Anatomical Distribution of Scabies Lesions and Factors Associated With Typical Anatomical‐Site Involvement Among Patients Attending a Dermatology Center in Mogadishu, Somalia: A Facility‐Based Cross‐Sectional Study

ABSTRACT Background and Aims Scabies is a common parasitic skin disease with substantial morbidity, particularly in resource‐limited settings. Although the typical anatomical distribution of scabies lesions is well recognized, atypical presentations may complicate clinical recognition and diagnosis. Evidence describing the anatomical distribution of scabies lesions in Somalia remains limited. This study assessed the anatomical distribution of scabies lesions and factors associated with typical anatomical‐site involvement among patients attending a dermatology center in Mogadishu, Somalia. Methods A facility‐based cross‐sectional study was conducted at Olad Dermatology Center in Mogadishu, Somalia, from April to June 2025. Patients with a final clinical diagnosis of scabies, based on clinical assessment informed by the 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria, were included. Dermoscopy and laboratory confirmation were unavailable at the study site. Data on sociodemographic, household, socioeconomic, behavioral, hygiene, and clinical characteristics were collected using a structured questionnaire and clinical examination checklist. Because typical anatomical‐site involvement was a common outcome, multivariable Poisson regression with robust variance was used to estimate adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs). Results Among 423 patient records, 195 (46.1%) had a final clinical diagnosis of scabies. Of these, 146/195 (74.9%) had typical and 49/195 (25.1%) had atypical anatomical‐site involvement. The finger/interdigital region was the most frequently affected site (102/195, 52.3%). In multivariable analysis, participants with a monthly income of USD 300 or more had a higher prevalence of typical‐site involvement than those earning less than USD 300 (APR = 1.42, 95% CI: 1.17–1.73; p = 0.001). Primary education was associated with a lower prevalence of typical‐site involvement compared with illiteracy (APR = 0.77, 95% CI: 0.61–0.96; p = 0.021). Participants who reported no person with itching in their household or neighborhood also had a lower prevalence of typical‐site involvement (APR = 0.71, 95% CI: 0.57–0.88; p = 0.002). Other covariates were not independently associated with typical‐site involvement after adjustment. Conclusion Typical anatomical‐site involvement predominated, although approximately one‐quarter of patients had atypical anatomical‐site involvement. Higher monthly income was associated with a higher prevalence of typical‐site involvement, whereas primary education and absence of an itching contact were associated with lower prevalence. These findings should be interpreted cautiously given the cross‐sectional design, the relatively small number of atypical‐site cases, and the limited number of participants in some subgroups. Further multicenter studies with larger samples and confirmatory diagnostic methods are needed.