Atypically distributed cutaneous lesions of Norwegian scabies in an HIV-positive man in South India: a case report

Norwegian scabies in human immunodeficiency virus and tuberculosis-infected child: A case report

Norwegian scabies is a rare scabies with the manifestation of thick crusts of the extremities of the skin that contain eggs and mites. Several conditions in which scabies infection is easily transmitted include immunocompromised, home nursing, and severe neurological disorder. The aim of this case report was to present a thorough analysis of a comprehensive resource for the management of Norwegian scabies patients, with a specific focus on individuals who also have HIV or other immunocompromising diseases. A 1-year-and-7-month-old boy was presented to the hospital with a chief complaint of a thick crust that he had experienced for four months. It began as a red papule in the lower extremity, then crusted and spread to the whole body. The patient kept scratching due to itching, had a recurrent fever and diarrhea for three months, and cough for one month. The patient was diagnosed with human immunodeficiency virus (HIV) and pulmonary tuberculosis at three months, suspected to get the infection from the parents. Sarcoptes scabiei was found from microscopy examination of skin scraping. The patient received holistic treatment, including antiretroviral drugs, antituberculosis medication, scabies treatment, and malnutrition treatment. Appropriate scabies treatment aimed at peeling crusted skin, relieving itching, and increasing the patient ability to use the extremities. Comorbidity conditions caused by HIV and pulmonary tuberculosis should also be treated to optimize the outcome. The patient was discharged in good condition with sanitation education and regular follow-up at the outpatient clinic. This case highlights that Sarcoptes scabiei infestation may be a clue to an immunocompromised condition. Holistic therapy aiming to cure underlying infection, infestation and underlying nutrition and psychosocial problems must be addressed to fully cure this high-burden case.

Dermoscopy of Norwegian scabies in a patient with acquired immunodeficiency syndrome

The authors report here on the case of a female patient with Norwegian (crusted) scabies and acquired immunodeficiency syndrome whose compliance with antiretroviral therapy was poor. Definitive diagnosis was confirmed by direct microscopic examination, which revealed numerous Sarcoptes scabei. Dermoscopy showed pathognomonic scabetic burrows and brownish structures in the shape of a hand-glider with a millipede-like appearance. The latter constitutes a diagnostic feature in the pathology of Norwegian scabies that has not yet been described. The patient responded well to oral ivermectin and topical vaseline with sulphur at a proportion of 10%. There was a simultaneous improvement in dermoscopic parameters.

[Report on erythroderma and scabies infection in connection with two cases of scabies norvegica]

Erythroderma is an inflammation of almost the whole surface of the skin, characterized by erythema, skin infiltration and desquamation. Despite the etiological factors, the generalized inflammation of a large body surface can lead to a life-threatening condition in itself. Parasite infection lies rarely in the background of erythroderma. The Sarcoptes scabiei var. hominis belonging to the mite family is the cause of scabies disease. While the prevalence of "classic" scabies is high world-wide, the more severe and more dangerous form - scabies norvegica - is only seldom observed. Diagnosis and treatment is highly important from an epidemiological aspect. The authors discuss the differential diagnostic problems and epidemiological significance of scabies infection and erythroderma using two cases.