The hidden face of scabies

Globally, scabies affects more than 200 million people at any time. Prevalence estimates in the recent scabies-related literature range from 0.2% to 71%. The treatment of scabies is now neglected in Latvia and there is a possibility, that self-treatment with 4% permethrin (5% permethrin elsewhere in the world) is present. Scabies diagnosis and treatment has a number of unresolved weaknesses, which consequences are not always evaluated. The aim of this study is Scabies related issue update and validity of Scabies excluded from “Reportable Sexually Transmitted Diseases (STDs)"  in Latvia. As of today available literature in databases, epidemiological data, regulatory documents and guidelines were gathered and clinic's experience in scabies care was evaluated. Is scabies really familiar to us - problems are caused by pure human scabies, coincidence with itchy and papuloskvamous dermatoses and treated scabies. There is no understanding in new “2020 IACS Criteria for the Diagnosis of Scabies” about necessity for microscopic diagnosis and the use of dermatoscope for visualisation. Immunohistochemical, confocal examination, biopsy are not used. For the treatment is used a product with 20% lower active ingredient content – 4% permethrin,that is longer enough and should be used longer than 5% permethrin. Therapy mainly is symptomatic, and is done without diagnosis. There is no epidemiological observation performed in closely populated groups of people. Consequences: irritated skin becomes the entrance gate for infection (streptococci etc.) allergens. Sensitization occurs with the following auto-aggressive reaction, including eczema, psoriasis, glomerulonephritis, chronic renal failure and rheumatic fever. Previous low cases of scabies can be explained by: the direct unavailability of a dermatologist, the absence of epidemiological reports and the replacement of diagnosis of scabies with "dermatitis". The increase of allergic conditions can also be associated with ignored scabies.