Skin hygiene and scabies: the pivotal role of the occupational health physician
G. Viti – C. Forcella – I. Meraglia – I. Mauro – N. Magnavita
Introduction & Objectives
The occupational health physician plays a pivotal role preventing and detecting occupational diseases and promoting the overall health and well-being of employees. In Italy more than 10 million workers are compulsorily examined by a doctor every year. Only a small proportion of these workers are routinely examined by a dermatologist, however they can always ask for a medical examination performed by the occupational health physician. During the COVID-19 pandemic many health care workers have experienced fatigue, burnout and stress because of fears of personal safety, high workload and limited support. In some case this situation has resulted in a neglection of their own health. During the pandemic, a scabies outbreak in Europe was reported and the nurses were a group of healthcare professionals particularly vulnerable.
Materials & Methods
A 38-years old nurse affected by post-traumatic stress disorder, depression, and intolerable nocturnal itching without any specific rash underwent the mandatory occupational medical examination.
Results
A close inspection during the medical examination revealed the presence of comma-like burrows, the pathognomic sing of scabies. A treatment with permethrin 5% cream was prescribed. An intervention in the workplace was arranged to interrupt the chain of transmission.
Conclusion
Scabies is a neglected global disease which must always be sought in patients who experience itching, even when this is associated with psychological trauma and conditions of exhaustion which could support a psychogenic origin of the disorder. Healthcare workers are occupationally exposed to scabies. In medical care facilities regular hygienic skin examination of both nursing and medical staff should be mandatory to avoid the spread of scabies among the health professionals and the patients. The occupational health physician can include an examination of the skin in the worker’s routine examination to early identify and treat scabies. Skin examination does not overburden the occupational physician and provides undeniable public health benefits. The occupational medical examination may be an opportunity to disseminate knowledge on promoting skin hygiene.
Giacomo Viti