Dear Editor,We read with interest the article by Griffin et al. published recently in Clinical and Experimental Dermatology.
The authors noted an increase in patients with scabies resistant to topical therapy during the pandemic period compared with the average of the previous 4 years. The authors reached this conclusion by comparing the rates of systemic ivermectin use. As noted by the authors, the development of resistance to topical treatments has increased considerably recently. This situation may have increased the applications to the dermatology outpatient clinics of secondary and tertiary hospitals. The authors also stated that staying at home under strict quarantine conditions and increased transmission in the home might have contributed to the increase in the number of cases.We would like to make additional comments about this situation, based on our experience. First, the increase or decrease in the intake of drugs used for a disease may not directly reflect the change in the number of cases. For example, Launay et al.
published an article in which they stated that the purchase of topical scabies drugs from pharmacies during the pandemic period was less than before the pandemic, therefore suggesting that the number of patients with scabies decreased in France. In our study, in which we compared the outpatient diagnoses of the pandemic period and the pre‐pandemic period, we found that the number of patients with scabies increased in Turkey during the pandemic period.
Similar to our study, Kutlu and Aktaş
also periodically followed the rates of patients with scabies during the pandemic period in Turkey, and also observed a sudden increase in the incidence of scabies 2 months after the onset of the pandemic.The coronavirus caused significant changes in the diagnosis of scabies at dermatology outpatient clinics. Because of the strict quarantine conditions, patients preferred to stay at home and avoided going to hospitals for many diseases that did not cause severe symptoms. Despite this, many patients preferred to request treatment from hospital for scabies, which causes severe itching, and this may have contributed to this increase. Another reason is that the intensive use of teledermatology methods such as WhatsApp by the patients in this period may have decreased the number of visits due to other diseases while increasing the rate of admission due to scabies because of the severe itching. In the survey study we conducted among dermatologists during the pandemic period, we found that teledermatology was used extensively.