Author

Ismail M.T; Ghafir Y.; Kafri A.

Published in

Journal of Laboratory Diagnosis, Volume 4, Issue 5, April 2007

Abstract

Human scabies, caused by skin infestation with the arthropod mite, Sarcoptes scabiei, Scabies is generally self-limiting in humans but a small minority of people develop hyperinfestation, so-called crusted scabies, where the patient may harbour up to many millions of mites. This was formerly called Norwegian scabies on account of its first recognition in Norway in 1848 among patients with leprosy. There is no evidence of increased virulence of mites in such subjects; the aetiology is generally attributable to immunosuppression either iatrogenic or caused by specific diseases such as advanced HIV infection, lymphoma, malnutrition, etc. However, crusted scabies also has been reported among Indigenous Australians with no known immune deficiency. It has been speculated that such patients may have a specific immune deficit, the nature of which is yet to be defined.
The grossly thickened skin in crusted scabies shows the appearance of large hyperkeratotic warty crusts, typically involving the hands and feet but possible in all skin areas including trunk and scalp. These plaques are honeycombed with burrows that contain large numbers of mites, although burrows are rarely recognisable as such. Thick deposits of debris typically accumulate beneath the nails. The palms and soles may show deep fissuring of the crusts. These skin breaches along with other affected areas may show significant erythema, a sign of secondary infection. Crusted scabies carries a high mortality, with deaths frequently occurring due to secondary sepsis.

Link to read full paper

http://scla.org.sy/magazine/issues/4_5/169.html