IMPACT OF DEMONSTRATION OF EXTRACTED SARCOPTES SCABIEI TO PATIENTS ON THERAPEUTIC OUTCOME IN SCABIES

Sarcoptes Scabiei

Abstract

Objective: To evaluate the impact of demonstration of extracted Sarcoptes scabiei to patients on therapeutic outcome.
Study Design: Quasi experimental study
Place & Duration of study: Department of Dermatology, PNS Shifa Karachi, from Jan 2007 to Dec 2007.
Patients and Methods: Sixty patients (36 males, 24 females) with scabies of upto two months duration were included in the study. Patients with other concomitant chronic illnesses and those who had been treated with antiscabies medicines in previous two months were excluded. After informed consent and initial evaluation, diagnosis was confirmed in all the patients by extracting living Sarcoptes scabeii. The mite was extracted after direct identification under a magnifying lens with the help of a sterilized common pin. All patients were fully explained about the disease and method of treatment. Half of the patients (group 1) were shown the extracted living mite under microscope while remaining patients (group 2) were just informed about the disease and mite was not shown to them. Twenty four hour application of 5% permethrin cream (Lotrix) was prescribed for patients as well as their families. Response to treatment was recorded at the end of 2nd and 6th week. Patients with living mites in the lesions during follow up visit were again prescribed 5% permethrin cream after showing them and/or their attendants the extracted living mite.
Results: At follow-up visit after two weeks 12 (40%) patients of group one were having itching but no mite could be extracted from the resolving lesions while in group two, 14 (46.7%) patients were having itching (p>0.05). Treatment failed in six (20%) patients of group two who were found to have living mites in lesions. All patients of both groups were symptom free at the end of six weeks though some had a few residual resolving nodules on genitalia but no mite could be extracted.
Conclusion: Convincing the patient about the nature of scabies by showing him the extracted mites at the time of diagnosis significantly improves treatment compliance.
Keywords: Scabies, permethrin, sarcoptes scabiei