Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter to the Editor - Study Letter
2017:83:4;492-493
doi: 10.4103/ijdvl.IJDVL_1136_16
PMID: 28540869

Clinical characteristics of pruritus in scabies

Kihyuk Shin1 , Hyunju Jin1 , Hyang-Suk You1 , Jeong-Min Kim1 , Woo-Haing Shim1 , Gun-Wook Kim1 , Hoon-Soo Kim1 , Hyun-Chang Ko1 , Moon-Bum Kim2 , Byung-Soo Kim2
1 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
2 Department of Dermatology, School of Medicine, Pusan National University, Busan; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

Correspondence Address:
Byung-Soo Kim
Department of Dermatology, School of Medicine, Pusan National University, Busan, 49241
Korea
How to cite this article:
Shin K, Jin H, You HS, Kim JM, Shim WH, Kim GW, Kim HS, Ko HC, Kim MB, Kim BS. Clinical characteristics of pruritus in scabies. Indian J Dermatol Venereol Leprol 2017;83:492-493
Copyright: (C)2017 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Scabies is caused by the mite Sarcoptes scabiei. Pruritus, the result of a hypersensitive reaction to the eggs, saliva, and fecal components of the mites, is the major symptom of scabies.[1] Furthermore, subsequent excoriation could make an entry point for bacteria, thus, pyoderma is a common complication of scabies.[2] However, the clinical characteristics of pruritus in scabies have not been explored. Itch is difficult to measure due to its subjective nature.[3] So far, few studies have focused on the sensory and affective dimensions of the pruritus experience in scabies. Recently Yosipovitch et al. developed a reliable and reproducible itch questionnaire to evaluate the pruritus in pruritic dermatosis with multi-dimensional approach.[4] This pruritus questionnaire is based on the McGill questionnaire which is the universally accepted questionnaire for pain.[5] In this study, we evaluated the sensory and affective dimensions of the itch experience in scabies patients by utilizing the modified McGill questionnaire.

A face-to-face modified questionnaire based on the McGill pain questionnaire was given to 82 scabies patients who visited Pusan National University Hospital from 1 July 2013 to 31 December 2015. All scabies patients were diagnosed by a dermatologist based on microscopic detection of the mite with skin scrapings. All patients filled out a detailed questionnaire with the aid of an assistant who ensured that the patients understood all the questions. Statistical analysis was performed using SPSS (version 21) for Windows. Spearman's correlation was used for correlation between VAS score for itch and VAS score for sleep disturbance.

Scabies patients comprised 34 men and 48 women with mean age of 52.9 ± 22.8 years and mean disease duration of 3.0 ± 2.7 months.

The most frequently involved areas for pruritus were the groin (62.2%), trunk (51.2%) and axilla (48.8%). Most patients experienced their pruritus before sleep (46.3%) and in the evening (36.6%), rather than in the morning (2.4%) or in the afternoon (3.7%).

Patients reported itch as stinging (73.0%), followed by burning (65.3%) and crawling (61.3%) to a more than mild extent [Table - 1]. Patients rarely perceived their itch as pinching sensation (30.3%). Fifty-one patients reported their itch to be moderately or severely worrisome (62.2%), 42 annoying (51.2%) and 30 bothersome (36.6%). The most common associated symptoms with the itch were heat sensation (47.6%), sweating (17.1%) and pain in the pruritic area (7.3%) [Figure 1a].

Table 1: Sensory dimensional characteristics of itch in scabies patients
Figure 1a: Associated symptoms of itch in scabies patients

The commonest aggravating factors of pruritus given by the patients were heat (40.2%), sweating (26.8%) and stress (18.3%) [Figure 1b]. The most common alleviating factors of pruritus were cool environment (32.9%), concentration to work (30.5%) and bath (28.0%) [Figure 1c].

Figure 1b: Aggravating factors of itch in scabies patients
Figure 1c: Alleviating factors of itch in scabies patients

The mean pruritus intensity assed by visual analogue scale (VAS) is 7.2 ± 2.0 and mean VAS score for sleep disturbance is 6.8 ± 2.4. There was correlation between VAS score for itch and VAS score for sleep disturbance (r = 0.6831, P< 0.0001) [Figure - 2].

Figure 2: Correlation between visual analogue scale score for itch, and visual analogue scale score for sleep disturbance in scabies patients

Our findings reveal multidimensional characteristics of pruritus in scabies, most frequently involved being groin with stinging sensation. Pruritus in scabies is aggravated with heat and alleviated with cool environment. Less than a quarter of our scabies patients (17.1%) visited our department during the winter season (from December to February), and it could be consequences of alleviated pruritus in cool environment. Considering that most scabies patients experienced pruritus before sleep, it is a reasonable result that VAS score for itch is positively correlated with VAS score for sleep disturbance [Figure - 2].

To our knowledge, there is only one previous report that investigated itch characteristics of scabies patients.[4] However, the previous report may be limited by the patient number (n = 19). They compared itch characteristics among five dermatoses, thus they did not solely focus on scabies.

Herein, we investigated the multidimensional qualitative features of pruritus in scabies using questionnaire adapted from previous questionnaires. Considering the clinical importance of itch in scabies, understanding the previously uninvestigated qualitative features of itch in scabies could support a clinical diagnosis and treatment of scabies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References
1.
Heukelbach J, Feldmeier H. Scabies. Lancet 2006;367:1767-74.
[Google Scholar]
2.
Wong LC, Amega B, Connors C, Barker R, Dulla ME, Ninnal A, et al. Outcome of an interventional program for scabies in an indigenous community. Med J Aust 2001;175:367-70.
[Google Scholar]
3.
Yosipovitch G, Ansari N, Goon A, Chan YH, Goh CL. Clinical characteristics of pruritus in chronic idiopathic urticaria. Br J Dermatol 2002;147:32-6.
[Google Scholar]
4.
Yosipovitch G, Goon AT, Wee J, Chan YH, Zucker I, Goh CL. Itch characteristics in Chinese patients with atopic dermatitis using a new questionnaire for the assessment of pruritus. Int J Dermatol 2002;41:212-6.
[Google Scholar]
5.
Melzack R. The McGill pain questionnaire: Major properties and scoring methods. Pain 1975;1:277-99.
[Google Scholar]

Fulltext Views
2,144

PDF downloads
1,203
Show Sections