Diagnosis and treatment of infectious diseases in HIV-infected hosts

Norwegian crusted scabies: an unusual case presentation

Scabies is a contagious condition that is transmitted through direct contact with an infected person and has been frequently associated with institutional and healthcare-facility outbreaks. The subtype Norwegian crusted scabies can masquerade as other dermatologic diseases owing to the heavy plaque formation. Successful treatment has been documented in published reports, including oral ivermectin and topical permethrin. Few case studies documenting the treatment of Norwegian crusted scabies have reported the use of surgical debridement as an aid to topical and/or oral treatment when severe plaque formation has been noted. A nursing home patient was admitted to the hospital for severe plaque formation of both feet. A superficial biopsy was negative for both fungus and scabies because of the severity of the plaque formation on both feet. The patient underwent a surgical, diagnostic biopsy of both feet, leading to the diagnosis of Norwegian crusted scabies. A second surgical debridement was then performed to remove the extensive plaque formation and aid the oral ivermectin and topical permethrin treatment. The patient subsequently made a full recovery and was discharged back to the nursing home. At 2 and 6 months after treatment, the patient remained free of scabies infestation, and the surgical wound had healed uneventfully. The present case presentation has demonstrated that surgical debridement can be complementary to the standard topical and oral medications in the treatment of those with Norwegian crusted scabies infestation.

Dermatology of the patient with HIV

Cutaneous diseases occur in most people infected with human immunodeficiency virus (HIV) and at a higher rate than people not infected with HIV. Common HIV-related rashes and rashes made unusual by HIV infection are reviewed.

Cutaneous Manifestations of HIV: A Primer

PURPOSE

To provide physicians and nurses with an overview of the characteristics and treatments for skin lesions associated with HIV/AIDS.

TARGET AUDIENCE

This continuing education activity is intended for physicians and nurses with an interest in identifying and managing skin lesions in patients with HIV/AIDS.

OBJECTIVES

After reading the article and taking the test, the participant will be able to: 1. Identify the characteristics of skin lesions associated with HIV/AIDS. 2. Identify treatment options for skin lesions associated with HIV/AIDS.