The Itch and Astrophysics
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Chief Medical Editor
Who knew scabies could be so interesting? Dermatologist Errol Craig, MD, PhD, of Walnut Creek, CA, sent me a copy of his book, The Itch: Scabies, which describes experiences with patients who had scabies, the lifecycle of the mite, the epidemiology of the disease, and the fascinating history of how the etiology of scabies was ultimately determined. In the issue, Dr Craig contributes our cover story feature, exploring how fomite contagiousness in scabies is tied to mite burden, which dermatologists should assess and note when treating scabies.
I have already found the book and the understanding of scabies it shares useful to me in my clinical practice. I am more aware of the potential for scabies in my patients who are itching and how to treat and counsel them. What fascinated me most about the book is how long it took scientists to realize scabies was caused by a mite and not a blood problem. Dr Craig quotes 19th-century Austrian dermatologist Ferdinand van Hebra, who in an 1844 treatise characterized scabies as being caused by the itch mite Sarcoptes scabiei, as saying, “If medical men in those days had but observed with unprejudiced eyes the favorable results which followed the use of popular remedies and cures for scabies, they probably would have sooner acquired correct notions concerning the nature and treatment of the disease. But more importance was then attached to theoretical pedantry than to the observation of the facts…”
A similar theme was brought to my attention earlier this month regarding astrophysicist Cecilia Payne. In her PhD thesis she concluded that hydrogen was the overwhelming constituent of stars, making it the most common element in the universe. Henry Norris, a pre-eminent astronomer of the day, dissuaded her from publishing, considering her findings “spurious” as they were inconsistent with existing theory. She was later proven right and credited for her discovery.
The human tendency to hold to our existing dogma can be strong. The Dermatologist hopes to provide convincing evidence for the best ways to care for patients, even if it means changing our current treatment patterns.
