key: cord-0847051-wb6u6vns authors: Turkmen, Dursun; Altunisik, Nihal title: Comment on ‘Unexpected consequences of SARS‐CoV‐2 pandemic: scabies infestation’ date: 2022-04-11 journal: Clin Exp Dermatol DOI: 10.1111/ced.15176 sha: 0a93a52348f0d7f80384c78b3091191cac4eeb0b doc_id: 847051 cord_uid: wb6u6vns nan We read with interest the article by Griffin et al. published recently in Clinical and Experimental Dermatology. 1 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. 2 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. 3 Similar to our study, Kutlu and Aktas ß 4 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. 5 and Nihal Altunisik Department of Dermatology, Faculty of Medicine, Inonu University, Malatya, Turkey E-mail: dursunturkmen44@gmail.com Conflict of interest: the authors declare that they have no conflicts of interest. Funding: none. Ethics approval: not applicable. Informed consent: the patient has provided informed consent for publication of case details and images. Data sharing: author elects to not share data. Accepted for publication 9 March 2022 Unexpected consequences of SARS-CoV-2 pandemic: scabies infestation Effects of the COVID-19 pandemic on head lice and scabies infestation dynamics: a population-based study in France Comparison of patients' diagnoses in a dermatology outpatient clinic during the COVID-19 pandemic period and pre-pandemic period Aktas ß H. The explosion in scabies cases during COVID-19 pandemic Views and experiences of dermatologists in Turkey about teledermatology during the COVID-19 pandemic