Crusted Scabies in an Immunocompetent Child : A Case Report
Keywords:
crusted scabies, diagnosis, treatmentAbstract
Abstract Introduction: Crusted scabies is an uncommon and debilitating type of scabies that is distinguished by hyperinfestation of millions mites and the clinical hallmark of hyperkeratotic skin crust. Case Report: This is a case report of crusted scabies in a 10-year-old immunocompetent female child. The case was first misdiagnosed at previous healthcare center as ichthyosis vulgaris and was given prolonged topical corticosteroid with no improvement. Microscopic examination of skin scrapings revealed multiple Sarcoptes scabiei and their eggs. Diagnosis of crusted scabies was made. Patient’s clinical outcomes improved after receiving combination therapy of oral ivermectin, topical permethrin 5% and topical keratolytic agents. Conclusion: Misdiagnosis of crusted scabies may pose risk of uncontrolled infestation and perpetuate an outbreak in society. It is also associated with complication of secondary bacterial infection. Therefore, it is important for clinicians to acknowledge the diagnosis and management of crusted scabies to improve clinical outcomes and control disease transmission.References
Glennie M, Gardner K, Dowden M, Currie BJ. Active case detection methods for crusted scabies and leprosy: A systematic review. PLoS Negl Trop Dis. 2021;15(7):1-17 .
Griffiths CEM, Bleiker TO, Creamer D, Ingram JR, Simpson RC. Rook’s Dermatology Handbook [Internet]. Wiley Blackwell; 2022. Available from: www.wiley.com
Mitra AK, Mawson AR. Neglected tropical diseases: Epidemiology and global burden. Trop Med Infect Dis. 2017;2(3):36; https://doi.org/10.3390/tropicalmed2030036
Apap C, Piscopo T, J.Boffa M. Crusted (Norwegian) scabies treated with oral ivermectin: A case report and overview. Malta Medical J. 2013:4;49.
Sunderkötter C, Wohlrab J, Hamm H. Epidemiologie, Diagnostik und Therapie der Skabies. Dtsch Arztebl Int. 2021;118(41):695–704.
Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: Scabies. J Am Acad Dermatol. 2020;82: 533–48.
Currie BJ, Hengge UR. Scabies. In: Tropical Dermatology: Second Edition. Elsevier Inc.; 2016. p. 377–86.
Arora P, Rudnicka L, Sar-Pomian M, Wollina U, Jafferany M, Lotti T, et al. Scabies: A comprehensive review and current perspectives. Vol. 33, Dermatologic Therapy. Blackwell Publishing Inc.; 2020.
Richards RN. Scabies diagnostic and therapeutic update. J Cutan Med Surg. 2021;25(1):95-101.
doi: 10.1177/1203475420960446.
Leung AKC, Lam JM, Leong KF. Scabies: A Neglected Global Disease. Curr Pediatr Rev. 2019;16(1):33–42.
al -Tarawneh AH, Shamasneh A. Crusted (Norwegian) Scabies Mimicking Psoriasis: A Case Report and Literature Review. Bahrain Medical Bulletin. 2021;43(3):648-50.
Sánchez-Borges M, González-Aveledo L, Capriles-Hulett A, Caballero-Fonseca F. Scabies, crusted (Norwegian) scabies and the diagnosis of mite sensitisation. Vol. 46, Allergologia et Immunopathologia. Elsevier Doyma; 2018. p. 276–80.
Wang MK, Chin-Yee B, Lo CKL, Lee S, El-Helou P, Alowami S, et al. Crusted scabies in a renal transplant recipient treated with daily ivermectin: A case report and literature review. Transpl Infect Dis. 2019;21(3): e13077.
Talaga-Ćwiertnia K. Sarcoptes infestation. What is already known, and what is new about scabies at the beginning of the third decade of the 21st century? Pathogens. 2021;10(7):868; https://doi.org/10.3390/pathogens10070868.
Widaty S, Rachmawati Y. Erythrodermic Manifestation due to Hyperinfestation of Scabies. Periodic Dermatol Venereol. 2021;33(2):141-4.
Aukerman W, Curfman K, Urias D, Shayesteh K. Norwegian Scabies management after prolonged disease course: A case report. Int J Surg Case Rep. 2019;61:180–3.
Zorbozan O, Gerçeker Türk B, Acar A, Oraloğlu G, Ünver A, Töz S, et al. Comparison of Skin Scraping and Standard Superficial Skin Biopsy in the Laboratory Diagnosis of Scabies. Turkiye Parazitol Derg. 2020;44(3):164–7.
Talty R, Micevic G, Damsky W, King BA. Erythrodermic scabies in an immunocompetent patient. JAAD Case Rep. 2022:112–115.
Davis JS, McGloughlin S, Tong SYC, Walton SF, Currie BJ. A Novel Clinical Grading Scale to Guide the Management of Crusted Scabies. PLoS Negl Trop Dis. 2013;7(9):e2387.
Aždajić MD, Bešlić I, Gašić A, Ferara N, Pedić L, Lugović-Mihić L. Increased Scabies Incidence at the Beginning of the 21st Century: What Do Reports from Europe and the World Show? Life. 2022;12(10):1598; https://doi.org/10.3390/life12101598
