Abstract：
OBJECTIVE: Crusted scabies (CS, Norwegian scabies) is a severe form of scabies, characterized by hyper-infestation of Sarcoptes scabiei mites. CS is commonly associated with immunosuppression but is also reported in overtly immunocompetent individuals. We reviewed immunosuppressive risk factors and comorbidities associated with CS.
METHODS: The National Library of Medicine (PubMed) database was reviewed for patient case reports of CS from January 1998 to July 2023. Two authors screened records for eligibility, extracted data, and one critically appraised the quality of the studies.
BACKGROUND: PROSPERO CRD42023466126.
RESULTS: A total of 436 records were identified, of which 204 were included for systematic review. From these, 683 CS patients were included. CS impacted both genders equally. Adults (21-59 years) were more commonly affected (45.5%) compared to children (0-20 years, 21%). Corticosteroid use was the most prevalent immunosuppressive risk factor identified (27.7% of all cases). About 10.2% of reports were associated with HIV/AIDS, and 8.5% with HTLV-1 infection. 10.5% of patients were overtly immunocompetent with no known risk factors. Overall, 41 (6.0%) died, many subsequent to secondary bacteremia.
CONCLUSIONS: This study represents the first systematic review undertaken on immunosuppressive risk factors associated with CS. This provides insights into trends of immunosuppression and mechanisms of CS development.
METHODS: The National Library of Medicine (PubMed) database was reviewed for patient case reports of CS from January 1998 to July 2023. Two authors screened records for eligibility, extracted data, and one critically appraised the quality of the studies.
BACKGROUND: PROSPERO CRD42023466126.
RESULTS: A total of 436 records were identified, of which 204 were included for systematic review. From these, 683 CS patients were included. CS impacted both genders equally. Adults (21-59 years) were more commonly affected (45.5%) compared to children (0-20 years, 21%). Corticosteroid use was the most prevalent immunosuppressive risk factor identified (27.7% of all cases). About 10.2% of reports were associated with HIV/AIDS, and 8.5% with HTLV-1 infection. 10.5% of patients were overtly immunocompetent with no known risk factors. Overall, 41 (6.0%) died, many subsequent to secondary bacteremia.
CONCLUSIONS: This study represents the first systematic review undertaken on immunosuppressive risk factors associated with CS. This provides insights into trends of immunosuppression and mechanisms of CS development.
摘要：
目标：结痂（CS，挪威sc疮）是sc疮的严重形式，以Sarcoptesscabiei螨的过度侵染为特征。CS通常与免疫抑制有关，但也有明显免疫活性个体的报道。我们回顾了与CS相关的免疫抑制危险因素和合并症。
方法：从1998年1月至2023年7月，对美国国家医学图书馆（PubMed）数据库中的CS患者病例报告进行了审查。两位作者筛选了合格记录，提取的数据，一个人批判性地评价了研究的质量。
背景：PROSPEROCRD42023466126.
结果：确定了436条记录，其中204项被纳入系统审查。从这些,纳入683例CS患者。CS对两种性别的影响相同。成人（21-59岁）比儿童（0-20岁，21%)。使用皮质类固醇是确定的最普遍的免疫抑制危险因素（占所有病例的27.7％）。10.2％的报告与艾滋病毒/艾滋病有关，和HTLV-1感染的8.5%。10.5％的患者具有明显的免疫能力，没有已知的危险因素。总的来说,41人(6.0%)死亡，许多继发于继发性菌血症。
结论：本研究是对与CS相关的免疫抑制危险因素进行的首次系统评价。这提供了对免疫抑制趋势和CS发展机制的见解。
方法：从1998年1月至2023年7月，对美国国家医学图书馆（PubMed）数据库中的CS患者病例报告进行了审查。两位作者筛选了合格记录，提取的数据，一个人批判性地评价了研究的质量。
背景：PROSPEROCRD42023466126.
结果：确定了436条记录，其中204项被纳入系统审查。从这些,纳入683例CS患者。CS对两种性别的影响相同。成人（21-59岁）比儿童（0-20岁，21%)。使用皮质类固醇是确定的最普遍的免疫抑制危险因素（占所有病例的27.7％）。10.2％的报告与艾滋病毒/艾滋病有关，和HTLV-1感染的8.5%。10.5％的患者具有明显的免疫能力，没有已知的危险因素。总的来说,41人(6.0%)死亡，许多继发于继发性菌血症。
结论：本研究是对与CS相关的免疫抑制危险因素进行的首次系统评价。这提供了对免疫抑制趋势和CS发展机制的见解。
