Skin Infestations in the Diabetic Patients: Scabies

Scabies is a neglected tropical disease caused by an infestation of Sarcoptes scabiei var. hominis. Various studies highlight the close association between crusted scabies and diabetes mellitus. In immunocompromised patients, such as diabetic patients, there are immunosuppression and reduced skin sensation which facilitate crusted scabies development. Classic scabies presents as itchy skin lesions in typical distribution areas, while crusted scabies manifests as generalized hyperkeratotic skin lesions with thick crusts and numerous fissures. While classic scabies presents with intense pruritus, the pediatric population and crusted scabies patients are reported to have less intense pruritus. Classic scabies can be diagnosed based on the criteria developed by the International Alliance for the Control of Scabies, and the severity classification can be determined based on the criteria developed by Davis et al. Treatment failure can occur while treating scabies. Hence, comprehensive treatment is necessary, not only providing pharmacological management but also nonpharmacological management.