입원 환자에서 발생한 옴의 임상적 특징: 후향적 연구

초록

Background: Scabies, a common contagious skin disease caused by ectoparasites, is a significant public health concern in healthcare facilities, including tertiary hospitals. Objective: This study aimed to assess the clinical characteristics of hospitalized patients who were diagnosed with scabies. We focused on determining whether patient-related factors such as height, weight, underlying diseases, mobility, mental alertness, cognitive impairment, catheter insertion, and the presence of caregivers influenced the failure of the initial diagnosis or treatment. Methods: We retrospectively analyzed the medical records of 81 patients who were diagnosed with scabies during hospitalization between January 2011 and June 2023. Results: Of the 81 patients, 45 (55.6%) were male, with a mean age of 76.5 years. The most common primary diagnosis was an infectious disease (66.7%). The main suspected routes of infection were care facilities (63.5%) for patients who already had pruritic skin lesions before admission, and contact with caregivers (80.0%) for patients who developed new skin lesions after admission. The initial consultation failed to diagnose scabies in 19.8% of the patients, and among those, 62.5% had not undergone initial microscopic examination. Patients who were initially misdiagnosed had significantly longer hospitalizations and scabies treatment durations. Among the patients who underwent follow-up microscopic examination after the initial treatment, 60.0% showed positive results. Overall, 54.2% of the patients experienced initial treatment failure. Patient-related factors did not significantly differ between patients with and without initial diagnostic failure and between patients with and without initial treatment failure. Conclusion: Dermatologists should consider performing microscopic examinations more frequently in hospitalized patients to improve diagnostic accuracy. Considering the high treatment failure rate, follow-up microscopic evaluation is recommended after initial treatment.

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