Scabies: Clinical Pearls for Community Dermatologists

Authors

  • Patrick Fleming, BSc (Nutrition), MSc (Community Health), MD, FRCPC University of Toronto Dermatologist and Clinical Trials Investigator, York Dermatology & Research Centre

DOI:

https://doi.org/10.58931/cdt.2025.63146

Abstract

Scabies is a common parasitic skin infestation caused by Sarcoptes scabiei var. hominis, with an estimated global burden of over 200 million cases annually. Scabies remains underdiagnosed and can often be challenging to manage. Institutional outbreaks, diagnostic delays, and treatment failures contribute to ongoing morbidity. This practical literature review summarizes clinical pearls for community dermatologists, integrating recent diagnostic frameworks, treatment evidence, and evolving considerations related to drug resistance and public health control.

Author Biography

Patrick Fleming, BSc (Nutrition), MSc (Community Health), MD, FRCPC, University of Toronto Dermatologist and Clinical Trials Investigator, York Dermatology & Research Centre

Dr. Patrick Fleming is a certified dermatologist practicing in Toronto and an Assistant Professor of Medicine at the University of Toronto. He is a clinical associate at University Health Network where he sees inpatient consultations. Dr. Fleming works actively at Toronto-based COVID-19 Assessment and Vaccination Centres. He holds a master’s degree in community health and also completed the Global Clinical Scholars program in advanced epidemiology at Harvard Medical School. He is a fellow of the Royal College of Physicians and Surgeons of Canada and the Canadian Dermatology Association. He is a member of the editorial board of the Journal of Cutaneous Medicine and Surgery and Board of Governors for the Canadian Dermatology Foundation.

References

Schneider S, Wu J, Tizek L, Ziehfreund S, Zink A. Prevalence of scabies worldwide-an updated systematic literature review in 2022. J Eur Acad Dermatol Venereol. 2023;37(9):1749–1757. doi:10.1111/jdv.19167

Engelman D, Yoshizumi J, Hay RJ, Osti M, Micali G, Norton S, et al. The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. Br J Dermatol. 2020;183(5):808–820. doi:10.1111/bjd.18943

Meyersburg D, Hoellwerth M, Brandlmaier M, Handisurya A, Kaiser A, Prodinger C, et al. Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial. Br J Dermatol. 2024;190(4):486–491. doi:10.1093/bjd/ljad501

Mbuagbaw L, Sadeghirad B, Morgan RL, Mertz D, Motaghi S, Ghadimi M, et al. Failure of scabies treatment: a systematic review and meta-analysis. Br J Dermatol. 2024;190(2):163–173. doi:10.1093/bjd/ljad308

Levy M, Martin L, Bursztejn AC, Chiaverini C, Miquel J, Mahé E, et al. Ivermectin safety in infants and children under 15 kg treated for scabies: a multicentric observational study. Br J Dermatol. 2020;182(4):1003–1006. doi:10.1111/bjd.18369

Richards RN. Scabies: diagnostic and therapeutic update. J Cutan Med Surg. 2021;25(1):95–101. doi:10.1177/1203475420960446

Goldstein BG, Goldstein RP. Scabies: management: Wolters Kluwer; 2022 [updated October 31 2022, cited June 5 2025]. Available from: https://www.uptodate.com/contents/scabies-management.

Centers for Disease Control and Prevention. Clinical care of scabies: U.S. Department of Health & Human Services; 2023 [updated December 18 2023, cited June 5 2025]. Available from: https://www.cdc.gov/scabies/hcp/clinical-care/index.html.

Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: scabies. J Am Acad Dermatol. 2020;82(3):533–548. doi:10.1016/j.jaad.2019.05.109

Goldstein BG, Goldstein AO. Scabies: epidemiology, clinical features, and diagnosis: Wolters Kluwer; 2024 [updated July 17 2024, cited June 5 2025]. Available from: https://www.uptodate.com/contents/scabies-epidemiology-clinical-features-and-diagnosis.

Seiler JC, Keech RC, Aker JL, Miller W, Belcher C, Mettert KW. Spinosad at 0.9% in the treatment of scabies: efficacy results from 2 multicenter, randomized, double-blind, vehicle-controlled studies. J Am Acad Dermatol. 2022;86(1):97–103. doi:10.1016/j.jaad.2021.07.074

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Published

2025-09-18

How to Cite

1.
Fleming P. Scabies: Clinical Pearls for Community Dermatologists. Can Dermatol Today [Internet]. 2025 Sep. 18 [cited 2025 Sep. 19];6(3):20–24. Available from: https://canadiandermatologytoday.com/article/view/6-3-Fleming

Issue

Volume 6, Issue 3, Fall 2025

Section

Articles