Crusted scabies in an elderly woman

Area of Science:

• Dermatology
• Infectious Diseases
• Geriatrics

Background:

• Crusted scabies is a severe, contagious skin infestation with high morbidity and mortality.
• It disproportionately affects the elderly and immunocompromised populations.

Observation:

• An elderly woman in an assisted living facility presented with widespread, thick scaling resembling sand on her skin.
• The scaling affected her trunk, limbs, scalp, hands, and feet.

Findings:

• The patient was diagnosed with crusted scabies.
• Treatment included topical permethrin 5% lotion and oral ivermectin.
• Despite treatment and isolation, the patient succumbed to sepsis.

Implications:

• This case underscores the critical need for prompt diagnosis and isolation of crusted scabies in elderly and immunocompromised individuals.
• Early recognition and aggressive management are crucial to prevent severe outcomes like sepsis.
• Healthcare facilities must maintain vigilance for highly contagious conditions in vulnerable residents.