroğlu said, “We started to see it very frequently, and sometimes it can be confused with allergies. If there is itching, which increases especially at night, if other members of the family also have complaints of itching, and if there are some localized lesions in areas such as the palms, soles of the feet, and armpits, then a scabies epidemic must be considered in addition to allergy. Another important point is that, in the current period, we have started to see the rash associated with the fifth disease, which we call parvoviris, very frequently. With the use of shared pools in the summer months, viral rash diseases such as hand, foot and mouth disease are becoming more common. Especially in this regard, we should not confuse it with allergies.
If there is involvement of the palms and soles of the feet, hand, foot and mouth disease may come to mind, and attention should be paid to this. Unfortunately, viral infections are becoming increasingly common as a result of pool usage increasing with the summer months and therefore shared use. The mother and father are itching, and the child has rashes. Mistakenly, these are called food allergies. Mothers of our very young 3-4 month old children come to us by eliminating milk, eggs, wheat, nuts and many other foods from their diet. This deteriorates the quality of breast milk. When they say it’s scabies, they think it has something to do with cleanliness and themselves, when in fact it’s not such a thing. Scabies infection can occur even when you are trying on clothes outside. Therefore, it is not a mistake made regarding cleaning at home. “It is not a situation to be afraid or ashamed of, it is a condition that can be treated,” he said. (IHA)
