The Ewha Medical Journal
Ewha Womans University School of Medicine
Guidelines

Clinical practice guidelines for the diagnosis and treatment of scabies in Korea: Part 1. Epidemiology, clinical manifestations, and diagnosis — a secondary publication

Park Jin1, Soon-Hyo Kwon2, Young Bok Lee3, Hei Sung Kim4, Jie Hyun Jeon5, Gwang Seong Choi6,*
1Department of Dermatology, Jeonbuk National University Medical School, Jeonju 54907, Korea.
2Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Korea.
3Department of Dermatology, The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, Seoul 11765, Korea.
4Department of Dermatology, The Catholic University of Korea, Incheon St. Mary’s Hospital, Seoul 21431, Korea.
5Department of Dermatology, Korea University Guro Hospital, Seoul 08308, Korea.
6Department of Dermatology, Inha University Hospital, Incheon 22332, Korea.
*Corresponding Author: Gwang Seong Choi, Department of Dermatology, Inha University Hospital, Incheon 22332, Korea, Republic of. E-mail: garden@inha.ac.kr.

© Copyright 2024 Ewha Womans University School of Medicine. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Oct 13, 2024; Accepted: Oct 13, 2024

Published Online: Oct 31, 2024

Abstract

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient’s age, health status, the number of mites, and the route of transmission. Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.

Keywords: Diagnosis; Epidemiology; Practice guideline; Sarcoptes scabiei; Scabies