An Itchy Problem: A Clinical Case of Crusted Scabies

Scabies is an infestation of the skin by the mite Sarcoptes scabiei. A more severe form called crusted or Norwegian scabies may occur in immunosuppressed patients and the elderly. Crusted scabies mostly differs from normal scabies by the exuberance of its lesions, body distribution and high contagiousness, and requires different and more prolonged treatment. Early recognition of the lesions and isolation precautions are crucial for disease control and prevention of transmission. The authors describe a clinical case of crusted scabies with pruritus and exuberant cutaneous lesions. LEARNING POINTS: Crusted scabies is an infestation of the skin by the mite Sarcoptes scabiei that is highly contagious and results in an intensely pruritic eruption with exuberant cutaneous lesions. Crusted scabies occurs in patients with AIDS, lymphoma or compromised cellular immunity, and sometimes in older patients. It is characterized by an elevated burden of mites and does not have a characteristic distribution pattern. This disease requires strict isolation measures and treatment which differs from and is more prolonged than for scabies.