IDCases 5 (2016) 4–5
Contents lists available at ScienceDirect
IDCases journal homepage: www.elsevier.com/locate/idcr
Case report
Crusted (Norvegian) scabies Alexander Kreuter *, Kevin Bockholt Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth Hospital Oberhausen, University Witten-Herdecke, Germany
A R T I C L E I N F O
Article history: Received 11 May 2016 Accepted 24 May 2016
[(Fig._2)TD$IG] A 86-year-old fully bedridden woman with dementia and chronic kidney disease presented with extensive, grey-yellowish hyperkeratotic plaques located on the palms, axillae, chest, and face that had occurred 3 months ago (Fig. 1). Moreover, a generalized rash with thickening of the skin and intense pruritus was present. Dematoscopy revealed several dense triangles suspicious for scabies mites head parts (called ‘‘delta wing jet sign’’) (Fig. 2; arrow). A lesional skin biopsy as well as specimen obtained from scraping confirmed an infection with Sarcoptes scabiei (Fig. 3; arrow, Fig. 4). The patient was treated with a
[(Fig._1)TD$IG]
Fig. 2. [2_TD$IF]Several dense triangles suspicious for scabies mites head parts (called ‘‘delta wing jet sign’’) are present in dermatoscopy.
[(Fig._3)TD$IG]
Fig. 1. [1_TD$IF]Clinical findings at first presentation. Grey-yellowish hyperkeratotic plaques located on the left palm.
* Corresponding author.
Fig. 3. [3_TD$IF]Sarcoptes scabiei in histopathology. Four mites are located in statum corneum.
http://dx.doi.org/10.1016/j.idcr.2016.05.004 2214-2509/ß 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
[(Fig._4)TD$IG]
A. Kreuter, K. Bockholt / IDCases 5 (2016) 4–5
5
combination of oral ivermectin and topical permethrin, resulting in a complete clearance of all lesions. Crusted scabies, also called Norvegian scabies, is a rare and severe variant of scabies that most commonly affects elderly, immobile or immunosuppressed individuals. Crusted scabies is extremely infectious. Our patient had infected her relatives and several other housemates in her residential care home.
Fig. 4. [4_TD$IF]Sarcoptes scabiei in light microscopy.
Contents lists available at ScienceDirect
IDCases journal homepage: www.elsevier.com/locate/idcr
Case report
Crusted (Norvegian) scabies Alexander Kreuter *, Kevin Bockholt Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth Hospital Oberhausen, University Witten-Herdecke, Germany
A R T I C L E I N F O
Article history: Received 11 May 2016 Accepted 24 May 2016
[(Fig._2)TD$IG] A 86-year-old fully bedridden woman with dementia and chronic kidney disease presented with extensive, grey-yellowish hyperkeratotic plaques located on the palms, axillae, chest, and face that had occurred 3 months ago (Fig. 1). Moreover, a generalized rash with thickening of the skin and intense pruritus was present. Dematoscopy revealed several dense triangles suspicious for scabies mites head parts (called ‘‘delta wing jet sign’’) (Fig. 2; arrow). A lesional skin biopsy as well as specimen obtained from scraping confirmed an infection with Sarcoptes scabiei (Fig. 3; arrow, Fig. 4). The patient was treated with a
[(Fig._1)TD$IG]
Fig. 2. [2_TD$IF]Several dense triangles suspicious for scabies mites head parts (called ‘‘delta wing jet sign’’) are present in dermatoscopy.
[(Fig._3)TD$IG]
Fig. 1. [1_TD$IF]Clinical findings at first presentation. Grey-yellowish hyperkeratotic plaques located on the left palm.
* Corresponding author.
Fig. 3. [3_TD$IF]Sarcoptes scabiei in histopathology. Four mites are located in statum corneum.
http://dx.doi.org/10.1016/j.idcr.2016.05.004 2214-2509/ß 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
[(Fig._4)TD$IG]
A. Kreuter, K. Bockholt / IDCases 5 (2016) 4–5
5
combination of oral ivermectin and topical permethrin, resulting in a complete clearance of all lesions. Crusted scabies, also called Norvegian scabies, is a rare and severe variant of scabies that most commonly affects elderly, immobile or immunosuppressed individuals. Crusted scabies is extremely infectious. Our patient had infected her relatives and several other housemates in her residential care home.
Fig. 4. [4_TD$IF]Sarcoptes scabiei in light microscopy.
