Scabies and lice infestations in Gaza: risk factors and public health challenges during the 2023-2024 conflict

To the Editor, I read the article ‘Scabies and lice infestations in Gaza: risk factors and public health challenges during the 2023–2024 conflict’ with great interest, published in the Egyptian Journal of Dermatology and Venerology, volume 24, issue 2, 2025 [1]. Given the ongoing crisis in Gaza, this is a very timely topic to discuss, as dermatological manifestations are mostly neglected in conflict zones [2]. However, I have some observations about the article that I would like to draw your attention to. When I read through the introduction, there were verbose descriptions of the conflict in Gaza; however, it lacked a description of the repercussions of the conflict on scabies and lice, or dermatological manifestations in general, either in Gaza or in similar settings like the Middle East region or Ukraine. The introduction cites one article [3] for the sentence: ‘Notably, this tiny geographic region has endured numerous conflicts, and it is well-documented historically that wars are closely linked to the dissemination of infectious diseases, with scabies and lice being a prime example’, yet the article lacks a description of scabies and lice in particular. Given the specific focus of the topic, such a detailed account of scabies and lice may not be warranted in the article. The article is presented as a review article; however, a clear typology of review, whether systematic, scoping, or narrative, could have been mentioned. Based on the typology, further steps and methodological considerations could have been articulated. The article heavily relies on media articles without primary peer-reviewed resources. It mentions around 96 417 cases since October 7, 2023, based on two newspaper articles; however, the same number derived from observational studies could have provided more credibility and validity to the evidence. While discussing the factors, the authors repeatedly mention certain aspects, such as overcrowding and poor hygiene. Conditions like overcrowding, poor personal hygiene, and sharing personal belongings are interrelated and evident in areas affected by a humanitarian crisis, which could have been effectively documented without fragmentation. The meaning of keywords such as ‘confect’ and ‘infestation’ remains unclear. Furthermore, the article lacks mention of its limitations, and the recommendations are too generic, such as ‘strongly advocates for urgent intervention from international, civil, UN, and WHO’. The article could have provided a comparative assessment of similar situations elsewhere in the world, such as the refugee camp in Syria and the Rohingya situation in Bangladesh. Although these points could have helped to refine the article, I applaud the authors’ attempt to present timely research that indeed warrants urgent attention, as dermatological manifestations are often neglected in these situations, with the primary focus directed towards more life-threatening scenarios. Conflicts of interest There are no conflicts of interest.