The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies.


Journal

The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041

Informations de publication

Date de publication:
11 2020
Historique:
accepted: 07 02 2020
pubmed: 9 2 2020
medline: 15 5 2021
entrez: 9 2 2020
Statut: ppublish

Résumé

Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods. To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings. Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods. The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library. The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.

Sections du résumé

BACKGROUND
Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods.
OBJECTIVES
To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings.
METHODS
Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods.
RESULTS
The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library.
CONCLUSIONS
The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.

Identifiants

pubmed: 32034956
doi: 10.1111/bjd.18943
pmc: PMC7687112
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

808-820

Informations de copyright

© 2020 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

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Auteurs

D Engelman (D)

Tropical Diseases, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Melbourne Children's Global Health, Melbourne, VIC, Australia.

J Yoshizumi (J)

Yoshizumi Dermatology Clinic, Tokyo, Japan.
Department of Dermatology, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.

R J Hay (RJ)

Department of Dermatology, King's College London, London, UK.

M Osti (M)

Tropical Diseases, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.

G Micali (G)

Dermatology Clinic, University of Catania, Catania, Italy.

S Norton (S)

Children's National Medical Center and George Washington University, Washington, DC, USA.

S Walton (S)

University of the Sunshine Coast, Sunshine Coast, QLD, Australia.

F Boralevi (F)

Department of Paediatric Dermatology, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.

C Bernigaud (C)

Department of Dermatology, AP-HP, Hôpital Henri Mondor, Université Paris-Est, Créteil, France.
Dynamyc Research Group, Faculty of Medicine, Laboratory for Animal Health, USC ANSES, Créteil, France.

A C Bowen (AC)

Department of Infectious Diseases, Perth Children's Hospital, Perth, WA, Australia.
Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Menzies School of Health Research, Darwin, NT, Australia.

A Y Chang (AY)

Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.

O Chosidow (O)

Department of Dermatology, AP-HP, Hôpital Henri Mondor, Université Paris-Est, Créteil, France.

G Estrada-Chavez (G)

Department of Dermatology and Dermato-Oncology, Instituto Estatal de Cancerología 'Dr Arturo Beltrán Ortega', Faculty of Medicine, Autonomous University of Guerrero, Acapulco, GRO, Mexico.

H Feldmeier (H)

Institute of Microbiology and Infection Immunology, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany.

N Ishii (N)

National Sanatorium Tama Zenshōen, Tokyo, Japan.

F Lacarrubba (F)

Dermatology Clinic, University of Catania, Catania, Italy.

A Mahé (A)

Department of Dermatology, Hôpital Pasteur, Colmar, France.

T Maurer (T)

Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
Department of Dermatology/AMPATH, Indiana University, Indianapolis, IN, USA.

M M A Mahdi (MMA)

Department of Dermatology, Omdurman Friendship Hospital, Khartoum State, Sudan.
Department of Dermatology, Khartoum Dermatology and Venereology Teaching Hospital, Khartoum State, Sudan.

M E Murdoch (ME)

Department of Dermatology, West Hertfordshire Hospitals NHS Trust, Watford General Hospital, Watford, UK.

D Pariser (D)

Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA, USA.

P A Nair (PA)

Department of Dermatology, Venereology& Leprosy, Pramukh Swami Medical College, Karamsad, Gujarat, India.

W Rehmus (W)

Department of Pediatric Dermatology, University of British Columbia, Vancouver, BC, Canada.
BC Children's Hospital, Vancouver, BC, Canada.

L Romani (L)

Tropical Diseases, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.

D Tilakaratne (D)

Menzies School of Health Research, Darwin, NT, Australia.
Royal Darwin Hospital, Darwin, NT, Australia.

M Tuicakau (M)

Department of Leprosy/Dermatology, Tamavua Twomey Hospital, Suva, Fiji.
College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.

S L Walker (SL)

London School of Hygiene and Tropical Medicine, London, UK.
Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK.

K A Wanat (KA)

Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA.

M J Whitfeld (MJ)

Department of Dermatology, St Vincent's Hospital, University of New South Wales, Sydney, NSW, Australia.

R R Yotsu (RR)

School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan.

A C Steer (AC)

Tropical Diseases, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Melbourne Children's Global Health, Melbourne, VIC, Australia.

L C Fuller (LC)

Chelsea and Westminster NHS Foundation Trust, London, UK.
International Foundation for Dermatology, London, UK.

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