Pruritic Crusted Scabies in an Immunocompetent Infant

Area of Science:

• Dermatology
• Parasitology
• Infectious Diseases

Background:

• Crusted scabies (Norwegian scabies) is a severe, highly contagious skin infestation.
• Characterized by extensive mite proliferation, hyperkeratotic lesions, and minimal pruritus.
• Usually observed in immunocompromised patients, with rare occurrences in healthy individuals.

Observation:

• An 11-month-old, otherwise healthy Malay infant presented with symptoms of crusted scabies.
• The infant exhibited widespread, crusted, hyperkeratotic papules, plaques, and nodules.
• Pruritus was notably absent, a typical feature of this scabies variant.

Findings:

• The case represents a rare instance of crusted scabies in a healthy infant.
• Demonstrates that crusted scabies can occur even in the absence of significant immunosuppression.
• Highlights the diagnostic challenge due to atypical presentation in a young child.

Implications:

• Expands the known clinical spectrum of crusted scabies presentation.
• Suggests considering crusted scabies in infants presenting with unusual dermatological conditions, regardless of immune status.
• Underscores the need for prompt diagnosis and treatment to prevent transmission.