ImportanceScabies, bedbug, and body lice infestations are caused by organisms that live on or in the skin, on clothing, or in the environment and commonly cause pruritus and rash. In 2021, approximately 622 million incident cases of scabies occurred globally. Data on bedbug infestations are limited. Body lice prevalence ranges from 4.1% to 35% among persons experiencing homelessness worldwide.ObservationsScabies is caused by mites (Sarcoptes scabiei) that burrow into the epidermis. Transmission primarily occurs from prolonged skin-to-skin contact with an individual who has an infestation. Common scabies is characterized by excoriated pruritic papules, plaques, and pathognomonic burrows on finger/toe web spaces, volar wrists, ankles, axillae, buttocks, male genitalia, and areolae. Permethrin cream and oral ivermectin are first-line treatments for adults, with similar clearance rates by week 2 (74% with permethrin vs 68% with ivermectin; relative risk, 0.91; 95% CI, 0.76-1.08). Treatment failure can occur with oral ivermectin (11.8%; 95% CI, 8.4%-15.4%) and topical permethrin (10.8%; 95% CI, 7.5%-14.5%). Bedbugs (Cimex lectularius, Cimex hemipterus) are insects that live on mattresses and furniture and feed on blood nocturnally, causing linear pruritic erythematous papules. New skin lesions on waking, cohabitants with similar symptoms, and recently residing in a high-occupancy setting should raise suspicion. Treatment requires eradication with pest management. Body lice (Pediculus humanus humanus) are insects found on clothing that travel to the skin for blood meals. Body lice bites cause pruritic excoriated macules/papules and hyperpigmentation in areas where clothing seams contact skin. Treatment and prevention require at least once-weekly bathing and laundering of clothing and bedding.Conclusions and RelevanceScabies, bedbug, and body lice infestations are common. Accurate diagnosis requires taking a history, including social drivers of health (eg, housing status, living environment), and physical examination. First-line treatments include scabicides for patients with common scabies and their close contacts. Scabies, bedbug, and body lice infestations should be treated with decontamination measures.

中文翻译：

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疥疮、臭虫和体虱感染


重要性疥疮、臭虫和体虱感染是由生活在皮肤上或皮肤内、衣服上或环境中的微生物引起的，通常会引起瘙痒和皮疹。 2021 年，全球发生约 6.22 亿例疥疮病例。有关臭虫侵扰的数据有限。在全世界无家可归者中，体虱患病率从 4.1% 到 35% 不等。 观察疥疮是由钻入表皮的螨虫 (Sarcoptes scabiei) 引起的。传播主要是由于与感染者长时间的皮肤接触而发生。常见疥疮的特征是手指/脚趾间隙、掌侧手腕、脚踝、腋窝、臀部、男性生殖器和乳晕上出现瘙痒性丘疹、斑块和特征性洞穴。氯菊酯乳膏和口服伊维菌素是成人的一线治疗方法，第 2 周时的清除率相似（氯菊酯为 74%，伊维菌素为 68%；相对风险，0.91；95% CI，0.76-1.08）。口服伊维菌素（11.8%；95% CI，8.4%-15.4%）和外用氯菊酯（10.8%；95% CI，7.5%-14.5%）可能会出现治疗失败。臭虫（Cimex lectularius、Cimex hemipterus）是生活在床垫和家具上的昆虫，夜间以血液为食，引起线状瘙痒性红斑丘疹。醒来时出现新的皮肤损伤、有类似症状的同居者以及最近居住在高占用环境中都应该引起怀疑。治疗需要通过害虫管理来根除。体虱（Pediculus humanus humanus）是在衣服上发现的昆虫，它们会传播到皮肤上吸血。体虱叮咬会导致衣服接缝接触皮肤的区域出现瘙痒、抓破的斑疹/丘疹和色素沉着过度。 治疗和预防需要每周至少洗澡一次以及清洗衣服和床上用品。结论和相关性疥疮、臭虫和体虱感染很常见。准确的诊断需要采集病史，包括健康的社会驱动因素（例如住房状况、居住环境）和体检。一线治疗包括针对普通疥疮患者及其密切接触者使用杀疥剂。应采取净化措施治疗疥疮、臭虫和体虱感染。