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Norwegian crusted scabies: an unusual case presentation
Michael M Maghrabi1, Shireen Lum2, Ameha T Joba2
1Director of Podiatric Medicine and Surgery Residency Program, Presence Health, Saints Mary and Elizabeth Medical Center, Chicago, IL.
Summary
Surgical debridement aids in treating severe Norwegian crusted scabies when standard treatments fail. This complementary approach, combined with oral ivermectin and topical permethrin, led to a patient
Area of Science:
- Dermatology
- Infectious Diseases
- Surgical Pathology
Background:
- Scabies is a contagious parasitic infestation.
- Norwegian crusted scabies presents with severe plaque formation, mimicking other skin conditions.
- Standard treatments include oral ivermectin and topical permethrin.
Observation:
- A nursing home patient presented with severe plaque formation on both feet, initially yielding negative scabies biopsy results.
- Surgical biopsy confirmed Norwegian crusted scabies.
- Extensive plaque removal via surgical debridement was performed.
Findings:
- Surgical debridement, combined with oral ivermectin and topical permethrin, successfully treated the patient.
- The patient achieved full recovery and remained scabies-free at 2 and 6 months post-treatment.
- Surgical wounds healed without complications.
Implications:
- Surgical debridement can be a valuable adjunct therapy for severe Norwegian crusted scabies.
- This approach may improve outcomes in cases with significant plaque burden.
- Early diagnosis and aggressive treatment are crucial for managing severe scabies infestations.
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