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In resource-poor settings, scabies is associated with considerable morbidity. Which factors determine morbidity and how rapidly it recedes after specific treatment is not known. Patients with scabies were recruited in three urban slums in Fortaleza, Northeast Brazil. Diagnosis was established according to dermatoscopy, skin scraping, or adhesive film test. Severity of scabies-associated morbidity was assessed semiquantitatively. Patients and close contacts were treated with oral ivermectin (200 μg/kg, repeated after 7 days) and followed up for 2 weeks. Ninety-five patients were included in the study. Papules were the most common lesion type (98.9%). Excoriations due to scratching were observed in 43.2% and bacterial superinfection in 24.2%. Predilection sites were the arms (82.1%) and the abdomen (81.1%). At baseline, 36.3% of patients complained about intense or severe itching. Intense or severe itch decreased to 6.3% 2 weeks after treatment (p=0.02). Whereas 37.5% of the patients complained about intense or severe itch-related sleep disturbances at baseline, only 8.8% reported the symptom 2 weeks after treatment (p=0.35). At baseline, the degree of itching was correlated with the degree of sleep disturbance (ρ=0.64; p<0.001). One week after the first dose of ivermectin, the intensity of itching and of sleep disturbance decreased significantly (p<0.001). In patients living in resource-poor setting, scabies was associated with considerable morbidity. Treatment with ivermectin rapidly reconstituted health in almost all cases., (© 2011 Wiley Periodicals, Inc.)

Background: Scabies is highly prevalent in resource-poor communities in developing countries and is associated with considerable morbidity in this setting. How the parasitic skin disease impairs the quality of life of patients has rarely been investigated., Methodology: A modified Dermatology Life Quality Index (mDLQI) was developed to assess the quality of life in adults and children with scabies living in an urban slum in Fortaleza, capital of Ceará State, Brazil. A total of 105 patients with scabies (58 children and 57 adults) were included in the study. The diagnosis was made by dermatoscopy, skin scraping, and adhesive film test., Results: Feelings of shame was the restriction most frequently noted (adults 77.2% and children 46.6%). Other types of quality of life impairment were the need to dress differently (35.1 vs. 29.3%), restriction on leisure activities (24.6 vs. 36.8%), social exclusion (24.6 vs. 17.9%), stigmatization (21.1 vs. 25.0%), teasing (only children: 26.3%), and problems with sexual partners (only adults: 10.9%). Women and girls perceived more restrictions than men and boys. mDLQI scores indicated that 13.9% of the patients noticed a large or very large effect on their life, 65.2% considered their quality of life lightly or moderately reduced by scabies, and 20.9% did not feel any restrictions. The degree of impairment increased parallel to the degree of itching and severity of scabies (P=0.003)., Limitations: Owing to active case finding, most of the patients were in an early phase of scabies, and clinical pathology was not very pronounced., Conclusion: Scabies considerably impaired the quality of life in adults and children living in poverty in an urban slum. Females particularly suffered from restrictions., (© 2012 The International Society of Dermatology.)