A rare form of crusted scabies (also called Norwegian scabies)!!
This is a peculiar and severe version of scabies showing hyperkeratotic or psoriasiform papules or plaques or sometimes diffuse erythroderma. It is caused by a common scabies mite, which often develops in people with weakened immunity. The most susceptible are people whose immunity has been reduced due to AIDS, tuberculosis, lupus erythematosus, etc. Also, patients with a neurological disease, the elderly, the disabled, or those who are mentally impaired. The clinical feature of the Norwegian scabies is a massive layering of crusts on different areas of the skin. The peels of a yellowish-dirty, brownish-black color, dense, with a smooth or striated surface with a thickness of several millimeters to 2-3 cm are arranged in several layers (5-7). Between these layers and under the whole crust a large number of scabies mites are found. The usual features of scabies (itching and a rash) may be absent. Crusted scabies is very contagious and can spread easily both by direct skin-to-skin contacts and through contaminated items such as clothing, bedding, and furniture. It is caused by superinfestation with Sarcoptes scabiei var hominis, but why the crusted scabies develops is unknown. People with crusted scabies should receive quick and aggressive medical treatment for their infestation to prevent outbreaks of scabies. Ivermectin is used for treatment.
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