Crusted Scabies Case


A 71-year-old man with cirrhosis presented to the emergency department with severe diffuse pruritus. Three months earlier, he had presented with erythematous and scaly skin on the scalp and hands. Two skin scrapings had not revealed mites, and he was treated with oral and topical glucocorticoids. After initial improvement, his condition subsequently worsened. Physical examination now revealed a generalized erythematous and scaly rash with intense hyperkeratotic lesions on the face, neck (Panel A), interdigital areas, and genital areas (Panel B). Microscopic examination of a skin scraping from the abdomen confirmed the presence of mites (Panel C), and the diagnosis of crusted scabies was made. Crusted scabies is a rare and severe form of scabies. It is highly contagious because of the large numbers of mites found on the skin. Crusted scabies predominantly affects immunosuppressed patients or those with sensory or motor neuropathy or dementia but can sometimes occur in persons without clear risk factors. An undiagnosed case of crusted scabies may be the source of an outbreak of scabies in health care and residential facilities. The patient was treated with oral ivermectin and topical salicylic acid cream, and his symptoms resolved within 2 weeks after presentation.

Interferon-free therapy for hepatitis C ‘cured’ 90% of patients

Currently, doctors treating hepatitis C patients with cirrhosis (liver scarring) can only offer treatments that rely on the drug interferon, which unfortunately, only works for less than half of patients. Now, a new study found that an interferon-free combination of drugs was safe, well tolerated and cured over 90% of …

What is cirrhosis of the liver?

Cirrhosis of the liver describes a condition where scar tissue gradually replaces healthy liver cells. The main causes are sustained, excessive alcohol consumption, viral hepatitis B and C, and fatty liver disease – however, there are other possible causes. People with cirrhosis may develop jaundice (yellowing of the skin, eyes, …

Hepatitis A

Hepatitis A is a virus that causes┬áinfection and inflammation of the liver.┬áIt rarely results in serious liver damage or death and does not develop chronic liver disease. Unlike hepatitis B or C, it does not lead to chronic liver disease, but it can result in significant loss of income and …

Show Buttons
Hide Buttons