Farmacoriflessioni
Trattamento della scabbia
Sapigni E, Nigro R, Mattei G, Matteo G, Di Nuzzo S, Motolese A, Corazza M, Conti A, Marchetti F.
Giugno 2025 - pagg. 381 -387 | DOI: 10.53126/MEB44381
Abstract
Scabies, a parasitic dermatosis caused by Sarcoptes scabiei, is classified by the World Health Organization as a neglected tropical disease due to its global burden. In recent years, the Emilia-Romagna Region has reported a significant increase in scabies cases, with higher incidence among males, children, adolescents and young adults. This guideline aims to provide evidence-based recommendations for the diagnosis, treatment and management of scabies, by focusing on target populations and types of scabies, with specific consideration for paediatric patients. The guideline was developed by a multidisciplinary team of dermatologists, paediatricians, public health officials and pharmacists from the Emilia-Romagna Region. It is based on systematic reviews, meta-analyses and international guidelines published in the last six years (2019-2024). Permethrin 5% topical cream remains the first-line therapy. Benzyl benzoate and oral ivermectin are effective alternatives in selected cases; oral ivermectin is specifically recommended for treating large groups or patients with extensive eczema. Crusted scabies requires a combination of topical and systemic agents, along with keratolytics. Early treatment of close contacts and a structured two-week follow-up are also recommended. A practical section on paediatric topical application is included to assist caregivers and improve compliance. This guideline supports healthcare professionals in the standardised management of scabies and emphasizes the need for effective interventions to address the rising incidence of cases.
Riassunto
La scabbia, una dermatosi parassitaria causata da Sarcoptes scabiei, ่ classificata dall'Organizzazione Mondiale della Sanitเ come malattia tropicale trascurata a causa della sua diffusione globale. Negli ultimi anni, la Regione Emilia-Romagna ha segnalato un aumento significativo dei casi di scabbia, con una maggiore incidenza tra maschi, bambini, adolescenti e giovani adulti. Queste linee guida mirano a fornire raccomandazioni basate sull'evidenza per la diagnosi, il trattamento e la gestione della scabbia, concentrandosi sulle popolazioni target e sui tipi di scabbia, con particolare attenzione ai pazienti pediatrici. Le linee guida sono state sviluppate da un team multidisciplinare di dermatologi, pediatri, funzionari della sanitเ pubblica e farmacisti della Regione Emilia-Romagna. Si basano su revisioni sistematiche, metanalisi e linee guida internazionali pubblicate negli ultimi sei anni (2019-2024). La crema topica a base di permetrina al 5% rimane la terapia di prima linea. Il benzoato di benzile e l'ivermectina orale rappresentano alternative efficaci in casi selezionati; l'ivermectina orale ่ specificamente raccomandata per il trattamento di gruppi numerosi o pazienti con eczema esteso. La scabbia crostosa richiede una combinazione di agenti topici e sistemici, insieme a cheratolitici. Si raccomandano anche il trattamento precoce dei contatti stretti e un follow-up strutturato di due settimane. ศ inclusa una sezione pratica sull'applicazione topica pediatrica per assistere i caregiver e migliorare l'aderenza alla terapia. Questa linea guida supporta gli operatori sanitari nella gestione standardizzata della scabbia e sottolinea la necessitเ di interventi efficaci per affrontare la crescente incidenza dei casi.
Parole chiave
Classificazione MeSH
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Bibliografia
di riferimento
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