Nowadays, most and least who has heard of scabies, also called scabies, even if only through the well-known saying Itching With pleasure it does not sting, This disease is an ‘old’ acquaintance, so much so that the Greeks and Romans already theorized about it. However, this did not happen until 1687 when an Italian doctor, giovanni cosimo bonomoParasites were thought to be responsible for these itches and were later described as Sarcoptes scabiei. Since then, humans have been struggling to find a way to end it.
The matter is not an easy task. Although many people believe that itching is a thing of the past, The war continues even in our days, to such an extent that dermatologists are seeing an increase in cases of this disease. “For a decade, in different countries in Europe, we believe we are seeing an increase in the number of cases diagnosed,” says Cristina Galván, vice president and member of the International Alliance for the Control of Scabies (IACS). Fight Against Infection Foundation.
The reasons for this increase are not very clear. There are suspicions that this is a multifactorial phenomenon, driven by two realities that dermatologists point out. First, the aging population: “Our elders are living longer, but their defenses also become older. People who lose the ability to protect themselves against mites have a greater ability to spread disease. Second, all population movement This is what the continent is experiencing in recent years and this gives rise to large groups of people coexisting in inadequate conditions.
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Galván is also the author of a recent study promoted by the Spanish Academy of Dermatology and Venereology (AEDV) on the clinical and epidemiological characteristics of patients suffering from this disease in our country. according to investigation typical scabies This is the most common form in Spain. There is no discrimination based on gender and, although the distribution by age is wide, there is still an impact Predominance in younger patients,
resistance to scabicides
The document also provides a very interesting conclusion about the heated debate surrounding scabies: various sources support the idea that the increase in incidence can be explained by a Mite resistance to scabicides (Cream) First line indicated. In fact, among the patients analyzed, it was found that “a high proportion of cases had received previous scabicide treatment for the current episode, without achieving its resolution”, but among them, a much higher percentage I didn’t treat it properly,
“It is true that in our study and in some others, many shortcomings have been found in the completion of treatment. And this does not surprise me, because it is cumbersome, requires a lot of explanations and it has to be done thoroughly and all “Should be done by the cohabitant at the same time,” comments the dermatologist. However, he clarifies: “Noting the shortcomings in the completion of treatment gives us hope in knowing that we can Greatly improve information and monitoring Which we give to patients. But this does not allow us to say for sure whether the drug is effective or not.”
To analyze the effectiveness of treatments against scabies in the laboratory, experts face huge difficulties, because this mite knows how to live only on the skin of living humans. “The reality is that all doctors We suspect that the medicines may have lost their effectBut formal studies, at the moment, do not prove this,” Galvan continues.
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The study also cannot understand actual incidence data, which is one of the main obstacles to scabies. A report by the National Epidemiology Center study of the Carlos III Health Institute in Madrid and the National Center for Tropical Medicine confirmed in 2021 A rising trend since 2014, but these are just guidelines. As the dermatologist explains, there are no official data in Spain, since it is not a notifiable disease: “Some indirect data, such as the increase in sales of medicines against scabies, support this idea. However, we There are no real figures “.
According to data provided by the Ministry of Health on the consumption of prescription drugs in pharmacies charged to the National Health System, the sales of permethrin cream -A Main directions of action against the disease, has skyrocketed in the last decade. While a total of 60,480 units were delivered in 2012, This figure will reach 593,330 in 2022, Translated into percentage, this represents an increase of 881.04%.
great global cargo
Meanwhile, the doctor argues that, globally, there are estimates based on mathematical models that say the prevalence is 200 million cases and the incidence is 455 million people per year. In fact, according to the previous global burden (2019) Of the LancetAmong all the diseases affecting the skin, itching and acne are prominent. about what bad bug never dies Makes more sense than ever. The question is, why is it so difficult to get rid of itching?
“It’s certainly not due to any one factor,” Galvan predicts. “For me, one of the most influential silent treatment of sarcoptes scabiei, the mite that causes it. The first time a person is infected, the mite appears on his skin, but it begins Feeling itching and skin changes after several weeks, between two and six. “During this time, he does not seek medical attention or take precautionary measures to avoid infecting others.”
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Marta’s case perfectly illustrates the latter. He contracted the disease in a hostel in Berlin and symptoms began after some time. “The first thing I remember was The skin cracks and itches a lot“The young woman never suspected it might be scabies, until her partner at the time told her he had gone to the doctor and they had been diagnosed with it. “I was surprised when she told me, because I thought this couldn’t happen anymore“He confesses.
The belief that it is a disease of the past is another best means for the disease to proceed secretly. sarcoptes scabiei, apart from the slab of stigma. Related to unhealthy environments, there is a tendency to think that this is something that just happens in the worst families, “People who are affected by this communicable disease Have to face situations of contempt and stigma Because of that misunderstanding. Galvan claims that scabies can affect people from any country in the world, of any age, gender or ethnicity and regardless of hygiene-hygiene status.
What is scabies transmitted by? direct and prolonged skin-to-skin contact, Therefore, it is logical that people who do not have access to decent housing or who share living space are at a higher risk of getting infected if anyone around them is affected. Covid is a perfect example of how this can happen. As dermatologists confirm, although the surge in cases of scabies was noticeable before the pandemic, during it Imprisonment This increase is more impressive.
All of the above creates a breeding ground that provides guidance towards this ancient problem. However, the debate cannot be ended without talking about one important factor: a disease improves as long as resources are allocated for it. At this point, the doctor dares to give a very personal opinion: “Many less troublesome diseases and with much lower global incidence generate many more research initiatives, drug developments and control measures. Scabies affects even more intensely for disadvantaged populations. And it never happened, nor does it seem like it will or will happen trend neither Diana of investment from which further economic benefits can be derived”.
Sadly, if the itching does not go away, secondary bacterial infection is guaranteed. “This infection, persistent, is known to cause malnutrition in children and is Major cause of kidney and heart failure In low-income countries,” the expert laments. In addition, she also points to the unbearable itching, which is capable of affecting the quality of life and the psychological sphere of those who suffer from it.