Crusted Scabies: A Cause of Erythroderma to Remember

Authors

DOI:

https://doi.org/10.24950/rspmi.648

Keywords:

Scabies/diagnosis, Scabies/drug therapy

Abstract

Crusted scabies or Norwegian scabies is a severe and highly contagious clinical variant of infestation by Sarcoptes scabiei, which can evolve exuberantly, coursing with diffuse
erythroderma, which makes etiological diagnosis difficult, especially by non-dermatologists. Thus, the authors present a case report of erythroderma in a 65-year-old woman, who
developed intense pruritus associated with erythroderma for about 2 weeks, with an associated fever peak. She had a previous clinical history of psoriasis and psoriatic arthritis, with long-term use of immunosuppressants and systemic corticosteroids. Evaluated by dermatologists who, through direct examination by skin scraping and skin biopsy, confirmed the diagnosis of crusted scabies. Based on this case report, the importance of differential diagnoses of erythroderma is highlighted, especially crusted scabies, a rare dermatosis that most often affects immunocompromised, frail, institutionalized patients or patients with precarious social conditions.

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References

Santiago F, Januário G. Escabiose: Revisão e Foco na Realidade Portuguesa. J Port Soc Dermatology Venereol. 2017;75:129–37.

Davis JS, McGloughlin S, Tong SY, Walton SF, Currie BJ. A novel clinical grading scale to guide the management of crusted scabies. PLoS Negl Trop Dis. 2013;7:e2387. doi: 10.1371/journal.pntd.0002387

Del Borgo C, Belvisi V, Tieghi T, Mastroianni CM. Atypical presentation of crusted (Norwegian) scabies. Infection. 2015;43:623-4. doi: 10.1007/s15010-015-0769-7.

Maghrabi MM, Lum S, Joba AT, Meier MJ, Holmbeck RJ, Kennedy K. Norwegian crusted scabies: an unusual case presentation. J Foot Ankle Surg. 2014;53:62-6. doi: 10.1053/j.jfas.2013.09.002.

Aqil N, Nassiri A, Baybay H, Douhi Z, Elloudi S, Fatima Zahra Mernissi. Erythroderma: A clinical and etiological study of 92 patients. Dermatol Online. 2019;10:1–6.

Li J, Zheng HY. Erythroderma: a clinical and prognostic study. Dermatology. 2012;225:154-62. doi: 10.1159/000342365.

César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10:1-9. doi: 10.3315/jdcr.2016.1222.

Akhyani M, Ghodsi ZS, Toosi S, Dabbaghian H. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5:5. doi: 10.1186/1471-5945-5-5.

Cuellar-Barboza A, Cardenas-de la Garza JA, García-Lozano JA, Martinez-Moreno A, Jaramillo-Moreno G, Ocampo-Candiani J. A case of hyperkeratotic crusted scabies. PLoS Negl Trop Dis. 2020;14:e0007918. doi: 10.1371/journal.pntd.0007918.

Sigurdsson V, Toonstra J, Hezemans-Boer M, van Vloten WA. Erythroderma. A clinical and follow-up study of 102 patients, with special emphasis on survival. J Am Acad Dermatol. 1996;35:53-7. doi: 10.1016/s0190-9622(96)90496-x.

Rothe MJ, Ba TL, Grant-kels JM. Erythroderma. Inpatient Dermatol. 2000;18:405–15.

Rothe MJ, Bernstein ML, Grant-Kels JM. Life-threatening erythroderma: Diagnosing and treating the “red man”. Clin Dermatol. 2005;23:206–17.

Goyal NN, Wong GA. Psoriasis or crusted scabies. Clin Exp Dermatol. 2008;33:211-2. doi: 10.1111/j.1365-2230.2007.02539.x.

Kutlu NS, Turan E, Erdemir A, Gürel MS, Bozkurt E. Eleven years of itching: A case report of crusted scabies. Cutis. 2014;94:1–6.

Vasanwala F, Ong C, Aw C, How C. Management of scabies. Singapore Med J. 2019;60:281–5.

Binić I, Janković A, Jovanović D, Ljubenović M. Crusted (Norwegian) Scabies Following Systemic and Topical Corticosteroid Therapy. J Korean Med Sci. 2010;25:188.

Ebrahim KC, Alves JB, Tomé L de A, Moraes CF de, Gaspar AD, Franck KF, et al. Norwegian scabies - rare case of atypical manifestation. An Bras Dermatol. 2016;91:826–8.

Alves AO, Filho FB, Martins G, Nogueira LLC, Lanza T de A, Nery JA da C. Escabiose: erupção pápulo-pruriginosa polimórfica em um paciente com tuberculose pulmonar - auxílio da dermatoscopia. J Port Soc Dermatology Venereol. 2013;71:507–10.

Bollea Garlatti LA, Torre AC, Bollea Garlatti ML, Galimberti RL, Argenziano G. Dermoscopy aids the diagnosis of crusted scabies in an erythrodermic patient. J Am Acad Dermatol. 2015;73:e93–5.

Richards RN. Scabies: Diagnostic and Therapeutic Update. J Cutan Med Surg. 2021;25:95–101. doi: 10.1177/1203475420960446.

Falk ES, Eide TJ. Histologic and Clinical Findings in Human Scabies. Int J Dermatol. 1981;20:600–5.

Gunning K, Kiraly B, Pippitt K. Lice and Scabies: Treatment Update. Am Fam Physician. 2019;99:635–42.

Sunderkötter C, Wohlrab J, Hamm H. Scabies: epidemiology, diagnosis, and treatment. Dtsch Arztebl Int. 2021;118:695–704. doi: 10.3238/arztebl.m2021.0296.

Thomas C, Coates SJ, Engelman D, Chosidow O, Chang AY. Ectoparasites: Scabies. J Am Acad Dermatol. 2020;82:533-48. doi: 10.1016/j.jaad.2019.05.109.

Published

2023-03-03

How to Cite

1.
Gonçalves Ferreira I, Lurdes Bueno J, Dupont L, Luzzatto L, Pereira Duquia R. Crusted Scabies: A Cause of Erythroderma to Remember. RPMI [Internet]. 2023 Mar. 3 [cited 2024 Nov. 21];30(1):32-7. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/648