Crusted (Norwegian) Scabies: Nine-Month Course With Iatrogenic Immunosuppression

Abstract

Crusted scabies (CS) is a highly infectious hyperinfestation variant of scabies with up to millions of Sarcoptes scabiei mites present on the skin surface. Diagnostic clues include intense itching and thick crusting especially on the face, groin, and buttocks, although variable presentations may mimic other dermatoses. CS has been associated with immunosuppression including the human immunodeficiency virus (HIV) and lymphoreticular malignancies.1-3 A long latency period from symptom onset to diagnosis and appropriate treatment is often reported. Clinical suspicion is required to obtain a mineral oil preparation or biopsy. We report a patient treated for eczema with 9 months of progressive immunosuppression who was found to have crusted scabies. J Drugs Dermatol. 2018;17(10):1131-1133.