Scabies: A New Vampire in Dermatology

Abstract

Scabies remains a significant global public health problem, particularly in resource-limited countries. Though scabies is evident from ancient times, recent years have seen a resurgence in cases, atypical presentations, and increasing treatment challenges, giving it the metaphorical identity of a “new vampire” in Dermatology—persistently spreading, difficult to eradicate, and silently affecting the community.

The incidence of scabies has increased in both developing and developed regions, often linked to overcrowding, migration, natural disasters like floods, and institutional outbreaks. Dermatologists face diagnostic challenges because classical features such as nocturnal itching and burrows are frequently accompanied by atypical forms, including crusted scabies and modified presentations due to prior steroid use. Emerging concerns include reduced responsiveness to standard treatment like permethrin and the need for repeated or combination regimens.

Reinfection, poor compliance, lack of knowledge, and untreated contacts contribute to its persistent cycle. Early diagnosis, appropriate treatment, contact management, health education, and community-level interventions are crucial to break the cycle of transmission. Recognizing scabies as a resurging threat is essential for improving control strategies and reducing disease burden.

Bangladesh J Medicine 2026; Vol. 37, No. 2(1): pp. 189