Crusted (Norwegian) scabies treated with oral ivermectin : a case report and overview

Abstract

Crusted (Norwegian) scabies is a severe and highly contagious form of infestation caused by the mite Sarcoptes scabiei var. hominis. It occurs in a subgroup of patients who are either immunocompromised or physically or mentally debilitated. Due to its atypical clinical presentation as well as difficulties associated with its management it presents a number of challenges both from a therapeutic aspect as well as from public health perspective. Failure to diagnose this condition may give rise to a massive epidemic when the patient is in an institutional setting. We describe a case of crusted scabies which occurred in a nursing home leading to an institutional outbreak. She received a combination of oral ivermectin and topical scabicidal with good results. This case highlights the importance of being alert to the possible diagnosis of crusted scabies and gives an overview of the condition as well as management strategies.