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Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports

Scabies is a contagious skin condition caused by Sarcoptes scabiei, and it is always associated with an intense, unbearable, nocturnal deteriorating itch. Its presentations include classic burrows, erythema, pruritic papules, pustules, vesicles, and inflammatory nodules, with diffuse or localized di...

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Autores principales: Zhao, Yu-Kun, Lu, Jing-Fa, Liu, Juan-Hua, Wu, Hui-Hui, Song, Lu-Li, Wan, Chun-Lei, Luo, Di-Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10467300/
https://www.ncbi.nlm.nih.gov/pubmed/37655266
http://dx.doi.org/10.1177/20406223231195632
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author Zhao, Yu-Kun
Lu, Jing-Fa
Liu, Juan-Hua
Wu, Hui-Hui
Song, Lu-Li
Wan, Chun-Lei
Luo, Di-Qing
author_facet Zhao, Yu-Kun
Lu, Jing-Fa
Liu, Juan-Hua
Wu, Hui-Hui
Song, Lu-Li
Wan, Chun-Lei
Luo, Di-Qing
author_sort Zhao, Yu-Kun
collection PubMed
description Scabies is a contagious skin condition caused by Sarcoptes scabiei, and it is always associated with an intense, unbearable, nocturnal deteriorating itch. Its presentations include classic burrows, erythema, pruritic papules, pustules, vesicles, and inflammatory nodules, with diffuse or localized distribution on the finger webs, wrist flexors, elbows, axillae, buttocks, genitalia, and breasts. Nodular scabies is an uncommon clinical variant of scabies. Its management is still challenging for some patients up to date, although topical, intralesional or systemic corticosteroids, topical calcineurin inhibitors, and crotamiton as well as cryotherapy alone or in different combinations are used. We here report five male patients of nodular scabies, aged between 14 and 25 years, who had classical scabies that had been cured by sulfur ointment for at least 4 weeks except for their itching nodules, and their residual pruritic nodules also failed in previous treatments including antihistamines, topical applying and intralesional injection of steroids as well as topical tacrolimus in different combinations before being recruited to this study. The patients were administered tofacitinib 5 mg, twice a day, which led to excellent and rapid improvement for both lesions and symptoms after 1–4 weeks of treatment, respectively, without any associations. During 6 months of follow-up, only one had re-infection of scabies associated with nodules that were cured by sulfur ointment and tofacitinib again. No adverse reaction was observed. The present results suggested that tofacitinib might be a potential agent for nodular scabies with excellent response.
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spelling pubmed-104673002023-08-31 Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports Zhao, Yu-Kun Lu, Jing-Fa Liu, Juan-Hua Wu, Hui-Hui Song, Lu-Li Wan, Chun-Lei Luo, Di-Qing Ther Adv Chronic Dis Case Series Scabies is a contagious skin condition caused by Sarcoptes scabiei, and it is always associated with an intense, unbearable, nocturnal deteriorating itch. Its presentations include classic burrows, erythema, pruritic papules, pustules, vesicles, and inflammatory nodules, with diffuse or localized distribution on the finger webs, wrist flexors, elbows, axillae, buttocks, genitalia, and breasts. Nodular scabies is an uncommon clinical variant of scabies. Its management is still challenging for some patients up to date, although topical, intralesional or systemic corticosteroids, topical calcineurin inhibitors, and crotamiton as well as cryotherapy alone or in different combinations are used. We here report five male patients of nodular scabies, aged between 14 and 25 years, who had classical scabies that had been cured by sulfur ointment for at least 4 weeks except for their itching nodules, and their residual pruritic nodules also failed in previous treatments including antihistamines, topical applying and intralesional injection of steroids as well as topical tacrolimus in different combinations before being recruited to this study. The patients were administered tofacitinib 5 mg, twice a day, which led to excellent and rapid improvement for both lesions and symptoms after 1–4 weeks of treatment, respectively, without any associations. During 6 months of follow-up, only one had re-infection of scabies associated with nodules that were cured by sulfur ointment and tofacitinib again. No adverse reaction was observed. The present results suggested that tofacitinib might be a potential agent for nodular scabies with excellent response. SAGE Publications 2023-08-29 /pmc/articles/PMC10467300/ /pubmed/37655266 http://dx.doi.org/10.1177/20406223231195632 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Series
Zhao, Yu-Kun
Lu, Jing-Fa
Liu, Juan-Hua
Wu, Hui-Hui
Song, Lu-Li
Wan, Chun-Lei
Luo, Di-Qing
Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title_full Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title_fullStr Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title_full_unstemmed Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title_short Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
title_sort recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10467300/
https://www.ncbi.nlm.nih.gov/pubmed/37655266
http://dx.doi.org/10.1177/20406223231195632
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