When Religion Gets Involved in the Treatment of Scabies: About A Case in the University Clinic of Dermatology and Venerology of ‘Centre National Hospitalier Universitaire Hubert Koutoukou Maga’ of Cotonou

Abstract

Scabies is a current and highly pruritic ectoparasitic infection caused by Sarcoptes scabiei var. Hominis. It is a highly contagious parasitic infection with specific lesions, like burrows, and non-specific lesions like papules, vesicles and excoriations. The typical regions touched are the palms, wrists, axillary folds, abdomen, buttocks, breast folds and, in men, the genitals. This disease is characterized by an intense nightly pruritus. Scabies is transmitted by close personal contact (parents, sexual partners, pupils, chronic diseases and over populated communities). The final diagnosis is made when the the scabies’ parasites or their eggs or fecal matter are identified in the optical microscope. New diagnostic approaches include the use of épiluminescence. For our case, it was 33-year-old patient, police officer and animist who consulted for a generalized pruritus with lesions evolving continuously since a week. The pruritus was more intense at night and a colleague was reported to have similar symptoms. As treatment he drank herbal tea. No particular medical background was noted. Before this clinical presentation, scabies was diagnosed. The HIV test was negative. No parasitology test was run. The patient was treated with topical benzyl benzoate, permethrine for his surrounding and ivermectine. Note should be taken that the patient categorically refused the topical treatment for religious purposes. We finally prescribed ivermectine for him and permethrine for his surrounding. Seen two weeks later, the evolution was favorable. The patient is whole, his spiritual dimension is very important for his equilibrium and it is important for us to know that and see him through. Let us remember that as concerns this patient, neglecting this aspect is synonym to losing track of him and lengthening the disease’s transmission chain (think of his other colleagues, his family, and especially the “patients” he cures with herbal medicine.