Authors: Sulasmia, Irene Djuardi, Widyawati Djamaluddin, Asnawi Madjid, Safruddin Amin, Anni Adriani, Sri Vitayani Muchtar, Dirmawati Kadir


Introduction: Crusted scabies, also known as Norwegian scabies, is a rare and highly contagious clinical variant of scabies infection caused by ectoparasite Sarcoptes scabiei var. hominis. This form of scabies mostly occur in elderly patients with malnutrition, sensory neuropathy, mental retardation, and immunosuppression. In <0.5% of reported cases, crusted scabies may present as erythroderma with erythema and scales on more than 90% of the body surface.

Case Summary: A 55-year old male patient with diabetes melitus and hepatitis B came with a chief complaint of diffuse erythematous hyperkeratotic plaque on both elbows and feet since one month before admission. Diagnosis of crusted scabies was established based on the history, physical examination, and the finding of mites from the lesions. The patient showed clinical improvement following treatment with permethrin cream and symptomatic therapy.

Conclusion: This case shows that crusted scabies should be considered as one of the differential diagnoses of erythroderma in immunosuppressed patients.





crusted scabies, erythroderma, permethrin

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