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Crusted (Norwegian) scabies

K A Kolar1, R P Rapini

  • 1University of Texas Medical School, Houston.

Insights

Crusted scabies is a severe, contagious skin infestation often missed due to unusual symptoms. Permethrin cream offers a safer, effective alternative to lindane for treating this condition.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Crusted scabies, a severe form of scabies, involves extensive skin mite infestation.
  • It is often misdiagnosed due to atypical presentations.
  • Individuals with cognitive or immune deficiencies are at higher risk.

Purpose of the Study:

  • To review the characteristics and treatment of crusted scabies.
  • To compare the efficacy and safety of permethrin cream versus lindane.

Main Methods:

  • Review of clinical presentations of crusted scabies.
  • Analysis of diagnostic methods, primarily skin scrapings.
  • Evaluation of treatment outcomes with lindane and permethrin.

Main Results:

  • Crusted scabies presents as generalized dermatitis with hyperkeratosis.
  • Diagnosis relies on microscopic identification of mites in skin scrapings.
  • Lindane is a common treatment but requires caution due to toxicity; permethrin shows comparable efficacy with a better safety profile.

Conclusions:

  • Crusted scabies requires prompt diagnosis and treatment.
  • Permethrin cream is a potentially preferred treatment for crusted scabies due to its safety margin over lindane.

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