Dear Editor,We read with interest the article by Launay et al. published recently in Clinical and Experimental Dermatology.
The authors reported that the rates of head lice and scabies in France decreased during the pandemic period compared with previous years, based on the comparison of the sales rates of topical head lice, topical scabies and ivermectin treatments during the COVID‐19 pandemic period and previous years. The authors found that medication use was higher for head lice than for scabies. However, decrease in medication use does not directly reflect the decrease in the number of cases, which the authors state as a weak point of the study.In the report, the authors stated that strict quarantine conditions in their country may have caused a decrease in the number of patients with head lice or scabies in parallel with the decrease in all hospital admissions, and that the closure of schools in this period and the ensuing summer vacation were the most important factors in the decrease in head lice cases. They also stated that for head lice, patients could not get treatments from hospitals during this period, but could buy topical antibiosis drugs over the counter from pharmacies. Apart from the reasons stated by the authors, we think that the fact that the patients received drugs directly from pharmacies following diagnosis via teledermatology methods such as WhatsApp for head lice, especially during the quarantine period, may also be a reason for this decrease, because in the survey study we conducted of dermatologists in Turkey during this period, we also found that the use of teledermatology methods by patients increased intensively during the pandemic.Launay et al. also stated that although the decrease was not as marked as for head lice at the beginning of the pandemic period, the rate of scabies also decreased significantly, and they suggested that this decrease was because the patients stayed at home under strict quarantine conditions. By contrast, both in our study
and in other studies in Turkey,
there was a significant increase in the rates of scabies compared with the number of all outpatient clinics, especially a few months after the onset of the pandemic. Kutlu et al.
periodically followed the rates of scabies patients during the pandemic period in Turkey, and observed a sudden increase in the incidence of scabies 2 months after the start of the pandemic.Like other authors, we attributed the decrease in the number of applications to a healthcare provider to various reasons, and the fact that patients with scabies preferred to request treatment for severe itching at outpatient clinics despite the quarantine.
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Although nearly 2 years have passed since the start of the pandemic, we observed a significant increase in the number of patients presenting with scabies once quarantine conditions were eased. The increase in referrals to tertiary outpatient clinics is probably due to resistance to topical drugs.