Norwegian (crusted) scabies is an opportunistic dermatological manifestation which is seen in HIV-infected individuals and which is probably acquired as a consequence of the immune system's inability to control the mites, thereby facilitating overwhelming reproduction. A rare case of an HIV-positive 16-year-old man with severe crusted Norwegian scabies initially misdiagnosed as a dermal fungal infection is reported. The patient had extensive, generalized, thick, hyperkeratotic, crusting, yellowish papule lesions distributed on the entire body from his scalp to his toes.
The patient was started with Ivermectin and topical Permethrin, which eventually resulted in complete resolution. Interestingly, despite quarantining efforts, one of the patient's acquaintances and a healthcare worker acquired the symptoms of itching. This atypical presentation of Norwegian scabies emphasizes the need to include scabies in the differential diagnosis when HIV-infected patients present with crusted, generalized cutaneous lesions.
Click here or on the picture, for more details of this rare case of Norwegian Scabies.
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